Care Plans in General

windsurfer8, BSN, RN · Mar 25, 2016

Spend more time doing what YOUR instructor wants you to do and less about what other students are doing. When you work in a hospital doing what THE doctor orders is what matters..not what doctor X in Brazil does.

Nursing school is about learning how to follow directions (orders) and completing the task at hand.

juardsrn · Mar 25, 2016

Lol like I said before, I was just curious.

I've been completing them how she wants them to be done. Overall, I'm surprised with the feedback I've gotten from her. I was sure she was going to rip them apart, but alas, she was pleased with them!

AspiringNurseMW · Mar 25, 2016

Ouch! Our school is pretty laid back about care plans. We have to complete a MAP with at least 5 to 6 nursing diagnosis with related to and as evidence by statement.

We only need to write out ONE goal, with 5 interventions for that goal. Sources may be where ever but they prefer our textbooks.

Easy peasy. And our clinical instructors collect and review them. Some are more anal than others. So far, out of the 4 clinical instructors I've had, 2 of them were very laid back, one was a little more meticulous, and the other in the middle

NurseGirl525, ASN, RN · Mar 25, 2016

Hmmm, first semester?? I can't even remember that now. Lol. My mind is so jumbled on fourth and graduation and NCLEX...... It's hard to remember.

I hope you get the drift here.

Purple_roses · Mar 25, 2016

I think it's really odd that your instructor tells you which nursing dx to go with. A big part of care plans (at least at my school) is to be able to figure out what the problem actually is.

juardsrn · Mar 25, 2016

I thought so, too. She doesn't necessarily "give" us the nursing dx, but she gives us choices to do our care plans on when they're due. For example, the care plan that is due tomorrow, the guidelines say to, "prepare a care plan on nutrition, skin impairment, or pain". So, the nursing dx is going to be "Acute/chronic pain r/t ____ AEB _____" if we decide to do it on pain (like I chose :cheeky: ) .

I'm hoping that the further we get into the program, the more freedom we'll have with our care plans, but from the sounds of it, I think this is the way it will be until we graduate.

juardsrn · Mar 25, 2016

Hmmm, first semester?? I can't even remember that now. Lol. My mind is so jumbled on fourth and graduation and NCLEX...... It's hard to remember.
I hope you get the drift here.

I hope I can feel that "pain" one day haha! Good luck with the NCLEX!!

vintagemother, BSN, CNA, LVN, RN · Mar 25, 2016

I've attended 2 different nursing schools (1 for LVN/PN and another for RN) I've also worked as a nurse.

Every school and every teacher and every facility will have different care plan expectations.

I think you should try to learn to write them the way that your instructor wants. And be prepared for your next instructor to have different requirements.

I was having a really hard time with care plans in term 3. My CI hated mine. I reached out to peers and helpful teachers for insight.

I tend to use 2 different care plan books plus my schools short list of nursing diagnosis suggestions when writing them now.

It's almost like doing a math formula. And the good thing about math is that there is a "formula".

At my school it's just as you wrote, "So, the nursing dx is Acute/chronic pain r/t ____ AEB _____"

The r/t often throws me off because I can't use a medical dx. I have learned to simply use what has worked before as far as the teachers preferences.

I'll add this caveat: it's a secret. I love care plans. I feel that once you learn them, they stick with you and you'll know the best interventions and outcomes for different problems. I think some nurses would agree with me that we do them in our heads all the time while working with pts. Other nurses think theyre a mundane waste of time.

AspiringNurseMW · Mar 25, 2016

I thought so, too. She doesn't necessarily "give" us the nursing dx, but she gives us choices to do our care plans on when they're due. For example, the care plan that is due tomorrow, the guidelines say to, "prepare a care plan on nutrition, skin impairment, or pain". So, the nursing dx is going to be "Acute/chronic pain r/t ____ AEB _____" if we decide to do it on pain (like I chose ) .
I'm hoping that the further we get into the program, the more freedom we'll have with our care plans, but from the sounds of it, I think this is the way it will be until we graduate.

Well, those guidelines aren't bad. My 2nd clinical instructor liked to align our care plans with lecture. So if we covered infection or pain in class, that week she would say to try and make the goal & interventions related to a nursing diagnosis involving that. It helped facilitate conversation post conference

NurseGirl525, ASN, RN · Mar 25, 2016

Truly, it's because you are first semester. By fourth semester it's way different. I honestly felt like on my last case study, they were wanting us to make a medical dx. I was like, wait, I can't do that. But then I realized, it's all about putting it together. And maybe a little of what I thought, because, you know, we as students are always right!!!!

You will get a lot force fed to you first semester. Enjoy it. I'm about to go crazy right now in my icu class as I feel like no matter what I study, it's not what is on the test. I long for the days where my biggest concern was how to properly make a bed. Which by the way, does not matter as it is different on every unit and evs does it for you!! But to make those darn triangles again.....

augurey · Mar 25, 2016

We have a template where everything has to be filled in. Current problem, history, I&O, more detailed description about the events that lead to their admission, what the plan for the patient is and what's happened since admission, diagnostic tests with results and rationales for it being performed, discharge plans, pathophysiology, patient teaching, patient labs, physician orders, list of all meds with pharm class, dose, route, frequency, med cards, pick 4 top nursing diagnoses, pick the priority diagnosis and do at least 3 goals, 10 interventions with rationale, outcome.