CarePlans & MDS's

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ewwwww....ive been a nurse about 19yrs and ive worked in careplans now for about 2years and i still hate to do care plans ..lol

anyone one else work in careplans, if so do ya like it?..lol

Specializes in Gerontology, Med surg, Home Health.
awwww jeezzzz. double :trout: :trout: to me!!!

I DO TRY to educate Dr's., but we've got a couple that... well I'm sure some of you have 'em too.

OK, I'm done with this topic now.

Wouldn't it be a hoot if all us smart nurses from these posts got together and opened our own facility?!? We'd have dedicated staff, staffing ratios that were doable, trainable MDs..........

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Specializes in MDS,ltc, resident focused care plans.
I need brushing up how to write new orders to careplans, can you help?:confused::confused::confused::confused:
I don't write all new orders into the care plans.....it makes them too long and complicated. If someone for instance goes on coumadin, I add a problem for bruising/bleeding and then mention the med, labs, etc. I NEVER put in order changes for treatment, I use "treat any areas as indicated".

I am not sure if you are using the "medical model" for care planning or doing the "I" format care plans......All I have known for 10 years is the I format care plan and have recently changed jobs and have converted 146 care plans from generic ECS (electronic charting system) to "I " or resident focused care plans. It is easier and much easier to follow than the computer generated ones. If I can be of assist, please write back.

cj:yeah:

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Specializes in Gerontology, Med surg, Home Health.

There are no hard and fast rules about care planning. Each facility has its own take on the perfect way to write one and every surveyor has her own opinion about what makes a good care plan. As long as they are patient oriented with reasonable goals and a way to measure achieving those goals, you'll be okay.

We don't care plan everything. If you put diuretic therapy on the MDS, you'll trigger for potential for dehydration. Well, if the patient has taken the same 10 mg of Lasix for the past 20 years and has no problems, don't care plan it.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

LOVE 'EM. Always loved doing 'em once I figured out what was what with them. I started out doing them in LTC. I answer a lot of care plan questions for the students here on the allnurses forums. I think the reasons many people don't like doing them is:

  • they can be time-consuming because they are a documentation style
  • they don't know or understand what they are supposed to do in the first place with a care plan and rather than take the time to figure it out they just give up and say they hate doing them.

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We are just starting to use the I-format care plans in our VA-Medical Centers. Do you have any information, such as books or examples that we could use as resourses. I would help immensely since we are really meeting a lot of critism about the new change. Thanks, packerrn

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Specializes in MDS,ltc, resident focused care plans.

Packerm, if you can somehow be in contact with me, I can send you some I care plans.....of course you will meet resistance, it is something new!!!! Change is hard in the medical field, especially when you move away from the medical model of care planning.....haven't got a deficiency yet for care plans with the I format.

carol:chuckle

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Specializes in LTC, MDS, Education.

What is the difference between "medical model" and " I care" plans? :confused: Thanks in advance!

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Specializes in MDS,ltc, resident focused care plans.

Medical model care plans are for "diseases" or medical issues the resident may have, copd, dm, pvd, chf, etc. The "I" format care plan puts it into a story about the resident......I have dementia and copd.

I am not able to wash or dress myself as my forgetfulness doesn't allow me to care for myself and I become very winded when I do much activity wise.

I need help from the staff daily go wash and dress

then you add a goal such as I will wash my face when handed the face cloth and cued

then interventions.

Hand me the face cloth,

Cue me to wash my face.

Allow me rest periods during my morning and evening care.

on and on and on.......

I "weave" into the nutrition problem with other issues like diabetes, chf, potential for dehydration, etc......

Hope that helps you :smokin::yeah:

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carol20lpn, would love to get some ideas from you. I'm new to this allnurses.com, so how would I go about getting in contact with you? Believe me, I'm desparate, if I hear one more care plan that says "I will sleep for 15 hours a day" (funny in a way, but someone is being a smarty pants) I will scream. Thank you for your offer to help!

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Specializes in MDS,ltc, resident focused care plans.

I would love to help you out if I can......can you send me your e-mail address and I will forward to you some I care plans......you will not get stuck by the state or feds if you "tell a story"....so what if your resident wants to sleep 15 hours a day or have breakfast at noon....don't forget we are visitors in THEIR home so we need to do what they want.......

What state are you located in also? Would love to help you if I can. :chuckle

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Care planning is supposed to be based on the assessment of the patient not on their medical diagnoses. This is what Marjory Gordon (as in Gordon's 11 Functional Needs), the first President of NANDA, was lecturing about for years. Was anyone listening to her?

I am helping lost students on the student forums all the time because they don't get this concept.

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Specializes in MDS,ltc, resident focused care plans.

I hear what you are saying daytonite about care plans......I know nothing other than the "I" care plan process as the company I was with was doing them before PPS came into play. The company that I recently moved to was all electronic and everyones care plan was the same, they all had constipation, and a million other things that didn't allow you to imagine who that person really was.

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