Care Plan Hell

We have just started these last week and I'm there with you....UGH!! All the writing...thank God my care plan isn't due until December 1st. But I do think we should have had a bit more direction....some of us really don't have a good idea of exactly what they want. I can do a diagnosis, intervention, rationale, and outcomes but I'm not sure if I'm doing it the WAY they want it. Of course, these things will be haunting me for the next 2 semesters at least. In our 3rd semester, if you receive a 100 on your care plan, you don't have to do ANY MORE for the rest of the 3rd and 4th semester....YAY! I will be working day and night to reach that 100 next year. But for now, I have to deal with them!

I can so relate; I have one due Wednesday and I haven't even started it yet...

i'm right there in care plan hell, i think i am doing fine and my instructor has sent both of them back to me saying unsatisfactory, and our graded one is due in less than a month. grrrr, so here i sit in care plan hell with two to fix and another one due on tuesday which i haven't started typing yet but have the dx, rationales, interventions, goals, evaluations, and modifications done. just typing to get done. i'm so frustrated and can't wait for this o be over, 6 more months to go until graduation.

lolol...

You all have it easy. My memory of care plans is arriving at the hospital after classes the day before clinicals in order to gather assessment data on the patients we were assigned--------then staying up all night long to do the care plan using that data. THAT was care plan hell in my opinion.

Care plans suck. I do like medical maps though. Medical Dx in a circle in the middle of the page, and you have the risk factors, clinical manifestations, complications, diagnostics, treatments, and nursing care coming off that circle like spokes. It puts a lot of information in one place. Very helpful. Much more fun than care plans from hell. -Lorus

rstewart, I agree with you! I remember having to do my careplans the night before clinical after getting the info. from the chart.

I flunked my 2nd semester of clinicals because I didn't get credit on my care plan:(

That was 12 yrs ago, but I'll never forget that instructor! That was in my ADN program. I had a B average on all my tests and had passed all my skills for that clinical. But not getting credit on any of my care plans = flunking. I had to sit out 2 yrs before getting back into the program. While waiting I took classes towards my BSN. I did go back to that university and graduate, thankfully I didn't get her as an instructor again!

4 yrs ago when I graduated with my BSN (from another college) the instructor that flunked me happened to be at the graduation with one of her family member. It was SOOOO sweet to have her see me get my BSN! :chuckle

I'm not too happy about care plans. I understand why the instructors want us to do them, but I feel, and some of the staff nurses I've talked to feel, like we are required to do way too much, at least at my school. It doesn't help that my mom's best friend, who has been a nurse for over 20 years now tells me that I don't have to worry about those because she never did one since she's been out of school! I am in the middle of my OB rotation and my instructor is very unconstructive of her criticism. She demands women's care plans the first day (4 of them!), yet doesn't outline her expectations. That would be nice, eh? Especially since I've only done med-surg ones, which I'm pretty good at now. Only a couple more days with her before we switch instructors. I guess you can tell that I'm a little burnt out, as is the rest of my class. I'm ready to graduate already. Only 6 and 1/2 months til graduation....

Wow! I've been out of school for 18 years and write care plans every time I complete an admission and then have to evaluate them to see if the patient is progressing. It's been this way as long as I've been a nurse. Wish I didn't have to write them but I don't know of any hospitals that don't use some form of care planning or care maps.

Care plans in school are time consuming and frequently a pain to write but they do help a student get a more global view of the client's needs rather than just their medical diagnosis. Care plans get easier the more you do and there are plenty of care planning manuals on the internet and in college bookstores. Good luck with school...it does get easier.

Well, I'll probably generate a lot of hate mail but here goes....

I actually LIKED writing care plans. We had to do five of them the night before hitting the unit each week for clinicals, based on the patient info we got out of the chart the night before.

Then we had two big graded ones, one due just before midterm time and one just before the final exam.

I nearly failed my first one because I was so worked up I missed the fact that they required three actuals, two risks for and one something-else-now-I've-forgotten-what-it-was.

After that, I got things straight and it got to be a lot of fun.

One approach that helped me was to think, what am I going to do for my patient? Then, why am I going to do it? Then, what is it about his/her physical, mental or emotional condition that is making the situation which I hope will be relieved by what I am going to do?

The other thing is, you can usually look in the chart and find the nursing diagnoses and enough chunks of the care plan to get a good start, but I liked writing my own.

You might find a classmate who has better luck (e.g., grades) on her care plans and ask to read them to see if there is something that jumps out at you. It might be something really simple that you are overlooking.

Also, I did my care plans on the computer in table form. When they were printed out, they looked really good, no matter how good they actually were. I think presentation helped.

Have fun! (Unless you've got other plans.... LOL)

What makes no sense to me is that in our program, we have to create the care plan based on the data in the chart. We haven't even seen the patient yet! It would sure make more sense if we could construct the care plan AFTER seeing the patient.

I loved writing them too ( although I could do without them now)...

Once I had the audacity to tell an instructor the only potential problem I could come up with that was suited to everyone, was " Potential for Death"..

As far as OB goes, what would you like to know, if anything?

Pain is usually first on the list....

Originally posted by oldiebutgoodie

What makes no sense to me is that in our program, we have to create the care plan based on the data in the chart. We haven't even seen the patient yet! It would sure make more sense if we could construct the care plan AFTER seeing the patient.

This is done on purpose and there is a reason for it. For my clinicals, we received our patient assignment at 6 p.m. and had to have our care plans ready at 7 a.m. While caring for the client (our practicum shifts are 10.5 hours), you will be surprised at how many of the normal interventions do not work for every patient. This teaches you to individualize the care plan for that patient. At the end of the first practicum day, we had to evaluate and modify our care plans for the next morning at 7 a.m. At the end of that second practicum day, we had to reevaluate our modified care plan and have EACH one turned in along with our modifications, why they were made, how they were made, and our evaluation of our modifications, and if any FURTHER modifications were needed. This had to be turned in the next morning at 9 a.m. at the beginning of our theory class.

Although it seems like a waste of time now, the more of them you do, the more important you realize they are. I have had many patients where, using Henderson's 14 Fundamental Needs to design my care plan, I have discovered issues pertinent to the client's health that had been missed for years - why? Because no one had ever bothered to ask.

The care plans teach you that the ideal theory is not the end all and be all... putting it into practice teaches you that each client is a PERSON and not a disease, or set of signs and symptoms.