Is it time for a new category of nursing diagnosis?

Professional vigilance, the art of "watching out," is the essence of nursing. Vigilance is the mental process that makes the informed nursing actions of assessment, diagnosis, intervention, and evaluation possible and meaningful. Nursing vigilance must be described in our nursing terminology or it risks remaining invisible to others. We propose that the current definition of nursing diagnosis be expanded to include surveillance diagnoses for which the nurse has the responsibility for problem identification and ongoing monitoring. Inclusion of surveillance diagnoses in the NANDA International taxonomy will better reflect the breadth and depth of nursing practice.