Nursing care plans.. who uses them??

purplemania, BSN, RN · Jan 13, 2005

Probably not used in the same way as in school. The purpose of care plans is to teach you to make decisions using the nursing process. The care plan has you write down all the pertinent data to be considered. You learn what to eliminate and what to focus on and how to rationalize your decisions. All these steps will be used daily as a nurse, so the "practice" you get with care plans is not wasted. Good luck in school.

begalli · Jan 13, 2005

JCAHO standards require nursing plans of care for all hospitalized patients. A clinical pathway is a very common plan of care. Though we know what the plan of care is for patients, we don't need to look at the plan of care before delivering care to find out what our goals are and what we should be doing.

Like the previous poster stated, care plans in school and in the real world are two different things. Writing care plans in nursing school contributes to developing the nursing process of critical thinking. In the real world we are constantly implementing a plan of care ...assessing, planning, implementing, and evaluating...constantly. Our required careplans are computerized and are updated every 24 hours.

Also, plans of care under JCAHO standards not only include nursing but also include PT, dietary, etc.

meownsmile, BSN, RN · Jan 13, 2005

Our care plans are computerized and easy to activate. We do have to address the plan of care in our E note at the end of shift. But as far as going to the care plan or reevaluating the care plan during the course of a patients stay its not done very often. We just continue to evaluate.

leslie :-D · Jan 13, 2005

as others have stated, care plans are assistive tools that are a major focus in school as it teaches you to think like a nurse...

assessment, diagnosing, planning, implementing and evaluation. these steps will be the foundation of what makes you a nurse. it is much more literal in school but very very necessary, imo.

by the time you become a nurse, you'll be thinking on automatic pilot when it comes to working with each pt.

just think of it more as preparatory in developing and mastering critical thinking skills.

much luck to you.

leslie

Tweety, BSN, RN · Jan 13, 2005

It's the hallmark of a profressional RN, "care planning, implementation, evaluation....".

We do it, but not in the way you do it in school. We have "standards of care" and we simply check off which one we are going to implement. When we check it off, we are saying that we are performing that particular care plan.

Put simply, it's what we do every day, we just don't think about it, or sit down and write out care plans. But in a round about way we are doing it.

I hated nursing diagnosises and care plans with a passion when I was in school. Good luck.

allnurses Guide · Jan 13, 2005

:chair: Not me ...

When a patient is first admitted you head on over to the computer and spit a care plan out for "COPD", punch holes in it, place it in the chart under "CARE PLAN" and forget about it. :rolleyes:

No one I know even looks at it again. We don't chart to the care plan. LTC must chart to the care plan - I work acute. So, no I don't use the care plan.

I can sorta see how it helps you learn to be a nurse while in school but after that . . .

By the way, I truly hated care plans in school. I am sure they were dreamed up by some PhD nurse who hasn't been to the bedside since 1952.

steph

Tweety, BSN, RN · Jan 13, 2005

:chair: Not me ...
When a patient is first admitted you head on over to the computer and spit a care plan out for "COPD", punch holes in it, place it in the chart under "CARE PLAN" and forget about it.
steph

This is oh so the true reality.

However, do you know how to care for a patient with COPD? If you do then aren't you really in the back of your mind following some sort of plan of care. That's kind of what I was saying. You focus you assessment and care on the patient, their illness, their culture, or whatever. You're following care plans without realizes it. In nursing school they have to define what you are doing, in real life you don't because you just do it.

allnurses Guide · Jan 13, 2005

This is oh so the true reality.
However, do you know how to care for a patient with COPD? If you do then aren't you really in the back of your mind following some sort of plan of care. That's kind of what I was saying. You focus you assessment and care on the patient, their illness, their culture, or whatever. You're following care plans without realizes it. In nursing school they have to define what you are doing, in real life you don't because you just do it.

That is true. I do know how to care for a COPD patient. I guess because of that it sticks in my craw to get a little note "you forgot to include the care plan". No one is afraid I forgot to care for the patient. They are (justly) afraid that jhaco will write the hospital up and cost them $$$ for a piece of paper rather than looking at the actual care the patient received.

steph

NP2BE · Jan 13, 2005

care plans, which have to be filled out by RN's, inusre us our jobs, of course they are stupid and no one looks at them and it is automatic how to take care of a COPD pt when you are in practice, but its good for nursing that RN's have to do them and not CNA's etc etc

Just my .02

allnurses Guide · Jan 13, 2005

Filled out? You have to fill them out? :rotfl:

Actually we have 3 big binders full of pre-printed care plans. I love it. Then we have the computer program where you actually have to pick stuff out related to your patient. I hate it.

I usually go for the big binders. All I add is the date and patient's info on a pre-printed sticker.

steph

begalli · Jan 13, 2005

Are you all really NOT required to update your careplans daily?

Ours are very simple. In the computer we have dozens and dozens of careplans. We just click on the one we need, for example CABG. It includes pretty much everything that a routine post-op cabg requires. We can add additional problems if we want to like if a person needs restraints, has skin issues other than the incisions, etc.

It takes a total of 4 clicks on the keyboard (after signing in) to update the plan of care nightly. JCAHO's happy and the hospital is in compliance.

We can't be the only ones doing this!?!