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.

[RadfordSN]

Alright, so care plans are what we're learning in Foundations this semester. It's on a Friday, 3 hours, last class of the day that began 6 hours ago...focusing in that class is a challenge. No one seems to know what's going on. Care plans are awful. I'm always wanting to make a medical diagnosis. Nursing diagnoses are hard for me to grasp at this point.

I understand how they're very useful, but holy crap they're making simple things way more complex than they need to be. Grrr...

[xjenn]

Yea, use of the proper medical jargon can get really annoying..at least from my instructor. She takes us off the floor for an hour to go over our care plans and how wrong they are and changes the wording around. I write exactly what my care plan book says and she marks it wrong!! So frustrating knowing a book is still not right for her!

I can so agree with this one.

Our instructor did the same with pulling us off the floor...and then reading what we "did wrong" in front of all the other students. We could show that we got it from the book we'd been studying out of and it was still never right.

In answer to the question though... I think the purpose of care plans is to see how you truly respond under real stress?!? lol.

[impress0508]

Thank you for this. In fact, I think this makes the point

[Daytonite, BSN, RN]

Alright, so care plans are what we're learning in Foundations this semester. It's on a Friday, 3 hours, last class of the day that began 6 hours ago...focusing in that class is a challenge. No one seems to know what's going on. Care plans are awful. I'm always wanting to make a medical diagnosis. Nursing diagnoses are hard for me to grasp at this point.

I understand how they're very useful, but holy crap they're making simple things way more complex than they need to be. Grrr...

So was (riding a bike, driving a car, roller skating, giving your first IM injection) the first time you did it.

[nursetwobe]

Alright, so care plans are what we're learning in Foundations this semester. It's on a Friday, 3 hours, last class of the day that began 6 hours ago...focusing in that class is a challenge. No one seems to know what's going on. Care plans are awful. I'm always wanting to make a medical diagnosis. Nursing diagnoses are hard for me to grasp at this point.

I understand how they're very useful, but holy crap they're making simple things way more complex than they need to be. Grrr...

I know how you feel..they are getting easier for me but I really rely on my nursing diagnosis book. I am hoping they will get easier over time. We practice them every week. I kinda felt like the nursing diagnosis were stupid at first, cause seems like a medical diagnosis would make more sense, but we are not doctors.

[RadfordSN]

I know how you feel..they are getting easier for me but I really rely on my nursing diagnosis book. I am hoping they will get easier over time. We practice them every week. I kinda felt like the nursing diagnosis were stupid at first, cause seems like a medical diagnosis would make more sense, but we are not doctors.

Seems like it would be an easier route compared to nursing. lol

I wish I could buy that nursing diagnosis handbook, but until my paycheck comes I'm relying on information found on the internet.

Everything's so technically complicated...

Good luck to you! :]

[RadfordSN]

So was (riding a bike, driving a car, roller skating, giving your first IM injection) the first time you did it.

You're absolutely right.

I know it gets easier, but with everything else that's going on it's hard to see that light at the end of this very long tunnel.

[AZ Nurse]

Dear Nursing Instructor......well said. I too teach nursing and hated doing NCPs as a student. My students often groan and moan too. What I tell them is, as you said, I can see by their preparation that they are prepared to safely care for the patient. They have looked up the patho, meds, know the labs, the history etc. Same with interventions. I must admit I am not as concerned with the exact wording as much as "does the student understand what is going on and can they think it through to outcomes?" I HATE grading those suckers as much as the students hate doing them. I too give up precious weekend time to do so. When my students whine I tell them to try this....ask the nurse what the main issue is with their patient - I won't be in NANDA terms but it will usually reflect a nursing diagnosis. Then ask why they are getting the meds - this tells them that they really do need to relate the meds to the patient. Finally I ask them to ask the nurse...based o their answers what will they be doing for their patient. Here they learn about interventions/outcomes. The lesson points out that while nurses don't do the NCPs like they did in school that they still incorporate the information mentally when delivering care. Writing NCPs is a method of learning to gather & oragnize information to safely and effectively care for the patient. After doing them all through school they can then 'think' the same material when are out in clinical practice. So yes...they do serve a purpose. As painful a process as it is there is a benfit to be gained!

One last thought that the last post mentioned. I truly hope none of you are ever involved in healthcare litigation.....however if you are I can guarantee you that the plantiff's attorney will know all the information that would be in a NCP for that patient. So you too had better know it!

[ZooMommyRN, ADN, RN]

I was the zebra of my class, I loved careplans, I would have rather sat down and put out a 14 page care plan with complete patho than write the 14 page APA research paper for mental health lol By my second year I was a walking care plan book, even the instructors would pop quiz me for fun lol I'm glad I took to them so well now, our computerized charting system at work has a careplan that is developed upon admission assessment ad reviewed/revised every shift.

[smiles82]

I was the zebra of my class, I loved careplans, I would have rather sat down and put out a 14 page care plan with complete patho than write the 14 page APA research paper for mental health lol By my second year I was a walking care plan book, even the instructors would pop quiz me for fun lol I'm glad I took to them so well now, our computerized charting system at work has a careplan that is developed upon admission assessment ad reviewed/revised every shift.

Any zebra tips you can share for the rest of us struggling along, or did you honestly love care plans right from the start?

[ZooMommyRN, ADN, RN]

I looked at them like a puzzle, and when you are finding nursing dx and interventions in the books, actually take the time to read them, it makes so much more sense, especially when you start piecing clinical and lecture together to make a complete picture of your patient and why you're doing what you're doing, is it working or is it not working? it's a big circle, you can't understand the treatments if you don't understand the disease, same as if you don't understand the disease, then finding the right treatment is that much harder

[AZ Nurse]

:yeah:Wow - you are a nursing instructor's dream. You really got the whole purpose of the exercise!