I just DO NOT understand care plans!!!!

[chnc1024, ASN]

I have an "A" average, and have been told by several instructors that I will be an wonderful nurse, so why is it that I can't do a care plan? I KNOW what my pts need, how to do it... everything that a care plan is "suppose" to be about, so why do I fail them? Ok I do know one reason, I'm an audio learner and my CI hasn't bothered to EXPLAIN what I'm supposed to do. I asked her the other day when she was going over one I had done. She telling me that what I was doing was wrong, so I asked "Ok, I'm not understanding what it is you are wanting from me. Could you please give me an example of what I could have written that would have been better so that I'll know what it is you are looking for?" and she replies "Use your book." How exactly is THAT going to help me? I did use my book! So I am wondering if any of you could give me some tips on how to do a proper care plan. I'm so fustrated it's rediculous.

Please help!

Chancie

[PEBBLES1]

Do you have a nursing dx book? If so, that's where your care plans come from. i.e if the pt has pneumonia. Look in the book for an airway problem like ineffective airway clearance, under that dx you will see the outcomes, interventions and so on. An intervention might be to cough and deep breath and an outcome might be the pt's pulse ox will be 97% on room. Hope this helps. Also check your medsurg books they also have careplans and interventions.

[Daytonite, BSN, RN]

here's a care plan in relation to something that has gone wrong with a car:

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

a care plan is merely writing down, after going through the nursing process (see above), the patient's problems and the strategies for doing something about them or even solving them. i think the problem some people have with the words "care plan" is that they have to sit down, pick up a pen or pencil and write out all this thinking that goes into it. writing is s-l-o-w compared to thinking.

i try to think of other professions to use as analogies as well. car mechanics and plumbers assess, diagnose and treat the same as doctors and we nurses do. police detectives do something similar, but the sequence they do it in is not the same. the process used, however is still there: assessment is used to gather facts; the facts are needed to prove the case.