The author used grounded theory methodology to explore the process of vigilance in women who had migraine headaches. Twenty-two women were interviewed. The basic social problem identified for women with migraines was the need to maintain function when faced with unpredictable bouts of pain and associated distress. One way women maximized their function was through the exercise of vigilance. Vigilance in these women can be conceptualized as the art of watching out. Watching out, the core category, had four subprocesses: assigning meaning to what is, calculating the risk, staying ready, and monitoring the results. Conditions for watching out were owning the label and making the connections. Deciding what to do and acting to maximize function were consequences of vigilance.

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PURPOSE. To determine how many state nurse practice acts include the term or concept of “nursing diagnosis” and describe their similarities and differences. METHODS. Investigators independently divided the practice acts of the 50 states and the District of Columbia into those that did or did not include the term “nursing diagnosis” or the word “diagnosis” within a nursing context. To describe other differences, the investigators operationally defined and independently categorized each act as trendsetting, contemporary, or traditional. FINDINGS. Thirty‐three of the 51 practice acts used the term “diagnosis” within nursing context. Of these 33, 13 were identified as trendsetters and 20 as contemporary. Seven trendsetting and 5 contemporary practice acts used the NANDA‐based language or “response” when describing the “what” of nursing diagnosis. None of the trendsetting practice acts, but 8 of the contemporary acts, used the NANDA‐based “individual, family or community” when describing the “who” of nursing diagnosis. CONCLUSIONS. The language of nursing is changing. The majority of practice acts now define the practice of professional nursing as including the diagnostic act, although the manner in which they use the term varies.