Schools without careplans

[cinja]

Does anyone attend a school where there is not much emphesis placed on careplans? Students have been beat over the head for decades on these and I am wondering if any evidenced based practice has found an alternative to care plans that eat up about six hours your evening.

I still haven't figured out what skill they are trying elicit or why there is no standard way of doing it.

[Daytonite, BSN, RN]

I still haven't figured out what skill they are trying elicit. . .

I'm sorry that your (college) nursing program didn't give you the purpose for the writing of care plans. This information should have been listed in the objectives for your nursing program that you received somewhere in the orientation to nursing school. It might also be in the objectives for some of your nursing classes. The skills a written care plan is trying to elicit are:

• proper knowledge and use of the English language
  
• how to use resource materials
  
• how to write and present researched literature
  
• critical thinking
  
• that you have learned nursing theory
  
• scientific reasoning and problem solving through the use of the nursing process
  
• ability and flexibility to think creatively
  
• the ability to successfully follow a set of rules and instructions

. . .or why there is no standard way of doing it.

The nursing process itself is the standard upon which all care plans are based. The format that is used to present the written care plan is what is different from school to school. The format is also going to be different from employer to employer as you will discover in the future. A written care plan should be thought of as the nursing school equivalent of a "term paper" or "research paper". The nursing process and nursing facts within the paper are going to be standard throughout the country. However, depending on how your instructors and schools have decided they want you to present these papers, they may range from very simple presentations to very complex ones with footnotes and references. Some programs use NANDA language; others provide students with a set of nursing diagnoses they want them to use; still others want students to formulate their own nursing diagnoses. These all involve manipulating the English language, not changing anything with respect to the nursing. Each school is free to make their own rules as to what they expect of their students. What is important is to learn and understand what the nursing process is and to learn your nursing fundamentals and theory. A written plan of care is nothing more than an extension of the nursing process to which some specific rules and instructions have been given for you to follow. This is why proficiency in English is a requirement and pre-requisite of most nursing programs in the U.S.

Let me give you an analogy. There are a number of games on the market based on the game of Tic-Tac-Toe. The basic strategy of the game doesn't change, but the makers of the different games that are on the market have tweaked the rules and instructions a little differently. Written care plans are much the same. The basic strategy is to follow the nursing process; but, each nursing school and each employer will give you different rules and instructions as to how to write the actual care plan.

I would suggest that if you are having problems with care plans it is either because you (1) do not completely understand the nursing process yet, (2) are not understanding the parameters of the rules and instructions that you have been given in creating your written care plans, or (3) both. Writing a care plan is a skill like any other nursing skill you have to learn. Your very first foley catheter insertions and IM injections take longer to accomplish and complete than the ones you will do many attempts later. The difference in writing care plans is that the work and effort you put into them is more mental than physical. With practice, you will be writing care plans quite rapidly. Promise.