Does anyone really use the care plan?

[psalm_55]

over the years and in different hospitals, i have never seen anyone really use care plans. they are just a required (non-functional) form placed on the chart to satisfy accrediting agencies.

like nursing diagnoses, they are fine as a learning tool (i suppose), but do they make us any better at what we do? (personally, i think the days of nursing dx and careplans have come and gone). when i went to school, i learned how to care for 'hepatic encephalopathy' or 'pneumonia' not 'fluid volume excess' or 'ineffective airway clearance'.

nursing diagnoses leave gaps -- or at best one has to peruse thru a long list of interventions and select only the ones that apply to this particular patient -- for example, the patient who is SOB -- where is "elevate the HOB"? or, what about the patient with hyperkalemia -- or any electroylyte imbalance for that matter?

so, does anyone really use the care plan? or is there a better way?

[Mags4711, RN]

I'll admit it, I have always wondered that as well.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

We pull out care plans from a drawer, stamp them, and either add what needs to be added, or cross out whatever isn't pertinent. Then each nurse initials them every shift. But no, they are never read after the admitting nurse puts them into the chart. I never saw any nurse actually read them.

[workingforskies]

We use them all the time. (By "all the time", I mean that magical 1 month period every 2 years when J.A.C.H.O. is expected.) :roll

[Joni's Mom]

Is the care plan information on the NCLEX exam? Just wondering, because I too think it is very time consuming :typing when we as students can be learning other skills.

[Luv2BAnurse]

We are mandated to have one on the patient's chart. I think that we do use them, but it is almost subconscious. As a student, we all had to seriously think our way through an assessment...neuro...we didn't just go in a room and talk to the patient, we would ask what day/time/etc it is...much the same way we can assess now without totally thinking each and every body system...we use the careplan as an identified problem and interventions to help overcome these problems. At least that's what I think to avoid going crazy over excess charting

[buildingmyfaith57]

if you don't read the care plan how are suppose to know whats the needs are and whats best for the residents or clients?

[GooeyRN, ADN, BSN, CNA, LPN, RN]

if you don't read the care plan how are suppose to know whats the needs are and whats best for the residents or clients?

Our care plans are generic, the same for every pt. If you read them once, it doesn't help to read them everyday. If you have a pt. with say, COPD, we grab a care plan for Ineffective airway clearance, one for Altered Gas exchange, one for having an IV(just about everyone gets one of those), and usually a risk for impaired skin integrity (just about everyone gets one of those). If something on the careplan isn't pertinent to the pt. it gets crossed off. We don't read them since you already know from nursing school that you want to check the pulse ox frequently, apply O2 2Lvia N/C if needed, cough, deep breath, orthopneic position for SOB, etc. So they just get stamped and stuffed in the chart, then we initial them q shift to say the care plan was "reviewed". Everyone there knows they are a waste of time and tree's, but it is a requirement so we do them.

[SouthernLPN2RN, MSN, RN, APRN, NP]

We have a preset list that we use. All of our pts get the same 10 plans done. All medications must be on a careplan somewhere. I don't know of anyone who uses them.

[burn out]

We use care plans daily because they are computor generated for each patient and we use them to receive report with. All teh orders are put in the computor then that is made into a care plan for the patient. Even if we didn't have them when I look at the care I give a patient , everything I do and know to do comes from the knowledge I gained in writing patient care plans as a student. They may not be written down but I think they are burned in our brains from school.

[buildingmyfaith57]

why do you think im getting my cna pulled? here in wisconsin if we're not going by the care plan,and something goes wrong we're out of there. why do you think im being reported to state?

[newnurse51]

We have to create a care plan for each new admission we get. After that I don't think any nurse looks at them. We basically know the nursing care that is needed with each diagnosis- I hated them in school but I can see why they were important. They are rarely looked at once you graduate and are working in the real world.