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.

[Daytonite, BSN, RN]

student care plans... what's their purpose?

here is all i have to say about this since it has been made a sticky. . .

the purpose of students doing care plans is to assist them in pulling information from many different scientific disciplines as they learn to think critically and use the nursing process to problem solve.

this is not the same purpose of care plans done by employed licensed nurses in the work place. those care plans are done to document the solutions to patient's nursing problems and they become a permanent part of the patient's chart.

[Daytonite, BSN, RN]

Thank you! As a new nursing student, I found your post very helpful. Im fwding it to my study group. Its nice to have some perspective from the instructor's point of view. Thanks!

Unless I'm very wrong, this thread was not started by an instructor! It started out on the General Nursing Discussion Forum by someone who is no longer a student and ended up here for some reason.

[studentinnursing]

I get it too!! Makes perfect sense that you would not take a care plan out of a book, period, when everybody is different, bodies react differently, comorbid conditions, medications they are taking, etc. You sound like an awesome teacher and I am excited all over again about starting school. I'm just doing prereq's now, but I've been doing transcription/editing for 13 years, so when I'm listening to histories, meds, allergies, exams I'm sorta "practicing" and always have, guessing what doc is gonna do/not gonna do/why/why not and then seeing if I'm even close when I'm listening to impression and plan, just a medical transcriptionist, and now here I am years later going into nursing. I don't know much about "care plans" as they pertain to my ADN bookwise but will soon find out, and I may be crazy, but it is the most fascinating part to me. My gosh, that's what it's all about, right? I love anatomy and physiology too . I'm hoping my studies go well AND be so enjoyable I'll never want to do anything else.

[amberfree]

Thank you scribbler. Your post was great and I am thankful for it as you have explained the reason behind care plans in a way students can understand. I start the nursing program in three weeks and I am excited and scared. Care plans were one of my fears, but now I think I understand the purpose of them, which helps. So many thanks to you for sharing!

[tlm2987]

I actually learned a lot by doing care plans - once I figured out what a care plan entailed. A lot of people complain about them, and I agree, it is a lot of work especially with all of the other paperwork that is required of us. But I have learned that *most* of the paper work assigned is very helpful and I learned a lot more in the clinical setting by doing paperwork than by sitting in lecture listening to the instructor talk at us about different disease processes. I would rather do clinicals and paperwork/care plans over lecture.

[B_santafe]

Hello, I have been unable to look into the site for few months because I was concentrated in my final semester classes. I took a glance to your email, and I do not agree (in part) of what are you saying. I do not know which nursing program you are taking, but those basics nursing care are very important to improve patients outcome, I know it sounds boring and repetitive mobilization, turning q2h, incentive spirometry, deep breathing and coughing, woung care, ADLs,.... but those are the core of nursing care and if they are not performed it does make a difference in pt's outcome negatively speaking. You are right, you should be trained in emergency care, how to think and respond, I wonder why you have not being trained on that because you are supposed to! At first I was confused with care plans and I thought they were a waste of time but then, with time you realized that you incorporate in your thinking what you were writing over and over again, of course every patient is different but regardless the etiology that causes fluid volume imbalance, less or more than body requirements, the interventions are the same! just few modifications depending on etiology base; so, I got it, and I can recognize any S/S, clasify the nursing diagnosis pertaining to them, and I know what to do within a nurse's scope of practice.

[TexasCowgirl24]

Would you trust a nurse with your health if they used poor rhetoric and grammer?

[RNnTrainin']

No need to flame you, I don't think. I think it is important for us (the students) to know WHY we have to do things, and it seems that the careplans are there to help us grasp the material better, even if we realize it or not. Thanks for the insight.

[scribblerpnp]

Would you trust a nurse with your health if they used poor rhetoric and grammer?

I think every person graduating with a college degree should have good writing skills, and that is why I'm picky about grammer and APA when students turn in papwerwork.

And how how smart would it make a nurse look if her charting had poor grammer and spelling, especially in a court case? Of course, chart writting seems to have a different type of grammer all its own.

[leeviaRN]

i agree care plans are a major pain, in my school besides giving a few nsg dx, they want the rationale and they want it cited. some of my interventions i can formulate in a few words. and that really irritates my especially when they want you to incorporate possible issues with meds.grrr. i finished w/ god still guiding me this semester.

but sooo much can be learned when doing the careplans because, in my opinion it helps on test ques. on what the nurse is supposed to, prioritise, etc.. as to doing the comp, selecting dx, don't get me wrong when you just want to do something quick its great..but on the other hand does not allow you to think...i have ob/peds which i know are crazy with careplans:coollook:

[AOx1]

The key with care plans, as with any other assignment, is to make them realistic. I guarantee you will not, as a practicing nurse, go in the night before to assess your patient, look at the chart, and write a 40-page care plan before caring for your patient. You will have to do this "on the fly." Care plans have their place, and that is to teach nursing process. They are by no means the only appropriate way to do this, and should not be the only means of assessing student performance. They are meant to teach students to have a framework for making decisions about care. They should not be used to the exclusion of appropriate questioning of the student, interaction with both the patient and student, and other means of assessing student knowledge. I am well aware that some people are tempted to copy out of the book and off online sources. But you can't as easily "fake" knowing what to do when someone asks you directly, and when you are on the spot. I ask my students questions all the time. For example, I will ask a student in an OB rotation whose patient has just had vag delivery what they would do if that patient began to hemorrhage. What would come first? Why is this most important? We sit and discuss it, not as an interrogation, but as a way to get at how much they know. My goal is for them to feel safe caring for patients, and for the public to remain safe were this student to care for them. It is important to use many strategies when teaching. As you can see on this board, there are many ways to learn, and people have differing preferences. Why limit instruction to only one method of teaching?

[RaElrA]

Yes, I hated them the first semester, but finally "got it." Care plans help us start thinking like nurses. Now that I've been working as a Tech, I can see a benefit from having done them...in the real world, things are happening so fast that the rationales need to be second nature. The more care plans we have done, the faster we can come to the right decision in a given situation, really. So...just grin and bear it, huh? I have two more semesters of doing them myself. : )