Nursing Diagnosis...acutually used?

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So I know I'm posting all over this board all my questions-but I guess thats what this is here for. So I don't mind doing all these care plans and such, but my question is-do you actually do these as a RN? I never see my nurses hunched over their NANDA book looking up interventions. Do you just eventually remember all the most frequently used ones and so you no longer need a reference or do they not make up Nursing Diagnoses but just treat the patient as they see fit to make the patient better? (More in Theory than in Practice)

Specializes in Geriatrics.
So I know I'm posting all over this board all my questions-but I guess thats what this is here for. So I don't mind doing all these care plans and such, but my question is-do you actually do these as a RN? I never see my nurses hunched over their NANDA book looking up interventions. Do you just eventually remember all the most frequently used ones and so you no longer need a reference or do they not make up Nursing Diagnoses but just treat the patient as they see fit to make the patient better? (More in Theory than in Practice)

I'm not an RN but I think that eventually you just get to know pretty much all of the diagnoses and the interventions. We have had to do a TON of care plans and I have already gotten to the point where I don't have to look them up anymore. I think it is something that comes with lots of "practice" and doing or reading it everyday will make it come a lot faster to ya. I do think though that once a year or so NANDA comes out with some new nursing diagnoses that you can find on thier website. Hopefully someone who is an RN can answer this better.

Specializes in Critical Care, Pediatrics, Geriatrics.

Certain hospitals in our area require that nursing care plans be a part of the patient chart...however these are normally computer generated.

The point of nursing care plans is to get you to think in "care plan mode".

When you have worked up ineffective airway clearance, activity intolerance, and risk for infection until you think you are going to die...it tends to stick and you find yourself automatically doing all the interventions you put into those plans of care. Tedious work yes...but it helps you in the long run!

Specializes in OB, ortho/neuro, home care, office.

Most of the nursing plans I've dealt with are predetermined, you fill in the explaination and that's about it.

You don't necessarily use 'NANDA' too much in the hospitals that I have worked in. You simply describe symptoms or use a medical diagnosis.

Specializes in Critical Care.

We place computer generated 'care plans' into the charts to fool JCAHO that they are relevant.

They aren't. And nobody, NOBODY looks at them.

Never looked back at care plans after nursing school and that was nigh 14 yrs ago.

They might be semi-useful to teach you in school. But I've never found a practical use for them in the real world.

That's not to say I don't plan care. But NANDA has nothing to do with it.

~faith,

Timothy.

Specializes in critical care.

I agree with Timothy. They are computer generated, and get stuffed somewhere in the back of the chart never to be seen again.

Yeah, I agree totally with Timothy. Ya have computer generated care plans in there to 'look good' but that is as far as it goes.

I graduated in 1986 and have never worked anyplace where they were actually used.

I do think they are useful to students to learn to think in planning care, but I will never forget all the sheer drudgery they were in school. Ugh!!!

Reading some of your replies on this subject makes me very proud of where I work. Our hospital uses IPOC's "idividualized plan of cares" for each patient. They are not computer generated and they are very individualized. Each discipline (i.e. PT, OT, Social Work, Dietary, etc.)adds to the IPOC as they have interactions & goals set for the patient. By looking at the IPOC when you come on to your shift & go to do chart checks (because the IPOC is under the first tab in the chart...even before orders)it's like getting to go to a mini care conference every day for each of your patients. You get an insight into what PT is doing with the patient this week, and so on. So...I guess my point is...although you may not see the benefit of hard work...or @ times copying out of care plan books over and over...you just never know when you'll need it. Good luck!

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

We have care plans much like Timothy describes. And much like he says most people don't look at them on a daily basis.

However, it is understood that we know what's in them. It's what we do and how we do it. It's hospital protocol. When someone says something like "it's our protocol to flush and NGT with 30 cc of normal saline every 4 hours and check for placement with 10 cc of air" they aren't talking off the top of their heads, they are citing the care plans.

To not look at and not know whats on the care plans is not a good idea.

But no, we use an evidenced-based practice where I work and don't use NANDA Nursing dianosis, thank goodness.

Thank goodness its more of a learning tool than a working tool cause I don't really enjoy care plans (who would?) and I was thinking "Goodness, if you have to do this every day your a nurse-BORING!"

Specializes in Nursing Professional Development.
We have care plans much like Timothy describes. And much like he says most people don't look at them on a daily basis.

However, it is understood that we know what's in them. It's what we do and how we do it. It's hospital protocol. When someone says something like "it's our protocol to flush and NGT with 30 cc of normal saline every 4 hours and check for placement with 10 cc of air" they aren't talking off the top of their heads, they are citing the care plans.

To not look at and not know whats on the care plans is not a good idea.

But no, we use an evidenced-based practice where I work and don't use NANDA Nursing dianosis, thank goodness.

That's the way it has been at most of the hospitals where I have worked. While the nurses don't look at them often, the standardized plans establish and document typical protocols and procedures.

Also ... while staff nurses don't see this at the bedside ... a lot of "evidenced based practice" is based on research that used NANDA to help define the research problem and the interventions that are the subject of the research. And that "care plan" process of "labeling a problem, planning interventions, intervening, measuring progress toward an established goal, etc." is a mirror of the research process itself. NANDA helps the profession organize its thoughts and coordinate its efforts in some ways that are not always obvious at the bedside. It's a tool for the researchers as well as for educators.

llg

Care plans describe our care of patients but don't really generate the care. They are an example of design by commitee and can be pretty silly. "potential for energy field disturbance"...give me a break!!!!!!

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