No more careplans!

Nursing Students General Students

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Just wanted to make you all jealous. :rolleyes:

NCLEX writers came to our school Monday and had a workshop with the teachers. Apparently, they told our teachers that they shouldn't be worrying so much about making us write careplans. So, today our teacher told us that next semester (our last) we will not have to do any. You should have seen everyone in our class. Woo-hoo.

I understand the importance of careplans but who really does them in the real world? And, besides, you learn your interventions in theory class. I thought I was going to die this semester. It would take me about 6-7 hours doing all that darn paperwork...on ONE patient!

Specializes in Geriatrics, DD, Peri-op.

I knew this thread was going to get some replies. :) :rotfl:

You will be doing careplans the rest of your life, if you are a nurse..........

In the nursing home, the only RN that does careplans is the ones that work on MDS's. In the hospital that I used to work at, we had a pre-printed careplan. For example, we had a patient admitted with a foley...ok print up that risk for infection. The hospital that I have done clinicals...nope. Careplans come on the computer automatically based on your assessment.

I'm not seeing where the average RN is having to write out careplans....but, maybe it's different down here. :rolleyes:

I understand the concept of the careplan. It's to get you thinking about how you should help your patient. I have NO problem with that. But, the stress of having to spend hours on a careplan...tweaking everything...making sure you have everything worded just right....well, I'm sorry, but, I can do without that.

Maybe it's also because I'm an LPN and have a good idea what to do already.

Anyway, flame away.... :chuckle

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Specializes in Geriatrics, DD, Peri-op.

nrse2b2005, you wrote exactly what I was trying to say. Read the book ahead of time? Who in the hell has time for that?

My last instructor wondered why we couldn't get our careplans done before 2am. We all laughed.

Here is an example of how she wanted our interventions worded:

"SN will turn client every 2 hours at 1600 and 1800 during SN's shift on 4/27/05 by verbal prompt and manual assistance."

If you left any part of who, what, when, or how out...she counted off.

Another instructor was fine with:

"Turn q 2 hours"

That particular instructor told us that since we were in our second year...we should already know who is doing what to whom. We all agreed with her. :rotfl:

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Specializes in Neuro/Med-Surg/Oncology.

I thought I was done too. I am done with school in two days. I was with my mentor and they do care plans on all new admissions. No such luck having the computer generate it for me. They are a really modern metropolitan hospital too. Was it the 30+ page assessment tools we had to do? No. It was two pages. As much as I hate to take the time to do them. I find it really beneficial to layout an overview of the patient's hospital stay. There are some diagnoses that we don't see too often and others that we see all the time. I find that the care plans put all of the different divisions of patient care on the same wavelength.

That being said, I was a little disgruntled that they assigned us one of the above mentioned assessment tools from h*** our last semester. They crammed sixteen weeks of content into ten and threw two of those in for good measure. I'm sorry. If we didn't know how to do those by our last semester, they're too late.

I definitely feel for you being glad to see the sleepless nights go, but they are a good learning tool while in school. (Even if you don't use them where you wind up working.)

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Maybe I am odd? However, I think they are doing you a great disservice by taking away this aspect of your schooling. I work in med-surg in my local hospital and all our charting, and careplans are done in the computer. Believe me, you need to be able to prioritize and intervene when needed. Careplans did come easy for me and I was always told I was lucky because my first semester of nursing school, I had the "hardest" clinical instructor. Hey though I saw here at a fair last week and she hugged me. I haven't been an RN for a year yet, and I have already been asked to be an instructor. Hard work and knowledge sure do pay off. Hey, even though you don't have to do them, practice. Remember if you don't use it, you lose it!!! Good luck with school.( BTW I am not being rude or mean, just giving you differentview.) YOU CAN DO IT!oh and this is what i had to write:

Patient will be turned every two hours on the even hours starting at 0600 this am, beginning with the first turn to window, then back, then right side, to decrease pressure and allow for no further skin breakdown. ( now I just say turn q 2 hours - whew!!1)

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Could you send them to New York, to explain this.

My professors say the same thing, but they have to teach and make us do them so at least we'll know how. Personally, I HATE doing them.

Where ever you will end up working, you will be doing careplans. Just becasue they may not be on the NCLEX exam doesn't mean that they won't be around. They are a vital part of how you plan care for you patient.....

whether you are on a med/surg floor, and ICU, an ER, or even the OR....

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Specializes in Med Surg/Tele/ER.

I don't really look foward to doing careplans but I really do learn from them. It's kinda like a puzzle for me & I sure am happy when all the parts fit together!! I am a little confused though, I have always gotten 98-100% on my careplans & was told that I had the process down pat then............ I get a different instructor & she has a completely different idea on how careplans should be done is this just part of nursing school??? Has anyone else run into this problem??? Now I'm not sure which way to go :uhoh3:

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I see that you are highly educated. Do you recall a time when you spent several hours developing careplans for your patients, only to have to redo them to the specification of that particular instructor's criteria?

I live this everytime I get a different clinical instructor. Though I understand the rationale for developing my own careplans (aids in critical thinking, prioritization and planning for future nursing), the fact that in the real world of nursing, careplans come in checkoff boxes and take 10 well-thought out minutes to complete just makes me bitter at this point. I am in the last weeks of third semester and am resentful at the time this takes away from my lecture readings, which do factor more into my future outcome as a nurse. I too wish they would do away with careplans after the second semester. Perhaps a quota of fifty would suffice--who knows?

Never had a problem with them not being accepted.......sorry that you are.

Careplans exist in all facilities, and are actually getting more detailed. This is per JCAHO, not up to just the hospital. All areas use them in some form or another.............wher eI am workin gnoiw, we are required to update it on a daily basis, and this is by each shift.........it actually is quite helpful, if you use them properly. We also have the other depts using the same document, from PT and OR, dietician, case managers, etc. So they can be very useful if used properly and correctly.........

And if you are third semester, it should not be taking you hours to get it done. You should already have alot of the info in your head......

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Specializes in Geriatrics, DD, Peri-op.
And if you are third semester, it should not be taking you hours to get it done. You should already have alot of the info in your head......

Wow. So, what are you saying?

How long's it been since you were in school? I don't think you understand that there is a BIG difference between careplans you do for school and careplans you do for work.

Did you read my post? I have NEVER seen RNs have to spend that much time on careplans...unless they were in a dept like MDS.

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I never spent hours on one careplan...............never did and never will.

They give you a base on what to focus on...........and what to look for. Clinical time has gotten much shorter in the programs from when I attended and they give you a structure on what to base your care. Some hospitals use computer generated, others you have to manually write out.............

But at this point, you should have enough info in your head so that it doesn't take you so long............

Look at it the other way, you may no longer have care plan type questions on NCLEX, but you still need to know what to do for a certain disease and what its priority is in carrying for the patient................and that isn't busy work.............

Sorry if you do not like my answer but I have a 100% pass rate going with all of my students in taking NCLEX exam, and for most, English is not their primary language. So, if I can get them to pass the first time and am offering suggestions to you, don't look a gift-horse in the face........ :uhoh21:

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Specializes in Geriatrics, DD, Peri-op.

I'm sorry if I came off rude. It's hard to type at times without doing that.

I really think that careplans are a good thing. Like you (and others) said, it gets you thinking about what you need to do for your patient. However, I can promise you that it is not that I do not know what I am doing with my careplans. It takes me hours because I have pages to do. My last one was about 20 pages long.

Maybe I didn't make it clear about what all we had to do. We have a prep-sheet with basic info/etiology/pathophysiology/signs and symptoms...etc. That's the first 2 pages. Then, we have a psychosocial form that is 3 pages long. Then, we have our assessment that is 3 pages long. Labs..1 page. Our "careplan": 2 nursing diagnosis, 6 interventions, 6 rationales, 6 evaluations...4 pages. And, then there's the meds. We were not allowed to use drug cards. We had to rewrite all of our patient's meds each time. I had 6 pages usually, including PRNs. To make a long story-short...I think I wrote about 30,000 words with just that paperwork.

So, if it were just a small prep-sheet and an actual "careplan"...that may not be so bad. But, damn....20 pages? For one patient? Do you see why we are all happy we don't have to do that anymore and why we had to stay up half the night? Do you see why the NCLEX writers were asking the instructors why they were making us do so much paperwork? Ughh! :uhoh21:

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Specializes in Geriatrics, DD, Peri-op.

So, when I said careplan...I meant all that paperwork. :chuckle

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twenty pages for a careplan is utterly ridiculous.........mine were never more than 6 pages. Can see why you don't want them, but it sounds like it has more to do with your instructors than anything else......Sorry that you are going thru that..........that definitely isn't the way that I teach and never would.

Disease processes, yes....twenty page careplan, no way..........I would have to read each one, or do they just weigh them???

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