Care plans- student nursing

Mkue · Sep 18, 2002

I will be starting on my first care plan tomorrow and I'm really excited about it.. thanks for all the tips and comments, they are really appreciated !!

Keep them coming if you think of anything else !

:)

ntigrad · Sep 18, 2002

I never even thought about copying care plans. Who would do that? How do you learn anything that way? We have to chose our NANDA nursing diagnosis from a book and go with their interventions, expected outcome and how that actually applied to this patient. That's the only thing we copy out of the book. My CD has a way of editing the care plan and printing out a personalized care plan, but do them by hand and don't use everything. Sometimes what they have it too much. Wow! Some of these really wild stories must be from RN schools. More power to ya!

Jill

Mkue · Sep 18, 2002

Originally posted by ntigrad
Wow! It's interesting how every school and program is different! In my LPN school, we have to do one care plan every week. We are taught to just basically get your info out of the book. I have a care plan CD that is so easy to use. No more flipping through pages, just click and you're there. Mine is by F A Davis. Great CD! I can do one in about an hour, depending on the extent of the illness, but I did do one that had 14 diagnoses and was about 30 pages long. Took about 3 hours. One of my instructors would have loved it, but as it was, we were assigned to a different teacher who doesn't like all the fluff. She thought it was funny and was very impressed, but asked me not to do that to her again. :) Which is fine with me. Any time I can do short and sweet is just fine!
Jill

Jill, we have to use books also, and write ours out by hand. I'm actually looking forward to the new experience, as I love doing searches and learning new things. We don't have a CD to use. I'm really anxious to get my patient tomorrow and start working on the care plan ! I'ts due Friday, so I'm sure I'll be fine.

OMG 14 Dx's and 30 pages long?? wow..

:eek:

Nurse K-Bear · Sep 18, 2002

we had to list our references when we did ours. They could be typed or hand written they just had to be done.

RNConnieF · Sep 18, 2002

A very wise instructor told me to:

Identify the Nsg Dx.

Identify the As Evidenced By

JUMP to the Goals

THEN do the Interventions and Evaluations. i.e.

Fluid Volume Deficit, Related to Decreased intake with increased loss, AEB; BP 3000 cc/day, poor skin turger with tenting. Goal: (look back at your as evidenced by) Pt will have a 500-1000 cc positive fluid balance for the next 24 hours, Pt's BP will return to baseline within 12 hours, urine spacific gravity will be (fill in the spacific numbers your facility uses) within 36 hours; pts skin will show no evidence of tenting in 72 hours. Now go to interventions, it's easy now: encourage PO intake of fluids, assess prefrences for juices, sodas, waters, soups; place dietary order for preferred fluids; record intake and output. Evaluation, again it's not too hard, your goals are either met or unmet, if they are unmet then you have to revise them. Try thinking in terms of :

This is the problem (Nursing Diagnosis)

This problem is cause by (Related to)

I know this is the problem because (As Evedinced By)

This is the resolution to this problem I want and I want it NOW(Goals, short term and long term)

This is what I have to do to solve this problem (Interventions)

This is how I'll know this problem is solved. (Evaluation)

You'll be surprised, but in a while you'll be thinking in these terms and doing a nursing care plan in your head and USING it every day. Hang in there, it gets easier.

Love-A-Nurse · Sep 18, 2002

we begun working (actually) with the care plans yesterday. yes, it is good to know we have the needed resources in books to help us with nursing diagnosis but coming up with the one that fits the patient's individual care is the key.

suzielee · Sep 18, 2002

Im in my final year of school. Nursing care plans suck but they do have relevance. Its important to understand what interventions are pertinent to your patient and their condition. Care plans tend to make all the infomration you recieve in that block kind of gel. Dont copy the care plans in the back of your patients chart-your not learning anything that way. Go thru your care plan texts and med surg texts-pick out the interventions and diagnosis that pertain to your patient and use your critical thinking skills to develop others unique to your patient. The one book Ive found completely indespensible during my 4 year stint is Lippincotts Practical Guide to Nursing. This book is amazing. It has condensed patho, nursing diagnosis, tests, surgical and medical procedures and all relevant interventions with raitionale- for 125$ its way more useful then any med surg

Mkue · Sep 18, 2002

Originally posted by suzielee
Im in my final year of school. Nursing care plans suck but they do have relevance. Its important to understand what interventions are pertinent to your patient and their condition. Care plans tend to make all the infomration you recieve in that block kind of gel. Dont copy the care plans in the back of your patients chart-your not learning anything that way. Go thru your care plan texts and med surg texts-pick out the interventions and diagnosis that pertain to your patient and use your critical thinking skills to develop others unique to your patient. The one book Ive found completely indespensible during my 4 year stint is Lippincotts Practical Guide to Nursing. This book is amazing. It has condensed patho, nursing diagnosis, tests, surgical and medical procedures and all relevant interventions with raitionale- for 125$ its way more useful then any med surg

Thank you for the book suggestion !:)

Mkue · Sep 18, 2002

Originally posted by RNConnieF
A very wise instructor told me to:
Identify the Nsg Dx.
Identify the As Evidenced By
JUMP to the Goals
THEN do the Interventions and Evaluations. i.e.
Fluid Volume Deficit, Related to Decreased intake with increased loss, AEB; BP 3000 cc/day, poor skin turger with tenting. Goal: (look back at your as evidenced by) Pt will have a 500-1000 cc positive fluid balance for the next 24 hours, Pt's BP will return to baseline within 12 hours, urine spacific gravity will be (fill in the spacific numbers your facility uses) within 36 hours; pts skin will show no evidence of tenting in 72 hours. Now go to interventions, it's easy now: encourage PO intake of fluids, assess prefrences for juices, sodas, waters, soups; place dietary order for preferred fluids; record intake and output. Evaluation, again it's not too hard, your goals are either met or unmet, if they are unmet then you have to revise them. Try thinking in terms of :
This is the problem (Nursing Diagnosis)
This problem is cause by (Related to)
I know this is the problem because (As Evedinced By)
This is the resolution to this problem I want and I want it NOW(Goals, short term and long term)
This is what I have to do to solve this problem (Interventions)
This is how I'll know this problem is solved. (Evaluation)
You'll be surprised, but in a while you'll be thinking in these terms and doing a nursing care plan in your head and USING it every day. Hang in there, it gets easier.

THANK YOU for sharing your wisdom Connie !!:)

Bonnie Blue · Sep 18, 2002

My 2 cents. I HATED care plans! More specifically, the nursing dx part and then working the patho backwards to get to the nursing dx. I appreciate the learning about patho and why certain treatments and meds are used. But I am a linear thinker, if x is going on, we need to do w, y, z to try to fix x. This year in our NP classes we're doing that. Also, there were some times that I was grasping at straws for a pertinent nursing dx in a body system that wasn't affected. We weren't allowed to say system healthy, we had to find something that could go wrong, even if it's a remote possiblity. SOAP's aren't going to be easy but at least they make sense.

Mkue · Sep 18, 2002

Originally posted by Bonnie Blue
My 2 cents. I HATED care plans! More specifically, the nursing dx part and then working the patho backwards to get to the nursing dx. I appreciate the learning about patho and why certain treatments and meds are used. But I am a linear thinker, if x is going on, we need to do w, y, z to try to fix x. This year in our NP classes we're doing that. Also, there were some times that I was grasping at straws for a pertinent nursing dx in a body system that wasn't affected. We weren't allowed to say system healthy, we had to find something that could go wrong, even if it's a remote possiblity. SOAP's aren't going to be easy but at least they make sense.

Thanks Bonne Blue ! Your thinking style makes sense to me !:)

kaytdid · Sep 19, 2002

Originally posted by nurs2b

Many hospitals use "generic" care plans... The same plan for every person... But in nursing school they want "individualized" care plans... You may use those to get you started but they probably won't be everything you need... And as far as them being hard... My personal opinion is that they aren't hard, its more of they are VERY time consuming and take ALOT of critical thinking...