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Reflections on the Judgement Axis, ICNP beta. International Classification of Nursing Practice.

This article presents questions, reflections and proposed resolutions regarding the Judgement Axis of the International Classification of Nursing Practice, Beta Version (ICNP beta). The Judgement Axis, in its present format, consists of an alphabetical listing of terms that are meant to reflect the clinical opinion of a nurse relating to the state of a nursing phenomenon appearing in Axis A of the ICNP beta. A review of literature indicates that judgement can be more extensive. Not considered in the development of the Axis is the fact that judgement can be clinical and actuarial. Actuarial judgement is predictive and based on statistics. Clinical judgement is patient-centred, creative and intuitive. Both are essential in defining nursing judgement. The list presents 49 modifiers in nominal form. Each of these is subordinated, in alphanumeric descending order, by qualifiers that do not conform to the concept of lexical hierarchy. We propose that the 49 terms which appear in the present listing as unique ordinates should be clustered into major categories with synonyms listed as subordinates of the major cluster headings. The qualifiers of degree, which are presently identified as subordinates in Axis B, might be presented in matrix format, providing a scale of degree of the modifier for the nurse.