Care Plans...will we really use them in the future??

Daytonite, BSN, RN · Jun 17, 2009

it amazes me how you are not even an rn yet (you just started lvn school, right?), but you understand why you have to learn care plans and feel comfortable writing them. i went to rn school and didn't understand one thing about care plans until well after i graduated and was sitting working in a nursing home and had to write them because the federal law of the u.s. said we had to. here are the federal medicare laws on care plans that every hospital and nursing home administrator knows (they can't bill medicare for the medicare patients they provide services to if they do not comply with these laws and they are regularly surveyed and certified if they are in compliance with them):

http://www.access.gpo.gov/nara/cfr/waisidx_05/42cfr482_05.html

part 482_conditions of participation for hospitals. section 23. condition of participation: nursing services. (b) (4) the hospital must ensure that the nursing staff develops, and keeps current, a

nursing care plan

for each patient.

http://www.access.gpo.gov/nara/cfr/waisidx_05/42cfr483_05.html

part 483_requirements for states and long term care facilities. section. 30. nursing services. (a) sufficient staff. (1) the facility must provide services by sufficient numbers of each of the following types of personnel on a 24-hour basis to provide nursing care to all residents in accordance with resident

care plans

:

when "a few of my instructors both young and old say care plans will eventually go to the way side" did they say when medicare plans on doing this? medicare is the one that follows these rules and they don't change their minds very much. the reason care plans are required in the workplace is to document the critical thinking process of nurses. the reason students are taught to do them is so they will be able to do them on the job. as an added bonus you learn a lot about medical diseases, their treatment and nursing care, not to mention that they put you in the frame of nursing critical thinking. as for "some of the care plans i have read in my clinical sites have been dated for years" that is because they were probably written years ago by someone, probably like me, who was interested in care planning for others who weren't interested in it so all they had to do was pull one out and slap it into a chart in order to keep the facility in compliance with medicare so they could keep their jcaho or medicare certification. those "canned" and "prewritten" care plans are designed to be added to or altered to accommodate individual patient needs and not to be used as is. yes, there are some things that are the same about them, but there are other things that are supposed to be changed or added to based on information that nurses should have taken time to learn about each patient. if something needs to be changed on the "canned" or "prewritten" portion of the care plan there should be a committee that oversees that. i used to be on one of those committees. the idea of those prewritten care plans is to save staff nurses time in having to constantly write out care plans all the time because a lot of the information, as you will learn after writing hundreds of them, gets repetitive.

what do you mean by still no complete accomplishment of anything listed on them (care plans)? if i understand what you are saying, that would be because no one took the time to customize the prewritten care plan to the patient's needs like they should have. somewhere in the facility policy and procedure manual should be instructions on how to use those care plans. you might be surprised at the instructions that you find that go with them.

tothepointeLVN, LVN · Jun 17, 2009

Care plans help you think ahead and anticipate the interventions needed for the patient. Nursing is not just about turning up.....