This is the acronym for the North American Nursing Diagnosis Association. This agency, which is now international, works to develop, classify, and update nursing diagnoses to help direct the nursing process.

The term nursing diagnosis was first used in 1953 as a necessary step in completing a nursing care plan, but it wasn't until 1973 at the first meeting of the National Group for the Classification of Nursing Diagnosis that the term became widely used. This group evolved into NANDA in 1982.

Using NANDA's system is another nemesis for many nursing students and often doesn't begin to make sense until you are actually using it on a regular basis to direct the care you are providing to your patients.

The diagnosis may be something that you use formally with written care plans and goals, or it may again be something you draw from informally. On any given day, your patients will exhibit more than one problem requiring nursing interventions. These can range from issues with their own well being such as acute pain to psychosocial issues of powerlessness and anxiety. The problems can also involve issues with their family or with caregivers who exhibit their own inability to deal with the patient and his pain and anxiety.

Your assessment and interventions will involve determining the signs and symptoms that contribute to the pain, measures that help to reduce the pain and providing measures to both increase the patient's tolerance as well as reduce the pain.

Your goals will be measurable and realistic such as: “The patient will state that his pain level is reduced from 9/10 to 4/10 with the use of relaxation techniques, therapeutic massage, and medication regime by day three of the current admission.”