[The complex relationship between nursing diagnosis and nursing management]

To begin with the meaning nursing diagnostic has upon nursing management is being emphasised. Contents and depths are being illustrated on the changements of "adjustment" and "development". Adjustment as adaption into the specific organisational rationality or development as analysis of organisational norms and values as well as reconstructing the context of a new frame of relations. The outcome of nursing diagnostics can be shown and discussed on the following four dimensions: 1. Task, goals and productivity, 2. Management of personnel , 3. Cooperation and integration, 4. Inner and outer flexibility. In addition to the elucidations of each dimension sample aspects are picked out to show the outcomes on the social and on the whole system. The necessity of the development of nursing and its context in a dialectical manner are being stressed. The meaning thereof for nursing management is being led by basic importance and the creation of jobs which further the personal development. In part two the meaning of nursing management for nursing diagnostics is stressed. It is discussed which aspects of leadership are essential, the network between them and the introduction of a process of development, such as nursing diagnostics. Finally, it is made clear to which degree the way changes are handled depends on the system of leadership and which norms and values in an organisation further or hinder learning and changing processes. This speech bases on the one hand on experiences in connection with a pilot project of the Department of Health of the State of Zurich under whose partonage the nursing model of DDr. Silvia Käppeli has been introduced in five hospitals. It was intended to integrate the planned changes into a process of conversion and development of the systems. On the other hand it depends on my long-term experiences as an instructor and adviser in the health care system.