Care Plans - What's their purpose? - What do you think of them?

[jjjoy]

I saw a nursing student and her instructor reviewing a care plan today and she was reviewing something about wording of the care plan and it reminded how frustrating nursing education can be and how mixed up it can seem to be sometimes!!!

At my school, anyway, a care plan for something as post-anesthesia nausea would be grilled for the wording of the nursing diagnoses, the specific wording of the nursing interventions and goals.... to make sure that we were using impractical "nurse speak" as opposed to - oh no! - referring to a medical condition directly (eg pt constipated, possibly d/t medication side effect, keep hydrated, adm laxative as ordered, etc). Students should ideally be able to rattle off quickly the what's and why's. I think the nitpicky round-about descriptions required in nursing school make simple concepts more confusing... and end up wasting the valuable time of students.

[RN BSN 2009]

i find they help me think like a nurse!

[msjam54]

THANKS rEXIE68,

YOU COULD HAVE SAID IT BETTER, i WOULD RATHER FOCUS MORE ON THE ACTION OF DOING WITCH WILL MAKE THE CARE PLANS MAKE MORE SENSE!

THANK YOU

MSJAM

[Goodoldnurse]

Planning care for a patient is not easy! As Instructors, we want to see that you know "why" you are doing or planning to do something. If your interventions do not speak to the problem the client is having, we need to steer you another way. We don't enjoy using our free time at home reading what you write, but it is necessary for us to find out that you understand the process.

After a while, planning for patient care becomes your thought process and not just something we do for torture!

[jeninthedesert, BSN, RN]

I think I am in the minority when it comes to care plans. I actually ENJOY doing them. It allows to me to get an idea of what my patient is dealing with so I can prioritize. And, it gets me oriented to nursing diagnosis and the nursing process. All in all, it helps me to "think like a nurse".

[BrynnLeann]

I completely agree with this rant about Nursing Care Plans, I found them absolutely ridiculous. While in our maternity rotation, we had to do a "wellness diagnosis" for a lady who states she is ready to breastfeed. We had to do a whole write up for this, to decide that our action at the end is to teach her to breastfeed. Well, d'uh. Did I really need to write a whole report for that? And every nurse I've asked about this has said they thought the care plans were useless as well.

However, I can't really complain. I'm from Winnipeg in Canada, and our nursing instructor said that in some parts of the USA you have to write 20 page reports for nursing care plans! GEEZ! Ours are usually one page in length lol, and even then they are a pain in the butt!

[NewNurse626]

Care Plans=Planning Care for your patients= Your Future Job!!!!

[madnurse2b]

Lucky you - at least you don't mention having to do concept maps! I get how many nursing diagnoses are connected, but careplans are a reasonable PITA and they get me very patient focused. Concept maps make me try to make a pretty picture on top of all the actual THINKING!

[statuspending]

While i didnt enjoy care plans I do feel my instructors feedback on them were constructive and I'd like to think i learned a little from doing them

[lizlafoe]

I believe there was an editorial in AJN (sometime in 2008) called "Death to Care Plans." I think they are on the way out. Still, I agree completely that professional writing is a crucial skill.

[Daytonite, BSN, RN]

i believe there was an editorial in ajn (sometime in 2008) called "death to care plans." i think they are on the way out. still, i agree completely that professional writing is a crucial skill.

not true. they are required by federal law to be a part of every patient's chart. as long as those laws are in effect, care planning will be taught in schools so students know how to do them since they are required to be done on the job. an editorial is an opinion and the american nurses association that publishes ajn has always been political. the government isn't changing it's laws or rules just because a few nurses over at ajn think they need to be changed. reimbursement (payment of bills) issues are tied up with the laws governing this.

this is the federal law for hospitals (title 42 part 482 conditions of participation for hospitals): http://www.access.gpo.gov/nara/cfr/waisidx_05/42cfr482_05.html this is the medicare law. section 482.23(b)(4) under the section for nursing services states "the hospital must ensure that the nursing staff develops, and keeps current, a nursing care plan for each patient." hospitals must comply with these laws or they cannot admit medicare patients. medicare patients are the bread and butter of every acute hospital in this country. jcaho accreditation incorporates these medicare laws into its standards and defines what a care plan should contain. care plans aren't going anywhere. ajn can only wish.

[NRSKarenRN, BSN, RN]

An editorial is an opinion and the American Nurses Association that publishes AJN has always been political.

Psssssssst:

As of September 2006, AJN ceased being the official journal of ANA. It is an independent publication of Lipincott, Williams and Wilkins, part of Wolters Kluwer Health.

ANA's new publication is the American Nurse Today.

[malaski]

Yeah it kind of ticks me off that professors are so picky about the stupidest details. I feel like they focus on stuff that isn't important. And the stuff we really need to know, doesn't get stressed enough. - I had 25-30 something page care plans that could have been reduced to 1/3 of that amount- if they focused on the important stuff. I felt like I didn't learn as much because I was just so focused on getting them done, or risk failing.