Two Ways of KNOWING (and why it's so hard to do!)
1. Gnosis
The ancient Greeks had a very elegant and precise language that has influenced almost every other language since. In fact our word diagnosis is derived from one of theirs. In Greek, GNOSIS refers to the quality of mindfulness that makes recognition possible. It's an ingrained familiarity. Here is a perfect example: you're driving around lost as a goose trying to find an address. Nothing looks right. You aren't sure if you're even headed in the right direction. Then you see a landmark, and suddenly you just know where you are. It's like a little child playing and ignoring those around her until suddenly she hears a voice and recognizes it as "mom!" The verb "to diagnose" means to recognize. A good clinician just knows what is going wrong with the patient.
This is how "NANDA's" work and it's why they are hard for you to learn and apply. Look at the list of 216 diagnoses established by NANDA-I. Each one stands on it's own. There is nothing sequential or systematic about them, though you can rearrange them and put them in any sequence you want, and many educators and authors have done just that. However, no single diagnosis is inherently more important than the next one. (It all depends... right?) You're supposed to pick the ones that are most critical for your patient? Consequently, it may seem to you that your instructors expect you to just know (gnosis) which diagnosis fits.
This is how "NANDA's" work and it's why they are hard for you to learn and apply. Look at the list of 216 diagnoses established by NANDA-I. Each one stands on it's own. There is nothing sequential or systematic about them, though you can rearrange them and put them in any sequence you want, and many educators and authors have done just that. However, no single diagnosis is inherently more important than the next one. (It all depends... right?) You're supposed to pick the ones that are most critical for your patient? Consequently, it may seem to you that your instructors expect you to just know (gnosis) which diagnosis fits.
2. Episteme
This second Greek word refers to a type of knowledge that is systematic or interrelated. It can be translated "understanding" or "reason". Episteme (for the Greeks) dealt with truths that were absolute, fixed, and stable. The goal of science and philosophy was to determine things that were undeniably true and would, consequently, form a basis on which to discover other truths. The type of clinical reasoning taught on these pages has more to do with episteme than gnosis. You won't be given a any lists of diagnoses and expected to just know which one applies best to your patient. You'll be given a set of basic truths (or basic human needs) and will be taught to systematically reason your way to what is going on with the patient and what you must do about it.
It's Not "Either-Or"... it's BOTH
If they could have gotten along with the "best" word for knowledge, the Greeks probably would have. But they didn't. There was no "best" word. Both gnosis and episteme were essential (along with techna and doxa... but that's for another day.) And though this site will not use NANDA-I (a gnoetic type of nursing thought) and will use a reasoned (epistemic) system, both styles are important. Not only that, they do link with each other. The epistemic system will help you analyze your assessment data so that when asked by your instructor for the right "NANDA"... you will just know it!