To much focus on care plans for students

RN1982 · Sep 12, 2008

Theory is wonderful but I think clinicals are a very important part of nursing school and I think there should be much more focus on them too.

SweetTeaRN, BSN, RN · Sep 12, 2008

As a student, I would have agreed with your post 100%. I always felt like the care plans were mostly a waste of time. I knew in my chosen specialty, ER, that I would never even see another care plan anyway. With that said, I think care plans are important even though RNs in the real world do not really use them. Why? Because they teach you to think like a nurse. They teach you to think about a pt. with a certain diagnosis, and look at the pt. holistically and think of the different body systems and their integrated role in the patient's illness. This is something that is learned through repetition and critical thinking skills. It is not easily acquired, which is why nursing school exists.

I agree that it sucks that many people do not learn procedural skills in school. However, they are easily learned on the job. They are learned only by rote, and the same can't be said for the critical thinking aspect of nursing. With that said, I can't believe you are having to spend only 2 of 12 hours doing patient care. My school wouldn't have allowed us to spend so little of our clinical time caring for patients. We had to do our care plans at home. So I agree with you that the way your school has it set up is unfair and is truly detrimental to the learning process.

JerseyGir1 · Sep 12, 2008

Completely agree w/ OP

nightmare, RN · Sep 12, 2008

While I agree whole-heartedly with the first two posters I can tell you that I probably spend more hours per shift on care plans than I do on direct patient care.It is not a situation that I like but have no choice because of all the new CYA paperwork that seems to be generated every month.This is the other side of the Pond but I expect it is much the same where ever you are now.

levisandtees · Sep 12, 2008

Also agree with OP...our clinicals were for six hours twice a week for six weeks and we had the same patient for the first three weeks and the same two patients for the last three weeks...I did CNA work which was fine because that's what got me interested in nursing in the first place but practically zero procedures--besides basic med pass got to give one insulin shot...I was totally upfront about this when I interviewed and with all of my trainers but sometimes they look at me with such disbelief or irritation to have to show me things.

I don't know about anyone else, but it seemed to depend on the professor...some were known to go to the facility prior to clinical and communicate with the nursing staff about procedures that needed to be done so that students could practice skills where other professors had to be tracked down just so that meds could be administered let alone doing anything extra.

I do agree with others, though--procedures are picked up quickly when you get to practice them daily on the job. :yeah: When I have never done a procedure, I ask that another nurse come to the room and walk me through it--that way I don't have to keep saying "I'm sorry but I have never done that"--and they know that I WANT to/am willing to jump in and do it myself. It's also a nice confidence booster and sense of accomplishment--when I did my first catheter I was over the moon!!!

SWEnfermera · Sep 12, 2008

Read the thread "Rant: Care Plans" Take a look at entry #7 from scribblerpnp who is a Nurse Educator. She does a fantastic job of explaining he importance of Care Plan Writing for the student nurse.

Hang in there!! :up:

https://allnurses.com/forums/f50/rant-student-care-plans-what-s-their-purpose-321788.html

jjjoy, LPN · Sep 12, 2008

It's not that school will teach student nurses all they need to know once they start; that's simply unrealistic. But as it is many places students have little opportunity to become competent at any skills, even just CNA level skills. Thus, how are they to have confidence that they WILL be able to learn all of those other skills on the job? If they've never had the experience of applying a new skill over and over until it becomes second nature, how will they be confident that they WILL get confident at it eventually? If they've never had the experience of learning on the spot from a colleague (versus memorizing a twenty step procedure for just washing hands where you might be marked off for breathing the wrong way), how are they expected to think that it's okay to learn a skill just by asking your colleague to show you how?

And as for care plans, they should be part of the learning process. It's just that it seems that too often they come to dominate the learning process, overshadowing the more experiential portion of learning. Critical thinking in a clinical environment also involves pulling upons previous experiences, not just book-learning and the ability to find information.

Care plans aren't discharged early, they don't carry liability, they can be taken home to grade, mistakes don't harm anyone, etc. Getting clinical experience for nursing students is much more difficult, as well as securing good clinical instructors. And in today's society, paperwork is the proof that something was done. Graded care plans are physical proof that the students did some work on their own and proof that the instructors spent time evaluating the students' work.

Just to reiterate, I do think care plans have a place in nursing education. I just think they way they are used could use some redesigning some places.

vampiregirl, BSN, RN · Sep 12, 2008

Read the thread "Rant: Care Plans" Take a look at entry #7 from scribblerpnp who is a Nurse Educator. She does a fantastic job of explaining he importance of Care Plan Writing for the student nurse.
Hang in there!!
https://allnurses.com/forums/f50/rant-student-care-plans-what-s-their-purpose-321788.html

Wow- this was a very helpful post. I'm a distance education student and up until now I truly didn't realize the importance of careplans and how they related to pathology.

I know of one place where nurses are required to use care plans... but they are already in the computer and the nurse simply selects the careplan appropriate to the patient (not individualized at all). When I inquired about the importance of them, I was told that this is just a regulatory requirement to have them and not something that was a useful resource.

I definately have a different view of careplans now!

txspadequeenRN, BSN, RN · Sep 13, 2008

i think there is to much focus on care planning period!!!!!!!

Daytonite, BSN, RN · Sep 13, 2008

remember that you are in college and working on getting a college degree. a care plan in a college nursing program is similar to a research paper. the result of being a college graduate is that we know how to use our minds to think and solve problems. when we graduate we can figure out how to do the clinical work. not everyone has the smarts to work out how to figure that out, but what a college graduate who has learned the underlying principles of nursing lacks is merely the practice. medical students have the same issues which is why they have internships. i think the nursing educators are coming to the realization that nursing needs the same type of structure in its education of nurses as well.

i think this should be part of the discussion on this thread on the general nursing student discussion forum that was made a sticky:

rant: student care plans... what's their purpose? https://allnurses.com/forums/f50/rant-student-care-plans-what-s-their-purpose-321788.html

AnnaSL, BSN, RN · Sep 13, 2008

hmmm... When I was in Third Year, Our Clinical Instructor is SOOOO STRICT.. She doesnt want us staying in the Nurse's Station and sit there for nothing.. She wants us to go to each of our assigned px and even stay At bedside just for us to be able to ASSESS a patient and thus, be able to derive a NURSING CARE PLAN... We were never ask to do a PLAN by THEORY but DEVELOP a "CLINICAL EYE" to what is the current problem of the px.

Honestly, NCP was really hard for me during that time but as time goes on, with HANDS ON and IN WRITTING, putting it together is really easy...

She's so strict that she requires us to present the plan 3 hours after intiatiating care to the patient..I can still remember, I mastered the nursing diagnosis of "HYPERTHERMIA related to increased WBC of ______as manifested by fever of 39 degrees Celsius and flushed face".

Well it just so happen that most of the patient assigned to me has FEVER.. hahahahahah

Honestly, I am still thankful to that Clinical Instructor, because without her being Strict, I wouldnt be able to have a keen eye unto things and able to initiate the task with ease, either IN WRITTING and HANDs-ON

My advice is, YOU ARE IN THE STAGE OF LEARNING, Take the initiative to LEARN a procedure and encounter a certain case.. Be there when a certain procedure is actually happening...

And put into heart every care that you do, because, it wont be hard to do something unless you put it by heart.