Care plans- student nursing

kittyw · Sep 15, 2002

ONE PER SEMESTER!!!! :eek:

We had to do one for EVERY patient and they had to be done BEFORE we saw the patient (except for the evaluation.) We would go to the hospital around 6-8pm (depending on the hospitals shift chg) and write the info down from the chart - standing up outside the room in the nurses way. Then we would have until 6am to complete the careplan.... NO SLEEP!!!

ok..... I'm over the inital shock that some schools don't require you to go through careplan he11 .... whew...... :)

We have to do the pathophys down to the cellular level, explain how the drugs work at the cellular level, why this drug is given to this particular patient (can't say it's a standard pain killer given to a post-op patient), explain each system (7), explain non-pharm interventions to cellular level, come up with a pharm intervention is there is none ...... and on and on and on....... Needless to say, the nice little careplan in the pt's chart did not even come close to what we had to do.

Mine were usually 20-25 pages in length.... and I'd write this in under 13 hours & try to catch some sleep while I was at it.

No more careplans!No more careplans!No more careplans!No more careplans!No more careplans!No more careplans! :D:D

No more careplans!

Ortho_RN · Sep 15, 2002

Originally posted by Vsummer1
We have one care plan to do this semester. We haven't got to the clinicals site yet, so that is coming later. One of the students who had this class said to look at the patients chart -- there is already a care plan in it. You just need to jot down what the care plan is. ---------- what am I missing in this thread when everyone says they are so hard? Please be nice in replies, this is a serious question -------

Many hospitals use "generic" care plans... The same plan for every person... But in nursing school they want "individualized" care plans... You may use those to get you started but they probably won't be everything you need... And as far as them being hard... My personal opinion is that they aren't hard, its more of they are VERY time consuming and take ALOT of critical thinking...

Mkue · Sep 15, 2002

Originally posted by kittyw
ONE PER SEMESTER!!!!

We had to do one for EVERY patient and they had to be done BEFORE we saw the patient (except for the evaluation.) We would go to the hospital around 6-8pm (depending on the hospitals shift chg) and write the info down from the chart - standing up outside the room in the nurses way. Then we would have until 6am to complete the careplan.... NO SLEEP!!!

ok..... I'm over the inital shock that some schools don't require you to go through careplan he11 .... whew...... :)

We have to do the pathophys down to the cellular level, explain how the drugs work at the cellular level, why this drug is given to this particular patient (can't say it's a standard pain killer given to a post-op patient), explain each system (7), explain non-pharm interventions to cellular level, come up with a pharm intervention is there is none ...... and on and on and on....... Needless to say, the nice little careplan in the pt's chart did not even come close to what we had to do.

Mine were usually 20-25 pages in length.... and I'd write this in under 13 hours & try to catch some sleep while I was at it.

No more careplans!No more careplans!No more careplans!No more careplans!No more careplans!No more careplans! :D:D

No more careplans!

Kittyw, thanks for that explanation!

Mkue · Sep 15, 2002

Originally posted by nurs2b

Many hospitals use "generic" care plans... The same plan for every person... But in nursing school they want "individualized" care plans... You may use those to get you started but they probably won't be everything you need... And as far as them being hard... My personal opinion is that they aren't hard, its more of they are VERY time consuming and take ALOT of critical thinking...

I hope to really enjoy doing them as I like to pick things apart and I like being challenged with all the critical thinking aspect..lol..

Next Thursday I get my patient, can't wait.

I'm sure in a few months I will be complaining about how time consuming they are .. thanks :cool:

Vsummer1 · Sep 15, 2002

OOOPSS MY BAD!!!!

I just looked this up, and it seems I WAS WRONG! We have to do 3 care plans... one Geriatric and two Acute Care Medical/Surgical. The first is due on 10/11 and they have not even gone over ADPIE yet, much less anything to do with care plans or nursing diagnosis.

Since I did these before in my class in AZ, I remember them as being time consuming but you could copy most of the stuff from the books or care plan sites and just type it up. I specifically asked during orientation here in CA on the topic of plagiarism if care plans were included in the no-plagiarism rule, and they said no they weren't because they are standardized. I would have to just get the info relevant to my patient.

In AZ we had to do a detailed patient assessment on each patient which would detail all the relevant dx and tx (the whys and hows) and how we planned to manage their care that day. We would be given the assignment the day before and have enough time to right their info then go home and write up the plan of care. But I am not sure if this is a "care plan" per se since I seem to remember that was a different animal. The care plan was typed up while the one on each patient was handwritten on forms they provided.

kittyw · Sep 15, 2002

Originally posted by Vsummer1
I specifically asked during orientation here in CA on the topic of plagiarism if care plans were included in the no-plagiarism rule, and they said no they weren't because they are standardized.

We had to use APA format ... had to quote/cite our sources and have a list of references page.

Just curious, what do you mean by "they are standardized" - the basic form you fill out or your plan for that patient? :confused:

Kitty (out of careplan he11, but in test overload)

MelH · Sep 15, 2002

HEY KITYW..POST SOME IDEAS...I NEED ALL THE HELP I CAN GET! THANKS!

Vsummer1 · Sep 15, 2002

Originally posted by kittyw

We had to use APA format ... had to quote/cite our sources and have a list of references page.

Just curious, what do you mean by "they are standardized" - the basic form you fill out or your plan for that patient?

Kitty (out of careplan he11, but in test overload)

By standardized I mean we have a diagnosis of something. We look up the care plan for that diagnosis in our patients chart, care plan book / on line site etc. Nursing diagnosis / interventions / expectations etc are pre-written (standardized).

We just pick the interventions for that diagnosis for our particular client. "Check the boxes that apply" type things I have found online, while the books tell you exactly what nursing diagnosis go with what medical diagnosis. I would then just extract whatever standard nursing diagnosis I needed, along with the related expectations, interventions etc. based on the information that I pulled from the patients chart and type it up.

I guess what I am trying to say is it isn't as if I am making anything up. I am merely copying the standards that apply to my patient based on their condition and medical diagnosis.

LOL, ASK ME AFTER I DO MY FIRST ONE AT THIS SCHOOL. As I said, that was how we did it from my school in AZ. Perhaps this program doesn't do it that way, but was why I specifically asked about plagiarism re: care plans. Why go through all that when you can cut and paste? Just edit out the stuff that doesn't apply to your patient.

Mkue · Sep 15, 2002

Originally posted by MelH
HEY KITYW..POST SOME IDEAS...I NEED ALL THE HELP I CAN GET! THANKS!

Good idea MelH:)

Mkue · Sep 15, 2002

Originally posted by Vsummer1

By standardized I mean we have a diagnosis of something. We look up the care plan for that diagnosis in our patients chart, care plan book / on line site etc. Nursing diagnosis / interventions / expectations etc are pre-written (standardized).

We just pick the interventions for that diagnosis for our particular client. "Check the boxes that apply" type things I have found online, while the books tell you exactly what nursing diagnosis go with what medical diagnosis. I would then just extract whatever standard nursing diagnosis I needed, along with the related expectations, interventions etc. based on the information that I pulled from the patients chart and type it up.

I guess what I am trying to say is it isn't as if I am making anything up. I am merely copying the standards that apply to my patient based on their condition and medical diagnosis.

LOL, ASK ME AFTER I DO MY FIRST ONE AT THIS SCHOOL. As I said, that was how we did it from my school in AZ. Perhaps this program doesn't do it that way, but was why I specifically asked about plagiarism re: care plans. Why go through all that when you can cut and paste? Just edit out the stuff that doesn't apply to your patient.

cut and paste sounds good to me !!:)

kittyw · Sep 15, 2002

Here's a sample from one of my peds patients (she was such a sweet little girl) ... just the info for one system and one intervention .... I didn't include the background patho, ECO, goals, & the other interventions I wrote up.....

At risk for alteration in cardiac output: decreased r/t incompetent aortic valve secondary to Cornelia De Lange Syndrome s/s loud S2, fatigue, capillary refill > 3 sec., cyanosis, cool skin temperature, and decreased blood pressure.

Cornelia de Lange syndrome is a genetic abnormality that involves anomalies in the cardio-vascular system. An incompetent aortic valve forces the heat to pump and repump the same blood because the valve does not close properly and blood backflows. Inadequate emptying of the ventricles results in increased pressure in the cardiac chambers, which leads to decreased pulmonary and systemic venous return and subsequent vascular congestion. To compensate for decreased cardiac output, there is an increase in sympathetic nervous system activity, ventricular dilation to accommodate the increased volume of blood remaining in the ventricles, stimulation of renin-angiotensin-aldosterone output and ADH release, and eventual ventricular hypertrophy. These compensatory mechanisms temporarily aid in maintaining an adequate cardiac output but eventually have a deleterious effect on the heart. (Marieb)

Intervention 1.) The nurse will promote a calm, quiet environment. Rationale: Stress causes a higher output of glucocorticoid hormone - cortisol. Cortisol promotes Na+ and water retention and potentates the actions of epinephedrine. Epinephedrine can over stimulate the beta1 receptors causing and increase in heart rate and contractility thus increasing the workload of the heart. The increase in Na+ and water also increases the workload of the heart by providing an increase in SVR that the heart has to pump against. (Moore)

I do agree ... cut & paste is one of the best features of the computer!!!

REDEEMED · Sep 15, 2002

Originally posted by kittyw
I HATE care plans!! :) I think this year we're focusing on SOAPs instead.... wooo hooo We had a "burn your careplans" bon fire at the end of last year! (Just shows ya the feeling is mutual!) But, if anyone needs any suggestions I still have mine on the computer .... not getting rid of until I'm out!