What are your care plans like?

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I am a little curious how care plans differ from one school to another. I am in my second semester of an ADN program. We have to do 3 care plans each week. For each one we have to do 2 pages of pathophysiology, come up with 5 nursing diagnoses, then do a care plan on the priority diagnosis. The actual care plan is 4 pages long (one page for each of our 4 interventions) and we are expected to write at least 10 sentences for our rationales. Not to mention the 6 pages of labs to fill in, all the patients meds (usually 2 pages), any x-rays or diagnostic procedures, and a few more pages about demographics, adls, etc. Each one is a total of 23 pages! This takes FOREVER to do. Most of the time spent flipping through our texts finding sources for patho and rationales.

They aren't that hard, just extremely time consuming. After getting my patients' information and driving home from the clinical site its about 6:30 pm, so I have a total of 12 hours to do three 23 page care plans, sleep, get ready to go, and drive back to the clinical site. I rarely get more than 3-4 hours sleep and some of my classmates don't sleep at all! And they expect us to provide safe patient care. I just don't understand. As much as I've tried to convince myself that I don't, I do learn from doing these care plans, but I think I would learn more if I only had to do one or if they were less involved because by the time I'm done I'm a zombie. I can only imagine how bad it will get the next two semesters.

I have seen posts about care plans that lead me to believe a lot of you don't have to do quite as much as this. I basically just want to know how many of you are in the same boat. Does anyone have it worse than this?

Specializes in Emergency.
Reality check here! .... You will be "thinking" care planning for the rest of your career as a nurse. If not, then I'm going to wonder what kind of knowledge you are coming away from your nursing program with. A care plan is nothing more than the written expression of the nursing process which any graduate nurse should know is the critical thinking pathway that we nurses go through ALL THE TIME when solving patient problems. And, that's what licensed nurses do--solve patient problems, stamp out fires, all shift long.

:yeahthat:

I agree 100%. My school uses a common sense approach to care plans. We had no more than 6 ndx and then our plan was based on what we were/are going to do with that patient during our shift. So we're talking 3 pages max.

I'm checked off on care plans, so I don't have to formally write any more for med-surg. But when I'm caring for my patients, I'm constantly thinking about what their critical issues could be and how I can prevent those issues from exacerbating. And that includes med checks (don't get me started on extended release HTN meds being crushed and administered via PEG tube). I may not always use NANDA & NIC/NOC terminology when I make my mental notes, but I certainly use the framework.

A rule of thumb (from my experience) in clinical practice.

If care plan has more than 5 nursing diagnosis (or more than one page long) then the care plan is useless and it is a waste of time.

Short and efficent written care plans ensures that different nurses ( which care for the same patient) are focusing on the SAME problem/s at least.

This ensures also that communication between nurses (who cares for the same patient) are in sync and reduces mistakes and misunderstanding.

I guess we're "blessed" down here. We do ONE care plan per rotation on a given scenario. We do weekly "pre plans" that have 2-3 nursing dx and med list, drug list, etc, but it is only 2 pgs. The "real" care plan is this huge monstrosity (sp) of citing papers, articles, etc. but only 2-3x per semester.

Thanks.

Richard

I go to a community college and we have 2 rotations each semester. We are required to do 3 4-part nursing diagnoses for each clinical day, and a total of 3 care plans for each rotation (for a total of 6 care plans). My school is very skill-focused, but we do a wide variety of paperwork.

Our care plans are very short, but they must be very detailed and we end up re-doing them at least once to make it perfect.

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