Need help with careplan please

pmabraham, BSN, RN · May 27, 2013

Hi:

https://allnurses.com/attachment.php?attachmentid=9723&d=1325358352 is a PDF file for Nursing Diagnoses 2012 – 2014.

https://allnurses.com/nursing-student-assistance/student-resources-nursing-424826-page2.html#post6007291 might also be helpful.

Other sites that may be helpful are as follows:

Nursing Care Plan | Nursing Crib

Nursing Resources - Care Plans

I don't know enough about carescribble.com to comment on whether it is good or bad.

Thank you.

akulahawkRN, ADN, RN, EMT-P · May 27, 2013

Another potential issue formatting of your care plan. If it's a table as shown in the above links, those may be a time-saver. However, if the school requires you to use forms they designed, there could be a problem using the above care plans. You may spend more time copying and pasting than actually writing the care plan.

Nyde21 · May 28, 2013

Hello! Thank you so much for replying.

Yes, my school requires me to use "their" form.

What do I do now?

Is copying and pasting really that bad? lol

akulahawkRN, ADN, RN, EMT-P · May 28, 2013

There may be an issue with any copyrights and it's possible that your instructors may already be familiar enough with those sites that they'd spot a copy/paste job right away. Certainly those should be able to point you in the right direction and speed up some parts of writing the care plan. I've been at this a while and it only takes me about 2 - 3 hours total to do 2-3 care plans. Mostly it's because I saved my previous care plans and have a med list that I add to as I go along. It's the patho that takes the longest time as I sometimes have to look up an unfamiliar disease process.

Esme12, ASN, BSN, RN · May 28, 2013

Hello! Thank you so much for replying.
Yes, my school requires me to use "their" form.
What do I do now?
Is copying and pasting really that bad? lol

Yes it is....considering it is the recipe card on how to learn to care for you patient and what to look for first to ensure your patient is safe. Believe me when I say your instructors are quite familiar with these sites for your idea isn't original...we have instructors on this site as well. Copyright isn't the only issue but plagiarism will be as well....which is grounds for dismissal/academic dishonesty.

There are resources that you can buy to help you....I use Ackley: Nursing Diagnosis Handbook, 10th Edition and Gulanick: Nursing Care Plans as the both have very detailed care plan constructors with references. Get yourself the NANDA reference book.

I think you will find these books will ease your time crunch.

nurseprnRN, BSN, RN · May 28, 2013

Where is your nursing assessment of his condition? This is all medical diagnoses.

See, you are falling into the classic nursing student trap of trying desperately to find a nursing diagnosis for a medical diagnosis without really looking at your assignment as a nursing assignment. You are not being asked to find an auxiliary medical diagnosis-- nursing diagnoses are not dependent on medical ones. You are not being asked to supplement the medical plan of care-- you are being asked to develop your skills to determine a nursing plan of care. This is complementary but not dependent on the medical diagnosis or plan of care.

Sure, you have to know about the medical diagnosis and its implications for care, because you, the nurse, are legally obligated to implement some parts of the medical plan of care. Not all, of course-- you aren't responsible for lab, radiology, PT, dietary, or a host of other things.

You are responsible for some of those components of the medical plan of care but that is not all you are responsible for. You are responsible for looking at your patient as a person who requires nursing expertise, expertise in nursing care, a wholly different scientific field with a wholly separate body of knowledge about assessment and diagnosis and treatment in it. That's where nursing assessment and subsequent diagnosis and treatment plan comes in.

This is one of the hardest things for students to learn-- how to think like a nurse, and not like a physician appendage. Some people never do move beyond including things like "assess/monitor give meds and IVs as ordered," and they completely miss the point of nursing its own self. I know it's hard to wrap your head around when so much of what we have to know overlaps the medical diagnostic process and the medical treatment plan, and that's why nursing is so critically important to patients.

You wouldn't think much of a doc who came into the exam room on your first visit ever and announced, "You've got leukemia. We'll start you on chemo. Now, let's draw some blood." Facts first, diagnosis second, plan of care next. This works for medical assessment and diagnosis and plan of care, and for nursing assessment, diagnosis, and plan of care. Don't say, "This is the patient's medical diagnosis and I need a nursing diagnosis," it doesn't work like that.

There is no magic list of medical diagnoses from which you can derive nursing diagnoses. There is no one from column A, one from column B list out there. Nursing diagnosis does NOT result from medical diagnosis, period. This is one of the most difficult concepts for some nursing students to incorporate into their understanding of what nursing is, which is why I strive to think of multiple ways to say it. Yes, nursing is legally obligated to implement some aspects of the medical plan of care. (Other disciplines may implement other parts, like radiology, or therapy, or ...) That is not to say that everything nursing assesses, is, and does is part of the medical plan of care. It is not. That's where nursing dx comes in.

A nursing diagnosis statement translated into regular English goes something like this: "I think my patient has ____(nursing diagnosis)_____ . I know this because I see/assessed/found in the chart (as evidenced by) __(defining characteristics) ________________. He has this because he has ___(related factor(s))__."

"Related to" means "caused by," not something else. In many nursing diagnoses it is perfectly acceptable to use a medical diagnosis as a causative factor. For example, "acute pain" includes as related factors "Injury agents: e.g. (which means, "for example") biological, chemical, physical, psychological."

To make a nursing diagnosis, you must be able to demonstrate at least one "defining characteristic" and related factor. Defining characteristics and related factors for all approved nursing diagnoses are found in the NANDA-I 2012-2014 (current edition). $29 paperback, $23 for your Kindle at Amazon, free 2-day delivery for students. NEVER make an error about this again---and, as a bonus, be able to defend appropriate use of medical diagnoses as related factors to your faculty. Won't they be surprised!

If you do not have the NANDA-I 2012-2014, you are cheating yourself out of the best reference for this you could have. I don’t care if your faculty forgot to put it on the reading list. Get it now. When you get it out of the box, first put little sticky tabs on the sections:

1, health promotion (teaching, immunization....)

2, nutrition (ingestion, metabolism, hydration....)

3, elimination and exchange (this is where you'll find bowel, bladder, renal, pulmonary...)

4, activity and rest (sleep, activity/exercise, cardiovascular and pulmonary tolerance, self-care and neglect...)

5, perception and cognition (attention, orientation, cognition, communication...)

6, self-perception (hopelessness, loneliness, self-esteem, body image...)

7, role (family relationships, parenting, social interaction...)

8, sexuality (dysfunction, ineffective pattern, reproduction, childbearing process, maternal-fetal dyad...)

9, coping and stress (post-trauma responses, coping responses, anxiety, denial, grief, powerlessness, sorrow...)

10, life principles (hope, spiritual, decisional conflict, nonadherence...)

11, safety (this is where you'll find your wound stuff, shock, infection, tissue integrity, dry eye, positioning injury, SIDS, trauma, violence, self mutilization...)

12, comfort (physical, environmental, social...)

13, growth and development (disproportionate, delayed...)

Now, if you are ever again tempted to make a diagnosis first and cram facts into it second, at least go to the section where you think your diagnosis may lie and look at the table of contents at the beginning of it. Something look tempting? Look it up and see if the defining characteristics match your assessment findings. If so... there's a match. If not... keep looking. Eventually you will find it easier to do it the other way round, but this is as good a way as any to start getting familiar with THE reference for the professional nurse.

nurseprnRN, BSN, RN · May 28, 2013

I'm currently going to nursing school while having two full time jobs. I only get around 2-3 hours of sleep per night, but if I don't work, not only will i not be able to support myself, I won't be able to pay for nursing school. As you can see, my time is EXTREMELY limited.
Starting this Thursday, I will have 2 days (more like 2 hours in total), to create and complete a careplan. Last careplan I did, with the VERY little amount of time I have, took me close to 3 weeks to to do. This time around, our time offered is only 6 days of which I only have 2 days (2 hours really) for this careplan.
Are there any books, or any applications or any websites that can help me in creating a careplan in 2 hours flat?

Now, let's see here. You're in nursing school to learn to think like a nurse, and somebody gave you the idea that you can short-cut it like this? You'd be fine with a nurse like that taking care of your mom, your child, your lover?

See, care plans are not just busywork that your faculty assigns to irk you. They are exercises designed to guide you in learning how to think like a nurse, which is, as we all know, the biggest barrier students have to overcome in nursing education because it's like nothing they ever did before, all new ground, all unfamiliar. We know this because we regularly deal with students who are flunking their nursing exams because they just don't get it. And that is what they just don't get.

Your first one, they gave you three weeks. And now you're further along in your education, and six days isn't enough. Golly. Newsflash: When you graduate you'll be expected to be proficient enough to do them on the fly.

And you think you can just ... be a special snowflake and do it in two hours. If you know that much already, hey, great. But I sorta don't get that from what you wrote.

Ah, the mind boggles. I understand having to work, having been there, done that myself. But you can't be like that.

BrooklynRN11201 · May 30, 2013

sorry to tell you, but I actually LOVED care plans and my school required me to use their format as well... I don't think a single one took me any less than 8 hours. I can totally empathize with going to nursing school while working (what I've done for the past 4 years), but short cuts (ahem, cheating) is not going to get you very far. what good is getting a care plan done in 2 hours when you don't pass the exams or the NCLEX for your license?

the only actual advice I can give is to constantly gather data for your care plans as you go along... practice reading scenarios and think of the nursing diagnoses you'd assign for that patient - when you get used to doing this, it might take less time. I really like the NANDA book from Mosbys too - that helped me a lot.

trust me, I googled a bunch for info on my care plans and found very little that was appropriate for my patient. this stuff needs to come from YOU and you alone, sorry.

mchristensen5 · May 30, 2013

First, take a deep breath!!

I just finished my first year of nursing school and care plans were very hard for me at first. Then, one day I realized they were only hard because I was making them hard by over thinking them. Everyone tells you they are hard so they must be.....

I literally got to where I could do a care plan in under an hour by not over thinking it. I always got 100% on them as well. I use the book Nursing diagnosis manual isbn: 13:978-0-8036-2221-0

This book helped me a lot. start with the diagnosis then fill in the goals. Don't obsess over the medical dx, although it can be good when used as a r/t part of your dx. think more about what that medical dx does to the patient. This will help you come up with a nursing dx.

Hope this helps! Just breath and take a step back. Care plans are only as hard as you make them... :)