are care plans a joke for you?

Nurses General Nursing

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so much emphasis was placed on them when i was a student. i enjoyed the challenges of writing individualized/relative/practical care plans back then even though i realized what was required of us to write was unrealistic in the real world. it was a just another student-hoop we had to jump through and i jumped like all the other students.

bam! real world! i work in a hospital and care plans are a pre-chewed and spit-out part of the software we use to document. there are some basic diagnoses to choose from and their complementing, basic interventions. 2nd shift is responsible for keeping them current (goal met/goal not met/continuing). other shifts may chart on them.... and of course other shifts don't.

what's your opinon on care plans/how you're required to write/document them at your facility? do they make an impact on patient care?

Careplans are designed to get you in the habit of prioritizing care to give the patient the best care they deserve. Yes, a lot are preprinted and on the computer but YOU SHOULD BE ABLE TO DO THEM IN YOUR HEAD! If you notice, not all the time do the hospital nurses check all careplans that apply to the patient. They just print off a few and say "that'll do". Keep in mind that knowing how to do careplans and continually doing them in your head will make you a much better nurse than those that "make do". Please don't take it as a joke. You were the better person to take pride in your school work and learn what you needed to succeed.

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Specializes in Community Health, Med-Surg, Home Health.

I can see the value of a care plan if one worked in the ideal area where the implementation is assured. Unfortunately, no matter how nice it is on paper, may it be spit out of a computer or not, they do not mean a hill of beans when the nicely prioritized care plans cannot be implemented. A nurse in LTC that is responsible for 50 patients alone is not likely to be able to do it all is an example I can think of. You need the assistance of ancillary staff for some of them, and they are also overworked and short on their end. From what I have witnessed (and this is just from my hospital-I am not saying that this is everywhere, so no flames), the only thing the nurses really have a chance to deal with is the most emergent that comes up, and pray for the rest.

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Careplans are usually a waste. Who looks at them? Nobody I know of.

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I totally understand! It sucks!! I wish all nurses could come together and figure out a great solution because it does feel as if we are just able to "get by". Let me know if you come up with any good solutions. Would love to hear back from you

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Specializes in Community Health, Med-Surg, Home Health.
Careplans are usually a waste. Who looks at them? Nobody I know of.

Joint Commission, the nightmare of my life are the only ones that seem to be really concerned with them. From what I have witnessed, the careplans never reflect what is actually being done for the patient. :banghead:

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Specializes in Nephrology, Cardiology, ER, ICU.

As Elkpark pointed out, in school they are a necessary component of education. However, in real world nursing, they are useless. Personally, I was always so glad I worked ER where care plans weren't necessary! There was a pilot to have the ER RN's start the care plan for the admitted pts but that was nixed after there was mass revolt! lol

As an advanced practice nurse, nursing diagnoses are useless and a waste of time. Care of the American in the hospital is geared to the medical diagnosis and if we want to contribute to the plan of care, that's what we need to be using!

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Specializes in Community Health, Med-Surg, Home Health.
As Elkpark pointed out, in school they are a necessary component of education. However, in real world nursing, they are useless. Personally, I was always so glad I worked ER where care plans weren't necessary! There was a pilot to have the ER RN's start the care plan for the admitted pts but that was nixed after there was mass revolt! lol

As an advanced practice nurse, nursing diagnoses are useless and a waste of time. Care of the American in the hospital is geared to the medical diagnosis and if we want to contribute to the plan of care, that's what we need to be using!

Exactly!! Just by seeing the medical diagnosis, you basically know what sort of nursing care is needed. I thought they were stupid in school, and now that I saw that basically no one else is looking at them but another nurse (usually supervisor-in my end of the world) or the evil monsters of Joint Commission, I think they are a waste of time for a nurse that has too many patients and other headaches to ponder.:no:

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Joint Commission, the nightmare of my life are the only ones that seem to be really concerned with them. From what I have witnessed, the careplans never reflect what is actually being done for the patient. :banghead:

Exactly! Plus I have never at the bedside while taking care of a critical pt ever asked my self "what is the nursing diagnosis for this?"

I know your dying sir, but I can't tx til I finish my nursing diagnosis! LOL

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Specializes in Community Health, Med-Surg, Home Health.
Exactly! Plus I have never at the bedside while taking care of a critical pt ever asked my self "what is the nursing diagnosis for this?"

I know your dying sir, but I can't tx til I finish my nursing diagnosis! LOL

What usually grates my nerves when I used to read the nursing plan/diagnosis books is that there was a 'plan' to call the doctor to place in orders...like I wouldn't have known this before I read that...INSANE!!

And, then, they are updating nursing diagnoses...oh, boy...there is a whole committee creating this insanity.

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In school it helped me prioritize care and think about what I really wanted to improve for the patient. Sometimes as a working nurse I can do some of those things but I no longer need a careplan to think about them. But in reality, no one I know looks at the careplan for how to actually plan care, kwim. Everything information wise can be found in the nurses notes, chart or in report, and you should be able to plan care without a piece of paper by the time you become a working nurse.

Example, LOL in for CHF exacerbation. She's elderly, on falls precautions, so the bed is in low position, night light on, bed alarm on. She's on strict I and O, daily weights, has an iv put in the 26th, has diuretics and a foley. She's with it. I can tell her to watch her fluid intake, offer her pills with small sips of water. She's a LOL confined to bed most of the time so I tell her to turn q2h and then turn her if I see she's in the same position each time I come in or is having trouble doing it herself. I float her heels. The bed is on pressure relief mode. And then every time I go in there I try to engage her in conversation to combat loneliness, assess her LOC and keep her oriented. Ask about grandkids as I'm giving meds, emptying the catheter and provide catheter care aseptically, etc. Make sure she knows how to work the t.v. remote so she's not just sitting there with nothing to look at.

My paper careplan for her would include goals of zero falls, achieve fluid balance, maintain adequate nutrition, remain free from skin breakdown, remain free from social isolation, maintain LOC, decrease risk for infection. But by the time I write that careplan I've already done all of that stuff, its the end of the night and I'm just filling out more paperwork than I need to.

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