Help needed for CNA careplan. Thanks

Daytonite, BSN, RN · Jun 7, 2006

I'm assuming you are meaning the lady is in labor and not actually delivering the baby. I think the biggest problems you will want to list will be pain/discomfort, perhaps anxiety and safety. This is just my thinking on this. Perhaps it will give you some other ideas. With a care plan you want to list the problems the patient has or might have on the left and the nursing actions you can/should take on the right side across from the problem. I can't imagine that you would be expected to develop goals, but just in case, I've listed very simple ones. Hope you find these helpful.

Anxiety

Goal: Patient will appear relaxed

Introduce yourself and assure patient you will be there to answer her call light
Orient her to the room, use of the bed, TV, call light, visitor rules, etc.
Allow the patient the opportunity to talk to you about her fears and concerns
Encourage patient to walk, watch TV, read, or other activities to keep her occupied
Reassure her and her family, hold her hand if necessary
Report any concerns you have about the patient's fear and concerns to the nurse in charge
Encourage patient to demonstrate breathing techniques she learned in pre-birthing classes
Help to maintain patient's privacy during examinations by making sure she is not exposed

Safety (some of these are specifically to prevent the patient from getting an infection)

Goal: Patient will be free of injury or infection

Remind patient to move slowly
Keep side rails up if patient has been given pain medication
Wash your hands before and after contact with patients perineal pad
Give/assist patient with aseptic perineal care after urinating or defecating
Monitor vital signs per policy
Assist patient with IV lines when ambulating
Give cleansing enema if ordered
Prepare patient for safe transfer to the delivery room

Pain/Discomfort

Goal: Patient will be comfortable

Change perineal pads as necessary
Change linens if they become soiled or wet
Have patient attempt to empty bladder at least every 2 hours
Measure and record intake and output
Provide clear fluids (juice, broth, Popsicles, jello, ice chips) if permitted
Give/assist patient with mouth care
Assist with back and leg rubs
Assist with showering
Have patient pant and blow out if she feels sudden urge to push and notify RN
Keep lights of room low
Keep environment of labor room quiet

Bumashes, MSN, APRN, NP · Jun 7, 2006

Wow! Thanks a bunch! Some of these I was thinking but wasn't sure if I should write them down. Like I said, I've never even seen care plans before. Thanks again, you're a lifesaver!

RN and Mommy · Jun 9, 2006

Hi, I'm just finishing up a CNA course, and the last thing we're required to do is pick a pt from our clinicals to do a basic care plan on. Very basic. I've never even seen one before, though, so I was wondering if anyone had some suggestions. The pt I picked was in L&D for (duh) delivery. Her diagnosis said "delivery," so what kinds of things could I put down as CNA things to do. Maybe: Theraputic talking session, bring ice/snacks, Vitals q4 hrs, etc. I need a couple more. They only have to be very basic things as you can see. Thanks for any help you can give.

Wow, this seems kinda silly to me as CNA's do not do careplanning.

Bumashes, MSN, APRN, NP · Jun 9, 2006

Wow this seems kinda silly to me as CNA's do not do careplanning.[/quote']
I know. Our teacher just wants to familiarize us with what one looks like and contains because most of us are progressing towards a nursing degree. Sorry for the silliness.

BabyRN2Be · Jun 9, 2006

I don't know if I'd consider a CNA doing a careplan silly. If the CNA is going on to be an RN, I believe it would be very helpful just to see what one looks like, and to get a feel of what you'll be doing. It will give you a chance to think through things.

I think that this is a great opportunity for a CNA on their way to be an RN, wish I had the chance to do that.

However, if the CNA does not plan on going to nursing school, well, I don't know if that's exactly necessary.

This is just my humble opinion. :)

RN and Mommy · Jun 10, 2006

Being that I just finished nursing school, I think they do a more than sufficient job teaching careplanning there. I agree, that it is good to be thinking about what you (as a CNA) can do for the patients, but to have to write a careplan, I think that's silly. I know it's just an assignment, and this is only my opinion. Take it for what you like. Why not teach the CNA's how to give injections or something, because they will be doing that as a RN also. I think RN tasks should be taught in NURSING SCHOOL, not a CNA course.

Daytonite, BSN, RN · Jun 10, 2006

There was a time, and it may still be in many places, where the nursing care plan was available for all on the nursing staff, including the nursing assistants, to be able to see. It was their direction as to what they were to be doing with the patients. Care plans always were meant to be usable, functional tools for the nursing team. I see nothing wrong with an instructor of a CNA program encouraging the students to "think" about and, as an exercise, write a list of the care they should be giving to patients. How else will they know if they are being told to do something that is off the wall? I might not make a big deal about calling it a care plan and I certainly would make it clear that only RNs can write the official care plans that become part of the permanent chart. But again, I have to tell you that back in the day I was learning nursing it was perfectly acceptable for an aide to add to the nursing care plan any nursing interventions that they found worked with a particular patient. It was up to the RNs to review the care plans and approve or disapprove of the things written on it. Besides, I'll take a CNA who is thinking about what he/she is doing with patients any day over one who merely waits for every single instruction and is capable of doing only what he/she is told and nothing more.

Bumashes, MSN, APRN, NP · Jun 10, 2006

Being that I just finished nursing school I think they do a more than sufficient job teaching careplanning there. I agree, that it is good to be thinking about what you (as a CNA) can do for the patients, but to have to write a careplan, I think that's silly. I know it's just an assignment, and this is only my opinion. Take it for what you like. Why not teach the CNA's how to give injections or something, because they will be doing that as a RN also. I think RN tasks should be taught in NURSING SCHOOL, not a CNA course.[/quote']
Sheesh! I realize this is your opinion (which is fine), but try not to be so defensive over such a tiny thing. Just don't post if you don't have anything positive or helpful to add. I ask for help and I get criticized? Anyway. It's NOT a NURSING careplan we're writing. We are only listing some things we might do as CNA's to help the patient recover safely. My instructor just happened to mention that if we are going into nursing (many of us are) then we should be aware that we will be taught how to create a more in-depth and comprehensive nursing careplan while training to become nurses. What we're doing in my CNA class is more like an open ended question assignment. "Choose a patient from your clinicals and write what you should be doing to provide proper care for them." Try not to read so much into this. She's not teaching us useless stuff that only nurses can do, we're just recalling things that should be done for patients by us. I guess the "nurses eat their young" stage starts very early where you're from. Please don't discourage; just encourage. We know what we can and can't do, and there's nothing wrong with the instructor informing us about what could come in the future training we might partake of. Thanks to everyone else who is being helpful. I really appreciate it, and I can't wait to start nursing school!

VickyRN, MSN, DNP, RN · Jun 10, 2006

moderator's note:

please keep to the op's topic at hand and avoid unnecessary negative opinions or inflammatory statements. thank you.

RN and Mommy · Jun 12, 2006

I am sorry if I offended anyone, that was not my intention. I guess the lecture I had this past semester on delegation is still fresh in my mind. I'm sorry :imbar

smk1, LPN · Jun 12, 2006

Hi, I'm just finishing up a CNA course, and the last thing we're required to do is pick a pt from our clinicals to do a basic care plan on. Very basic. This is not a nursing careplan. It's more like listing things that the CNA should do for the patient. I've never even seen a careplan or anything close to it before, though, so I was wondering if anyone had some suggestions. The pt I picked was in L&D. Her diagnosis said "delivery," so what kinds of things could I put down as CNA things to do. Maybe: Theraputic talking session, bring ice/snacks, vitals q4 hrs, etc. I need a couple more. They only have to be very basic things as you can see. Thanks for any help you can give.

Are these interventions supposed to be ones that the CNA can initiate and implement on his/her own? I can't think of anything that would seem appropriate for the CNA to write because pretty much everything that the CNA does is going to be nurse directed/ordered, so writing a plan of care seems kind of ridiculous when their plan of care really is going to come from an RN as will the interventions. A better use of time in that class would be showing the CNA's actual nursing care plans so they can become familiar with things they will actually be working with. I 'm a bit confused as to what the instructor is expecting...