30+ page care plans

[Boog'sCRRN246]

Just curious...

I've read several threads where students mention having to write 30 page (or more!) care plans for every clinical. I've gone through LPN school and I'm eight weeks away from finishing RN school...and I've never had to write a care plan that even comes close to being that long I guess I'm just wondering, what in the world is in 30+ page care plan??

[~PedsRN~, BSN, RN]

We have a nifty little "patient data sheet" that we fill out. We are expected to have all pertinent patient information including labs, diagnostic procedures, medical diagnosis, surgeries, drugs, etc in some sort of form for pre conference every week. DUE every week we have a focus (LAME), concept map (dumber than care plans), and a problem list. Even back in the good old days of Fundamentals our care plans were 2 pages. LOL! I seriously can't even fathom one that is longer.

We wrote a 15 page *paper* in pediatrics... which sounds more like what you are describing!!! It included a two page care plan. LOL!!!

[singingtothewheat]

Ok, well this was ummm, like 22 years ago but as I remember it....

We had to write a complete care plan on every major diagnosis

We had to write out every single medication, understand fully, any side effects, possible interactions with other meds as well as medical condition.

We had to fill out a complete assessment from head to toe and that included psychosocial and spiritual as well as social

We had to know every single lab level, what the parameters were and be able to explain why these were potentially not within normal limits.

Wow, 22 years is a long time ago. I know there was more than this. Yea, they were like 30 pages and we had several of them every week and then we had several hundred pages of reading to do.

When I was doing some clinical instruction I was stunned that the care plans were as easy as they were and that the students complained as much as they did and put so little into completing them correctly. Almost every mistake was nothing more than NOT READING THE INSTRUCTIONS. lol.

[livin on a prayer]

The care plans we do at our school are at least 20 pages long. We include a database, patho page, all of the meds, including prn meds, and every nursing diagnoses that applies to that patient. We have 12 hour clinicals every Monday and Tuesday and have to turn in two care plans by Wednesday. It is so stressful!

[Rednights]

I can definitely make a care plan 30 pages if I hit the copy and paste button. It's really not that hard!

[Isabellah]

Our care plans are very long and extensive. It concludes a face sheet that lists patients symptoms and medical diagnosis that goes along with it. We then have to fill out five pages of physical assessment information. Next we fill out a medication sheet. Then we do lab values and listing what the abnormal values may mean. Then we do drug sheets on each drug-drug, class, adverse side effects, labs relevant to drug, nursing implications, and patient teaching. Then we have to do a concept map showing how we came up with our diagnosis. Finally, we have to list our nursing diagnosis with rationales, interventions, goals, and evaluation. We have to fill out the physical assessment sheet every day we work with the same patient. I forgot to add we also have to do nursing progress notes.:hdvwl:

[MissJulie]

We have seperate pages from the care plans to include stuff like meds, patho, physical assessments, etc. But, a care plan that long makes me want to cry!

[Grandy]

In the clinical environment nobody could be bothered to read a 30 page care plan let a lone actually write one. It seems that there are still some nursing schools where academics are completely out of touch with the real world where real nurses practice.

[Maddie-LPN]

When i was in LPN nursing school, we had to do a 20 page care plan every week, we had clinical every wed, thurs and fri. and it was due every friday by the end of clinical day, every semester was 4 months, 5 semesters. i stabbed both eyes out with pencils.......

[ruaalien2]

We had to write a complete care plan on four major diagnosis

We had to write out every single medication, understand fully, any side effects, possible interactions with other meds as well as medical condition.

We had to fill out a complete assessment from head to toe and that included psychosocial and spiritual as well as social

We had to know every single lab level, what the parameters were and be able to explain why these were potentially not within normal limits.

We have to write out a textbook diagnosis (linking a major diagnosis to our textbook and what the textbook says about it).

Takes btwn 20-30 pages. We have to pass 3 with a grade of over 75. My first one is due next week on a mock pt, I'm almost done with it.

[Boog'sCRRN246, RN]

"Finally, we have to list our nursing diagnosis with rationales, interventions, goals, and evaluation."

The way I was taught, the above is all a care plan really is. That's why I was so curious as to what other students were including in these things.

[HalfmoonMaggieRN]

I see how it would be possible to get 30 pages if the assessed needs of the patient were viewed in an extremely focused and isolated manner, and when beginning to write care plans this will probably be your approach. As you write more of these however, you will see that it is possible to use more comprehensive/holistic diagnoses, under which interventions from dozens of more narrow diagnoses can be listed. Note: The pencil in the eye reaction to the 30-pager sounds about right, though!

[crossingfingers10]

We did 20+ page care plans for every clinical, yes every one! Sometimes it was less depending on the amount of meds. Luckily we were allowed to type them out which saved our arms and hands. They included every med and the dose, route, frequency, interactions, side effects, and nursing implications, the patient's current dx, medical hx, social hx, family hx, procedures, diagnostic testing results, physical assessment, patho description, all labs and an explanation for any out of range, plan of care which included IVs, foleys, I&O status, physical activity, therapies, diet, etc; and multiple nursing diagnoses with at least 3 interventions and explanations for each.

I am so glad those days are over, I can't even tell you! It was a 6 hour project every weekend, ugh. For some rotations we would go in the night before and fill out a majority of the info so we would be prepared for the next day. However, during other rotations we would obtain all of this info during clinicals and bring it home to complete within about 48 hours. In rotations where we would pick a patient and have them for two days, we would be expected to review their labs and be ready to talk about their diagnosis, labs, and meds the next day.