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.

[2bRCRN2008]

3 words...They are STUPID

[srun21]

recently, my instructors tried journaling instead of care plans. we would describe the patho for the patient and then journal about our day including what intervention we did and why. this was easier for most students because we were not conforming to a set guideline, such as a careplan template. instead, we could 'free write' bakcing it up with facts to prove we know what we are doing.

[Rexie68]

That sounds like a great idea! We do something similar in our mental health rotation. For med/surg we just have to fill out a nursing assessment form. No care plans at all this year! woohoo!!!

[PsychRNMsz]

I don't think your reply was mean at all...and I do get how to do them. I actually have no problem grading wise because I always follow the nursing process to develop the ideas for outcomes and interventions. its just the reediting because one instructor doesn't like the way something is worded or the way the rationale was cited when it fits the apa guidelines. its just like i said something I have noticed between the semesters.

[mommyjskns]

Hey, Sharla! How have you been? What classes are allowing journaling vs care plans? That sounds awesome!

[TheSquire, DNP, APRN, NP]

Ok, so I finished my very first nursing care plan last night... and I don't see what the issue is. So yeah, it's a few hours worth of work to do it right. Big deal - I had assignments longer than that in undergrad. It's supposed to make us learn the nursing process by forced repetition so that, by the end of our two years, we will have internalized the whole thing.

If a few hours of work per week on something so central to our profession is making you whine so loudly, why are you (the whiners) here?

[Rexie68]

if it were only a few hours a week, i doubt many would "whine." when you have 4 patients a week who each have 5 or 6 diagnoses and many more nursing diagnoses, you could spend 4 hours a night on care plans. perhaps your school doesn't require that of you. many schools do, though. so perhaps they're not "whining", but rather making a very valid point. hopefully your workload will stay as light......

again, i say, thank goodness i don't have to do care plans this year!!

[jjjoy, LPN]

If a few hours of work per week on something so central to our profession is making you whine so loudly, why are you (the whiners) here?

Those who are whining simply because they're lazy, well, that's them and they're going to whine no matter what.

So let's focus on the pros and cons of the various student care plans that are required of nursing students. I started this thread and it wasn't to say that care plans are pointless or shouldn't have to be done. It was a vent that some care plans and some schools seem to take up way more time to complete as desired by the instructor than the educational benefit derived from putting them together. There is so much crammed into two short years of nursing school and if one is having to spend several hours a night re-writing care plans to get the wording just so in order to meet the instructor's varying demands and creating lengthy care plans from scratch over and over again, that is time *not* spent learning pathophys, meds, etc more thoroughly.

If student care plan expectations are reasonable and relevant, then I have no problem with them. I've always been a very good student, not afraid of putting in the work in order to learn and really retain the material. In my experience, after a while, care plans as they were required and graded at my school, felt more like busy work, taking away valuable time I could've been studying something that would truly benefit me both educationally and professionally. From what I hear here, others have had similar experiences, so it's not just one particularly bad school or instructor. If care plans at your school are reasonable and relevant, then count your blessings!

[Lexiesmom]

I hated care plans!!! All through school, LPN, RN!!! Hated them. But I will say this much for them. They do make you begin to THINK like a nurse instead of like a doctor. They make you think about the overall client and not just their diagnosis. They are PEOPLE.........they are not the appy in room 501! Nursing care plans do make you begin to look a the bigger picture. However, I do not think they are taught appropriately in nursing schools. The are very cumbersome, and for me, not at all well presented. As years go by and I learn more and more in my field, I do see them as a basis for viewing our clients as whole persons. But the nursing schools go overboard in formatting them andmaking students crazy. Learn the basic idea behind the care plan. And we all know after we start practicing, they are a piece of paper the RN must add to the chart. No one cares about them. But if you view them as a tool for you to look at the client, the stimuli that is affecting the client and the client's reaction to that stimulus, you will see a better view of care plans. I cannot defend them, I hated them too!!! But they do alter the way we think, if we use them in that way.

[Fermin Hernandez, ADN, ASN, RN]

I don't need my nursing teachers to teach me composition - that's what the English comp classes are for.

Traditional care plans are relics from a past time.

Now the nursing process...that's another story altogether. Believe it or not you can implement the nursing process without a dated care plan format...mindmaping, computer formats, etc.

A lot of people seem to confuse care plans and nursing process.

[Multicollinearity, BSN, RN]

I do really like and appreciate mind-mapping. I think some of my classmates benefited from thinking about how one problem affects another, etc.

[Lexiesmom]

Totally agree with you that it is very hard to keep up with each instructor's ideas. But hang in there. I am going through nursing school for the thirds time......LPN, to RN, to BSN and hopefully to MSN. They will make sense. You will find yourself thinking about what you have learned when encountering really difficulty patients. They are alot of busy work, but I believe they do train our brains to think outside of the box...........see a patient differently than a medical dx.