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Discussion

Realistic time frames for goals... help!

Hello all :)

I'm in my 4th semester of an ADN program. Up until my last clinical I have gotten fantastic remarks on my care plans, but my last clinical instructor said I need to work on making the time frames for my goals more realistic... for fluid volume deficit r/t orthopedic surgery (day 2 post-op total knee replacement) she said meeting my goal of balanced fluid volume within 24 hours was unrealistic and that I should have put 24-48 hours- which I completely understand, but how *exactly* do I learn what "realistic" is? Our text book (Brunner and Suddarth's Textbook of Medical Surgical Nursing) and care plan book (Nursing Care Plans: Guidelines for Individualizing Patient Care) don't address this specifically.

Are there any additional resources I could read to improve this aspect of my care plans??

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    Medicine is not an exact science if you think about how the body shifts fluid....http://www.nursingcenter.com/prodev/ce_article.asp?tid=666737........it would make sense that it would take a couple of days. I would stick to ranges. She was being a bit picky and she should have lead you to a resource. Check what the standard of care would be for that outcome based on evidence based practice. This link maybe helpful......http://www.ahrq.gov/clinic/.:)

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    I like to think that reasonable time frames comes with experience. As we know, each patient is different. Hence, we memorize ranges and not necessarily exact amounts. I don't think the books really go into detail about reasonable outcome time frames because the broad patient population and the infinite number of factors that goes into one's healing. Or, I'm way off base. Who knows.

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