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

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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.

Specializes in med/surg, telemetry, IV therapy, mgmt.
Each semester I have to relearn how to do care-plans for each clinical instructor. There is very little standardization; it's not a matter of higher demands as the semesters progress.

Not being mean here, but you do not understand what is going on with care plans yet. A care plan is a determination of a person's nursing problems and strategies to solve them. The fact that you have to "relearn how to do care-plans for each clinical instructor" is merely having to learn how to formally present the care for each instructor. The actual work that goes into the construction of the elements that make up the care plan never changes. The actual physical presentation does. It is similar to presenting a term paper. The standardization you are longing for is actually in applying the nursing process to the problem solving process in developing a care plan. If you are not doing that, then you are not thinking critically to solve the patients problems. Once the problems are determined and solutions presented it only matters to the instructor or the employer how the work is to be presented.

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Specializes in Acute Care Psych, DNP Student.
Not being mean here, but you do not understand what is going on with care plans yet. A care plan is a determination of a person's nursing problems and strategies to solve them. The fact that you have to "relearn how to do care-plans for each clinical instructor" is merely having to learn how to formally present the care for each instructor. The actual work that goes into the construction of the elements that make up the care plan never changes. The actual physical presentation does. It is similar to presenting a term paper. The standardization you are longing for is actually in applying the nursing process to the problem solving process in developing a care plan. If you are not doing that, then you are not thinking critically to solve the patients problems. Once the problems are determined and solutions presented it only matters to the instructor or the employer how the work is to be presented.

Daytonite,

I assure you, I am thinking critically to solve patient problems. If only you knew me. Please hear us. This is not entirely the whining of students finding their way. I understand that the nursing process does not change, and what you are talking about with problem-solving. I am talking about instructors having markedly different preferences, notions, and not communicating their expectations.

Perhaps it would be worthwhile to consider that there are some problems in nursing education, like too many adjunct instructors who have zero contact with the actual college campus where students are taught. Several of my clinical instructors who are adjunct mention they haven't been to the campus or a faculty meeting in ages, or since they were hired. They've said the secretary occasionally mails them something. It seems often there isn't any coordination between lecture instructors and clinical instructors. Some of the instructors only have BSNs from eons ago and haven't worked at the bedside in years. This is NOT to say all adjunct instructors are bad. I don't mean that at all. But I think the use of so many adjunct instructors combined with a lack of experience and lack of coordination about objectives can lead to the problems we are talking about.

I had one clinical instructor ask what semester we were in the program. If she didn't know what semester we were in, in the program, do you think she might have been shaky on other aspects of being an instructor? And then she forgot what semester we were and asked us again the next week. Then she canceled clinical because she had a "hot date." She marked up our care-plans with the strangest things. We said nothing.

Are you getting the picture about lack of teaching knowledge and consistency that we students sometimes experience? All of our instructors are not quite as organized about care-plans as you are.

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At our school, the instructors have adopted a policy of grading student assignments three times (once by three different instructors). The elements that are recognized as deficit after all three have graded the careplan are then brought to the attention of the student. This prevents the student from being docked for personal preference of the instructor. Our school faculty is very progressive in their thinking and I love them!!!:heartbeat:heartbeat:heartbeat

The majority of our instructors are students pursuing their doctorates and they understand exactly where we are coming from. Good luck! :nuke:

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Specializes in Acute Care Psych, DNP Student.
How do you know they're 'liberal,' and what does that have to do with APA format?

All undergrad programs have some form of standards they require for writing papers, whether it's MLA, APA, CMS, etc. Most medically based programs require APA. Be glad you didn't have to learn multiple formats like I did in undergrad. Makes for some interesting problems, when writing papers for multiple classes.

Yes. I had to toggle between MLA and APA for one year, with multiple classes, and it was a challenge. Ever since, I've only had to deal with APA.

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Specializes in Acute Care Psych, DNP Student.
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!

Some of these care-plans are longer than 20 pages. I had one that topped out at about 40-something pages.

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Specializes in ortho, oncology.

I think that care plans are the stupidest, most useless idea ever to take over nursing school. They are not practical, and most of the time, by the time you do them, you are done taking care of that patient anyway. I understand the idea of teaching them to new nursing students to enforce the idea of patient care as organized as possible, but out there on the floor, NO ONE uses these!!!

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I know care plans are awful and they are long and tedious, but they serve a great purpose. Care plans solidify your knowledge base. We retain 75% of what we write. They also teach you logical steps for caring for you patient and understanding the patients condition. They help so much, in making you a stronger student and nurse.

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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.

sometimes, i think nursing care plans are a waste of time, it makes me more stressed out, makes my brain "pop" if i may say.. But i realize, in order to give quality care to the patients, PLANNING is very essential.. But Let's admit, it's not as easy as we thought..

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care plans in nusrsing school are absolutely retarded. i usually threw them together at work the night before they were due. 2 or 3 is enough... doing them over and over again is absolutely... retarded!

focus 90 percent of your energy on your EXAMS. those are what mattter in the end. to pass clinical you have to show up with a positive attitude, do what you're told to do. piece of cake! focus on your exams in your lecture class!

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Specializes in pediatrics.

Don't get me wrong....they suck. I think the purpose is to get the student to think (I'm still a student....I went right back to school after ADN) and when I mean think I mean that student/ nurses actually go through the process in their heads...the instructors just want it written down to see how the student nurse is conveying it. Yes the instructors are nit picky....I have written many of my "best ones" over because my instructor thought it was wrong but I must admit it has taught me to be careful with my wording in documentation. As nurses (unless a nurse practitioner), we can not diagnose...we can only make it obvious to the doctor. You will see care plans again but they will be on the computer and most of the time it will be written in for you.

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:banghead:I dont mind them so much, its just that they take so freakin long to do and of course...time is something i never have enough of! Ya, I have a different clinical instructor for every semester so far, and one would tell me how Im really good at writing them up...then this semester Im getting critiqued on little small things and sometimes the way i word stuff...blahblahblah. I appriciate the feedback, but, one will tell you how to do it one way and the other another way- its frustrating:smokin:

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Hi Smarty pants,

If the one instructor said you were doing a good job on them, you are. If the other is checking everything with a fine tooth comb, it because she see you has the gest up how it did, but she wants to take you to you adsolute best, because they have to feel you've got a good understanding on how to efficient care and treat clients.

You, just take a deep breath and keep up the goood work!!!!:yeah:

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