Dear nursing student - page 6

dear clinical student, i am your soon-to-be instructor. know that i love this profession and have dedicated my life to it and to my patients. i consider this profession to be a calling. i did not come to this profession for... Read More

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    Thanks for sharing instructor-to-be as new nursing student-to-be(Fall 2010) I want to be prepared for school. If you have any suggestions like any books to read in summer. Please share with us. Thanks

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    It was very nice to read such heart-felt writing from an instructor's perspective. I only have one gripe about it though -- care plans, but my complaint is not about how much time is deemed sufficient to spend on them.

    Care plans were very much emphasized when I went through school to become LVN. But never did I see them serving much purpose as I worked in acute care and long term care facilities. There's this little tab labeled "care plan" in the charts, never getting attention from anyone except by medical records and whoever's auditing the chart and harping on us if incomplete. In other words, they do not have much practical function other than being more paperwork for the sake of paperwork. Whether in a hospital or a nursing home, nurses working in today's condition of health care field simply do not have the time to sit and produce a writing composition. Please teach us relevant skills. Help us be efficient nurses and prepare us for the reality of nursing these days, not the outdated or irrelevant nursing models.

    Now, if the purpose of writing care plans is specifically to train us in critical thinking, then please forgive my impudence. However, if we're expected to believe that the plans themselves are actually important in our work, other than being yet another useless paperwork to be completed, I can't help but roll my eyes. I am extremely excited to start RN program this fall, but I dread for the vestigial parts of nursing education that will not see the light of day once we go out in real world.
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    Care plans in your work leave a "paper" trail. The purpose of which is to cover the ass of the facility/staff in the event of a lawsuit. They "prove" you addressed problems specific to the care of that particular patient.
    Last edit by dianah on Apr 4, '10 : Reason: mild profanity allowed by TOS
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    While in school, the primary purpose of care plans is to train you to think using nursing process. And, it works too.
    EDRNBSN likes this.
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    They're not easy to do, but yes they work though. They're a good practice to enhance one's analyzing skills. My problem has always been, coming up with the interventions. They are hard to figure out for LTC residents, since they HAVE been there for years. Care plans have to be realistic.
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    I just finished reading through an older thread that had a very interesting debate on whether nurses in advanced practice rely too much on medical model than that of nursing. That made me think very hard about nursing philosophy, and why I would not spare a glance at medical school in favor of pursuing nursing career.

    And yet, I never cared much for writing care plans. I now realize that's because I continued to think in terms of medical intervention. There were even times when I did not take nursing diagnoses and interventions seriously, which all seemed like nothing more than common sense to me. If I really think about it though, they are exactly why I wanted to become a nurse to do, written out on paper.

    In other words, HJS27 and vegas2009, you're right, care plans have their place and train us in line with nursing philosophy.

    My complaint still remains though. More often than not, we nurses are so busy putting out fires minute by minute on the floor, and barely having time to finish the required documentations, the care plans end up being just another annoying paperwork to finish and then ignored.
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    I wished people would get over being so judgmental about tattoos and piercings.
    CrazierThanYou likes this.
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    As I understand it, one of the biggest rationales for care plans in nursing school is to teach us the little bags of tricks that we'll be able to use as nurses. Obviously experience will teach us more, but they get the ball rolling. I frickin HATE care plans, and they're a royal pain in my patootie, but I can see their value in school. Whether or not we use a written care plan in practice is another argument altogether. I suppose that depends on where we choose to practice. But the care plan will always be there; it may just be in our heads because by then, it'll be second nature to us. I know I used my own version of a care plan in my job as an UAP, and I even used the same process. I just didn't call it a care plan and it certainly wasn't in writing. Assess the situation through subjective and objective data, come up with a "diagnosis," determine goals that need to be accomplished, what can I do to fix the issue at hand (complete with rationales), and constantly re-evaluate. Yep, that's a care plan, and I did it for years before I knew what a care plan was all about.
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    Quote from marty6001
    Wow, I didn't expect to take such a beating here.. LOL.. All I was trying to do was to tell students that they are not alone, that most of us out there teaching them were in their shoes as well, and that all we're trying to do is give them 10 years worth of education in 12 weeks in most cases.. I suppose I should have typed "if you are given constructive criticism, don't take it personally"... I'm really taken aback that the first 2 folks to comment have found fault. Sorry about that...

    Edit: I fixed it as I really meant to say constructive criticism.. As all my students hopefully would say, I am passionate about this profession, probably to a fault. My wife and I both have given a good portion of our adult lives to advancing the profession where we can, and really love what we do!! Thanks for opening my eyes to that one, I re-read it and shuddered!! LOL
    Unfortunately, there are many instructors (and nurses in general!) who HAVE forgotten what it is like to be a nursing student...
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    Wow, what a great bunch of comments... I enjoyed reading all of them, and did not expect this article to take off like this... Thank you all for the kind words. I am very passionate about nursing and teaching, and agree that an instructor's goal should not (and usually is not, even when perceived that way) to crush students. I am tough on mine on the unit. When they ask a question, I ask it right back to them. They are expected to get into the literature and their patho section rivals a medical student write-up. That is how a nursing student learns.

    One of my students and I were talking the other day. Here's what we came up with: If a student if afraid of their instructor, they will never learn. However, being afraid of the patient's illness, disease, or trauma is ok, use that to better your care.

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