Care Plan Hell

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I am now on my third straight nursing care plan of the day (have a major OB paper due). I am in Care Plan Hell. Anyone care to join me? The plans were beautiful in the beginning, but at this point, I must say my rationales are beginning to look a little ragged...

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.

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I'm thinking, too, that we use the data from the chart, so we do not need to SEE the patient before doing the care plan. The history has already been done by a nurse. We would have to reinvent the wheel if we also had to see the patient before we did our care plan. It would also take a lot longer to get that end product....

I'm interested in Henderson's 14 Fundamental Needs. This apparently escaped me in class. I'll be lookin' that one up.

Thanks!

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Specializes in cardiac, diabetes, OB/GYN.

From an older nurse....You arrange the care plan based on the available data and then individualize it after you meet the pt and assess his or her needs..This is done to minimilize any prejudiced view you may bring to the care plan had you met them first, which would increase the liklihood that you would leave out a necessary intervention or assessment because you already decided it wasn't needed.

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I have yet to complete my first care plan, but filling out a care plan is the only element to my Nursing Process class final exam. Check out careplans.com . I believe I got this site from a previous post on allnurses.

I hope this helps!

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Specializes in OB.

Hi Alexander! How is it going? E-mail me and I will talk to you about the nursing process final!!!!

Anyway...

This is my final semester and we had to come up with a care plan based only on the closet care plan for our patients. The first one was hard however our instructor pointed out that in real life nusing you are not going to be able to look through each Pts chart at the begining of the shift. You are going to get very basic info from report and have to run with it. This being said after the first one it was sooooo easy! You already know what kind of nusing Dx are going to apply to the patient. And most of your interventions are going to be similar. It made so much more sense to me.

You may never have to do another writen care plan like you do in nursing school, but here is a news flash you will be doing the care plan in your head everytime you get a new patient. You will think hmmm this patient is post op "whatever" they will have pain, impaired physical mobility, risk for infection, impaired skin integrity, etc etc etc. And you should automatically start the interventions.

Good Luck to all of you!!

Molly

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Specializes in cardiac, diabetes, OB/GYN.

Oh believe me, you WILL be doing more care plans.....Forever...

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:confused: We just started care plans and I'm ready to quit! I have never done anything so frustrating in my entire life! I am not a "detail" person, and just see point A to point B. Any pointers? I'm sooo frustrated!
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Originally posted by mother/babyRN

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

Pain is usually first on the list....

Thanks MB RN for the offer of advice. I actually just wanted to whine though:)

I tried Breastfeeding, effective and Knowledge deficit, infant care for Mom. Pain and Infection, risk for are always options in OB I assume, but I wanted to try something I hadn't done before, and my patient was a NSVD, healthy, doing well, and refusing pain meds by the morning of day 2- so I went for it.

It was a fun rotation! Still glad the paperwork is over with though (for now....)

Kim

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I am so glad I can kiss care plans goodbye. Had my last clinical yesterday and have to do a concept map for my final clinincal grade. What a relief!! I thoight this day would never get here. I knoe I will be dealing with careplans for the length of my nursing career, but just the thought of never having a grade deadline... well words cannot express how that feel. 32 days till graduation. YAHOOOO!!!!

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Woops. Sorry about the typos, I guess I'm just too excited.

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I am also in care plan hell. Two due for OB tomorrow. . . YUCK!!

:p :p :p :p :p

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