Care Plan Help for Self Care Deficit - Dressing

whodunit · Jan 28, 2009

Congratulations on being a first year nsg student,hang in there !:yeah:It may not seem like it now but all this stuff is really easy if you just think what is wrong with my pt, how can I provide care for them while promoting their independence and go from there.Here is an example ;Self Care Deficit,Related to; disorientation,confusion, anxiety memory deficits,pain, As Evidenced By;unclean disheveled appearance, body odor.What can you as a nurse do about this?Plan and Outcome;pt will participate in ADLS with assistance from caregiver.or Pt will accomplish ADLS to best of their ability.How?Well... you can provide a simple structured environment to minimize confusion,and /or provide plenty of time for pt to perform tasks,you can decrease anxiety from having to make a decision by providing 2 choices {like in clothes}.You can try to give them the same tech every day for consistency, and /or assess for pain and treat by administering pain medication prior to the bath, dressing.Involve pt in choices, what time do they feel better, morning or night?By involving the pt , you can gain their trust and increase their sense of control and independence. That said, please be aware we are not here to do your homework for you .:no:Best of luck.

WalkieTalkie, RN · Jan 28, 2009

This is one of those ludicrous care plans I hated doing in nursing school. It's the kind of thing that makes you want bang your head on the wall in frustration. Let's face it, unless you are assigned to a patient on a 1:1 basis for nearly most days of the week, it's practically impossible to address "dressing" when you are worried about the 999 things more important like ABCs, meds, nutrition, fluids, etc. Of course, I am a person who works in high acuity areas, but perhaps home health nurses and rehab nurses may have more time for this sort of thing.

I'm not saying that the patient's role in their care isn't important - it certainly is - I'm just saying it's silly to focus so much time on something that you probably won't use in the "real" world. Helping them with ADLs and teaching them about their meds and how they can be active in their care are great. It's just that a vast majority of the time, we simply don't have time to address things like "Self Care Deficit - Dressing."

I think care plans such as this are one of the reasons nurses aren't taken seriously sometimes. *sigh* :banghead:

Wait until you get to do nursing "theories." Talk about boooooooooring. I only remember one theorist because I actually had her as a patient in the ER one time...heh. She thought it was pretty neat that I knew of her theory (we had just discussed it in class recently).

Sorry, didn't mean to rant, but trust me, things do get better after the first semester :) Get yourself a good care plan book (sometimes the ones the school recommends aren't that good). Search Amazon.com and then look at the user ratings and you can pretty much determine which ones are worthwhile from the comments being made.

Now that I've ranted, I will actually be helpful. Hopefully these sites will benefit you:

http://www.rncentral.com/nursing-library/careplans/scddg

https://allnurses.com/general-nursing-student/having-problems-doing-308762.html

whodunit · Jan 28, 2009

I agree that a lot of the stuff you deal with in real world nsg does not leave time for a lot of the stuff on my example of a care plan if you tell yourself there is sooo much to do there isn't time .One of the reasons for this so called silly stuff is to learn how to think critically{by the way you will learn as you go that the above silly care plan can all be accomplished when you do your daily assessment and delegate the care}.Think about the first time you see your pt in ER, follow the same outline as above.What can I do to help them,how will it help, and follow thru.This goes and holds true for any field of nursing you are in; assess, provide comfort and care and yes teaching..Please try never to get into a mind set that the above silly stuff is a waste of time.Thats what nursing is all about.:redbeathe

jjjoy, LPN · Jan 28, 2009

I get that care plans help to break it all down and build it back up again... assessment of needs, appropriate interventions, rationales, goal-setting. That's great and useful.

I don't think, though, that it takes a full page of detailed explanations and rationales or the application of the nursing diagnosis "self care deficit" to figure out if a patient has terrible arthritis, a broken hip or just returned from open heart surgery that they will need assistance with their ADLs. I can see doing one or two simple care plans just to start out, to get a feel for how they work, but spending hours breaking down and building back up a whole slew of basic nursing care doesn't seem the best use of limited time. I know for my program, even towards the end, we couldn't plan to "manage patient pain", we had to list out specific signs (patient states "It hurts a lot - 9/10") and reference rationales (evidence shows that using a pain scale...). I don't see how one can insist students need to continually demonstrate understanding of the rationale behind the most basic of care while at the same time expect those same students to understand complex pathophysiological processes. It's seems contradictory!

whodunit · Jan 28, 2009

I agree, it is way too useless, and time consuming/frustrating but until change is made, this is what the going to be nurses have to do, so my attempt at the care plan is/was to help them see why its required and just start thinking like we nurses do without even thinking.Does that make sense lol?

laketrash · Jan 29, 2009

I think I know what you are tryng to get across whodunit, you are agreeing that long trivial care plans are useless and time consuming but also necessary in the beginning to teach new nurses how to think like a nurse?You sound like you really care about your pts .