Can anybody help me PLEASE!!!!!!

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Hello, thanks for reading this I am a second year student nurse and was really enjoying my course until now :o I have failed an assignment TWICE and have one last try to get it right or I am off the course :icon_roll I was hopeing that somebody might have one that I could look at???? or offer some much needed advice PLEASE... The assignment is a discharge care plan involving the multidisaplinary (sorry about spelling) team, have been for help from the tutors but they are of no help at all :angryfire. Thanks again for reading this

Karen xxxxxxx

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Whats the problem?

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The whole thing is wrong not picked the right problems not included the right members of the team, in other words I need to start all over again!!!!!

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Here is something that might be worth looking at...

http://www.elcmht.nhs.uk/pdf/aboutus/dischargepolicy.pdf

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Specializes in Medical and general practice now LTC.

What sort of patient are you discharging? Can you give a bit more on what is required for the assignment?

Moved to the UK forum

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Hi thanks for the reply the care plan is a dicharge care plan for a 45 year old man wo has had a below knee amputation due to vascular problems, I have to state 3 problems eg pain relief, mobility and then have an aim for each problem and a rationel eg district nurse will call I have gone over and over this in my head an think I need a fresh pair of eyes or to look at one.

thanks again karen

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Specializes in med/surg, telemetry, IV therapy, mgmt.

your discharge plan should not be a part of your care plan and should be incorporating parts of the care plan within it. however, if the patient is being discharged home then one of the things that you have to keep in mind is that you are most likely sending the patient back to a situation they have come from and you need to pay attention to how the patient is going to be able to achieve their activities of daily living and carry out the medical and nursing plans of care. these are the issues that you must address. so, part of your discharge activity is to assess their adl abilities at home and question them about what kind of resources they have. the adls are:

  • bathing
  • dressing
  • transferring from bed or chair
  • walking
  • eating
  • toilet use
  • grooming

other issues that you have to assess and address are

  • do they have adequate income (money available) to be able to purchase food and medications?
  • are they cognitively and emotionally able to perform the tasks they need to do when they are alone in their home? is the patient mentally challenged and need help? are there problems with the patient's ability to think rationally and be flexible enough to change things in their environment so that the plans of care can be carried out?
  • what kind of social network do they have? any family or friends who will be able to look in on them and help them out? or, will you need to refer the patient to social organizations to help out?
  • how will the patient get to and from doctor appointments for follow up care?

if there are issues in any of these areas then you need to problem solve for them and they become part of your discharge plan. in addition you need to include medications and treatments that the patient needs to continue taking and doing. your approach to a discharge plan is no different than the way we do a care plan. it is still a problem solving process. first you must assess, determine what the problems might be, and then design goals and interventions.

if you need help with care planning there are two threads on the student forums for this:

while discharge planning is not something that students ask about frequently, it really should not be hard to extrapolate what you need to address and apply the nursing process to it. visualize in your mind what the patient will encounter when they go home. a care plan and discharge plan are really the written documentation of your thinking of the problem solving process. follow the directions i've given you above (assess adls and patient's money, cognitive and social resources) and that should be a big help in completing this assignment.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

all care planning follows the nursing process:

  1. assessment (collect data from medical record and by doing a physical assessment of the patient)
  2. nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnosis to use)
  3. planning (write measurable goals/outcomes and nursing interventions)
  4. implementation (initiate the care plan)
  5. evaluation (determine if goals/outcomes have been met)

you must follow the steps in that sequence. without a doubt the most important step is the first one, assessment. if your assessment fails to be up to snuff in some way, the remainder of the care plan falls short. you determine your patient's problems from the abnormal assessment data you obtained during your assessment activities. you have to be a question box of a detective. this often takes time and experience. there is a thread on the student forums that has many links to various kinds of assessments that you might want to check out

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