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.

As they say, there's no limit to perfection...

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Specializes in I dream of ICU...one day. ;-).

My only issue with APA is that every instructor I've ever had all seem to have their own way of doing it. And their way is the "right" way. My sister is a librarian and she always proof reads my papers...and we both shake our heads cause we know that somebody is going to say this, that or the other is wrong. Of course, my personal background is in english lit. So I really miss MLA and I'm biased. :)

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I'm just posting to say "thanks". In over 40 years of being a nurse, I have seen no real usefulness in nursing care plans (which I really haven't written many of since nursing school back in the dark ages).

Just reading Scribbler's explanation has proved to me once again that I really am NOT too old to learn something new. Oh my! I wish I had realized 40 years ago how those care plans shaped my professional and nursing "thinking".

I am going to print that response to put on the bb at work to share with all the nursing students and young nurses.

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This is great! I dont start nursing school for a few more months, but have heard horrid things about care plans...thank you for the motivational pep post!

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Hi, I'm a nsg. student, and to be honest I can't stand doing careplans!! and further more we have 3 instructors, our class is divided into 3 groups, going to different clinical sites with each instructor and what one says is good careplanning, the other says is wrong, they confuse me!!!

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Specializes in Cardiac, Med-surg, Oncology.

I see that there are many of you that say there are no care plans in the real world of nursing.....I do not understand what u mean....? Everyday you work as a nurse and with a client you are one way or another doing a care plan...you have a method to your madness when working with clients, you assess and treat and do what is needed for your client and when one thing does not work you change and go on to the next we do it over and over and we each have our own style and to be honest even in our charting there are care plans...never seen a hospital yet that didn't have that screen where we have to open or update such thing as risk for infection, or impaired comfort, and if you dig a bit deeper into some of those screens it even gives you references to where they took their NANDA from.....have fun with them explore all the unique diagnosis's for your clients impress yourselves and you will impress your instructors...

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i think care plans are very useful for us because it can help us in giving the right and systematic interventions or care to our patients.

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Specializes in Cardiac, Med-surg, Oncology.
My little rant was about how, at least in my experience as a student (not very recent by the way), the particular way care plans had to be written didn't seem the most effective way of our spending very limited time in nursing school. And I'm referring the cumbersome wording required and redundancy of basic info, not to the overall structure of ADPIE, which is a very useful method of organizing information and problem-solving.

Here's an example (probably not very good since I've been out of school quite some time now)... Let's say there's a post-op hip replacement who needs assistance getting up because they can't put full weight on their operated hip d/t avoiding full pressure on the operated hip until it's had time to heal more. They are also in pain and recovering from anesthesia. The student, however, must carefully choose their words... limited mobility r/t hip surgery... no, can't say that... limited mobility r/t impaired body mechanics d/t hip surgery??... Pain r/t surgical incision... no, can't say that...

Identifying, monitoring for, and taking steps to prevent complications is another important aspect of nursing care that seemed to unnecessarily draw out the learning process. It doesn't take long to understand and remember what types of patients are at risk for skin breakdown. I don't think having to write "at risk for altered skin integrity d/t X; check pressure points for redness (rationale ABC reference XYZ), turn patient q2 hours (rationale ABC, reference XYZ), etc)" over and over on countless care plans for two years was the only way I'd remember all risk factors for and methods of preventing skin breakdown.

Did you use the same ones over and over, because that would bother anyone to keep re-writting the same stuff over and over. Care plans are to be different for every client, I do relize that there are diagnosises we can use over and over for all of our client but its finding the best that fits with your client at that time, and what you think is most important that counts. The more you use the more you learn, change things up a bit dont just use the same old same old....no teacher will knock you as long as you have justified and shown why its important for your client.

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IMO, I think care plans are helpful, but they are lengthy, and took forever for me to do them...very time consuiming. That was the only thing I didn't like about doing them, especially if we had a test that week...and this past flex, we had one due every week for each patient we took care of. At the hospital where I did my clinicals, they had care plans on the computerized charts, but they were short, and did not include rationales. But I do think they help in the long run...

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Specializes in LTC, MDS Cordnator, Mental Health.

I hated them in school. but now I use them every day. They are My key to communicating with the team. i look at them and update often.

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Care plans are definitely a pain. Not really too hard once you get the hang of it, but extremely time consuming. However horrible they seem, I don't disagree with the fact that they want you to learn how the nursing process works. I think they help you learn what interventions are specific to what conditions AND more importantly, the rationale for the intervention. With only 6 months of nursing school left, this is what my intructors have really zeroed in on rather than proper wording of the diagnoses, goals, and evaluations. They want in depth patho on why the interventions work. I hate doing them, but in a way I'm grateful, because I've learned more about nursing from doing care plans than I have from some of my not so attentive intructors. It's true they aren't really worked up by individual floor nurses in the real world, but I think they are a necessary learning tool while you're still in school.

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Specializes in Med/Surg.

My class stopped doing care plans. We just make a daily care plan for the patients we're working with, but without NIC/NOC. Very straight forward. List diagnosis, list treatments, explain patho verbally to instructor, write SOAP note, list "further treatment." (THANK GOD! I've seen students in other programs wasting valuable study time on "make believe" care plans...ridiculous!)

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