What EXACTLY is a care plan?

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    There are a lot of posts on this site about care plans; however, while I can somewhat guess what they are, I was wondering if someone could explain them to me. What are they? When in Nursing School do you do them? Why are they so difficult? I have people say on this site that "if you spend 10 hours on a care plan, that's not enough" why do they take so long? What is the length of one of them?

    I am sure my answers will be addressed when I start school later this month, I just like to know what's coming up!

    Thanks
    Joe V and RNintraining72 like this.
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  4. 2
    For me, what makes doing a care plan so long is writing up all of the meds. Names, side effects, classes, route, dose, frequency, pharmological action. At my school our care plans consist of an assessment tool for each system then we have to write up anywhere from 3-5 priority diagnosis. The write ups for each nursing diagnosis consist of at least 2 short term goals and one long term. Then we have to write what we will assess, therapeutic interventions, and finally what we will teach the client. Then if applicable a referral to a different health care professional.
    Personally, I have never spent over three-four hours on a care plan. I always scored in the 90s on them. We did a care plan for each day at clinical. This started 4th week of my first semester. My advice to you buy a care plan book it will help you tremendously. Not only will it assist you in writing up diagnosis but will help you understand the why behind the interventions, teachings, etc... and why the diagnosis is appropriate.
    Last edit by skulskcc01 on Aug 4, '12 : Reason: forgot info
    quirkyvanilla and RNintraining72 like this.
  5. 0
    Care plans will differ from school to school and facility to facility so there is no real way of knowing what you will have to do for them or how much work you will have to do for them until your lecturers give you your assignments.

    Care plans are exactly what they are called, plans of care for the nurses. They give the nurse a guide of the care that is required for that individual patient. Care plans can be comprehensive (as they usually are at nursing school) or specific to performing a certain nursing task.
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    My care plans are a worksheet we make for each patient, that helps us as students plan our care. My very first CP I ever did, took me 8 hours. I was totally stressing and freaking out over it, and that was only for one patient. My second one was stilll difficult but only took 3-4 hrs. We have to do one CPS per pt. and we have one day to do them in. (Example we take care of 5 pts, we have one night to complete 5 care plans. They are due the next morning.) since then I've started doing some things to make this easier. Make a med list on the computer. I've even done some interventions lists and rationale lists. Copy and paste. so much easier. Still takes awhile, but way easier. I try to take my Comp with me to clinical, then during post conference, bust out the computer and try to complete my CPs (care plan sheet) before I leave for the day, then I can go home and print that sucker out and I'm done!
  7. 26
    An academic torture device.
  8. 2
    Quote from skulskcc01
    For me, what makes doing a care plan so long is writing up all of the meds. Names, side effects, classes, route, dose, frequency, pharmological action. At my school our care plans consist of an assessment tool for each system then we have to write up anywhere from 3-5 priority diagnosis. The write ups for each nursing diagnosis consist of at least 2 short term goals and one long term. Then we have to write what we will assess, therapeutic interventions, and finally what we will teach the client. Then if applicable a referral to a different health care professional.
    Personally, I have never spent over three-four hours on a care plan. I always scored in the 90s on them. We did a care plan for each day at clinical. This started 4th week of my first semester. My advice to you buy a care plan book it will help you tremendously. Not only will it assist you in writing up diagnosis but will help you understand the why behind the interventions, teachings, etc... and why the diagnosis is appropriate.
    What care plan book would you suggest?????
    kmlnielsen and tyvin like this.
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    At my school our care plans consist of 3 pages of physical assessment + 1 page of psychosocial assessment. Then we have to fill in 1 page with all the meds, allergies, and lab values. We have to collect as much information as we can from our patient by doing a head to toe assessment and interviewing them, and you can also get extra information checking their chart in the computer.
    All that information is so important because it is your subjective and objective data which is what you need to write appropriate nursing diagnosis for that patient. Based on those diagnosis then you can start writing your "care plan" in which you'll have to develop each one of those diagnosis giving the goals that you want your patient to meet and what are you going to do to help them (nursing interventions).
    It is a very interesting and long process, but I think the more you do it the easier it becomes for you.

    My first care plan took me like 10 hours to finish. So far I've only completed 4 of them and the last one took me only like 4 hours to finish. So if you have a great care plan book and get a lot of useful information from your patients in clinicals then you shouldn't be taking 10+ hours to complete your care plans once you have been doing it for a while.
    quirkyvanilla likes this.
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    The plan of care is there to insure that all nurses give the same care 24/7 to insure the short and long term goals are achieved.
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    Careplans are a little different in school than in the workplace. The ones you do in school are more detailed, because you need to learn what you are doing before you start filling out the "short form" versions. They are usually meant as more of a teaching method so you learn how to use labs, medications and medical diagnoses to apply nursing diagnoses. So, of course they take longer to fill out.

    You will learn in school that there are doctor's diagnoses (such as sepsis, cancer, anemia, etc...), and nursing diagnoses. The careplan is filled out by the nurse who is admitting the patient, and every nurse who assumes care afterwords reviews, and if necessary, revises the care plan. This is meant to insure consistant care is given by all nurses.

    For example, if I admit an elderly patient who has orthostatic hypotension (their blood pressure drops with they stand up), they would be in danger of falling. A nursing diagnosis might be "risk of injury due to falls related to hypotension". So, then I would apply the necessary interventions to try to prevent the injury. Such as "bed alarm in place", "call button within reach", etc... This would all be called out in the care plan. So when you took over care of the patient you would review the careplan, and initial it. This stays in the patient's chart.

    There is an organization called NANDA North American Nursing Diagnosis Association. They put out a list of standard nursing diagnoses. This is the standard my school used and I would imagine a lot of other schools use as well.
    Good luck in school, I hope this helps.
    Last edit by Esme12 on Aug 5, '12 : Reason: TOS/weblink/self promotion
  12. 1
    I've been an LPN in a correctional setting and an ED for over 2 years now....

    1. Do RNs still create care plans anymore?

    2. Was school beneficial to learning the creation if a care plan if the answer to Question 1 is 'yes'?

    3. When a care plan is implemented by the RN on a hospital floor (non-ED), does the MD ever disagree with decisions made by the RN?

    4. Is a care plan becoming outdated in the hospital setting? Is there a certain population, like LTC, that a care plan is more productive?

    5. With so many lawsuits being thrown around, should the RN even create a care plan anymore and then be prosecuted for causing what the recoving surgery patient says is undue pain because he was made to ambulate or even a differnt example with perhaps more validity? (I see enough RNs/LPNs scared to do what is perhaps "right" for fear of being viewed as "wrong" and then being sued. Let alone poor reflection of the HCAHPS b/c the pt didn't get to sleep in until 10am).

    6. Is the current state of care-planning just to assist student with critical thinking skills?



    When I was a correctional nurse the closest thing I ever saw to a care plan was being encouraged to use NANDA approved nursing Dx for our offenders who came to the clinic. We were then also encouraged to document the various steps of the nursing process that pertained to the offender's visit and schedule a time for evaluation and document the teachings performed. In the ED neither RN nor LPN even does something of the sort, unless its a generic check box.
    quirkyvanilla likes this.


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