What are your care plans like?

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I am a little curious how care plans differ from one school to another. I am in my second semester of an ADN program. We have to do 3 care plans each week. For each one we have to do 2 pages of pathophysiology, come up with 5 nursing diagnoses, then do a care plan on the priority diagnosis. The actual care plan is 4 pages long (one page for each of our 4 interventions) and we are expected to write at least 10 sentences for our rationales. Not to mention the 6 pages of labs to fill in, all the patients meds (usually 2 pages), any x-rays or diagnostic procedures, and a few more pages about demographics, adls, etc. Each one is a total of 23 pages! This takes FOREVER to do. Most of the time spent flipping through our texts finding sources for patho and rationales.

They aren't that hard, just extremely time consuming. After getting my patients' information and driving home from the clinical site its about 6:30 pm, so I have a total of 12 hours to do three 23 page care plans, sleep, get ready to go, and drive back to the clinical site. I rarely get more than 3-4 hours sleep and some of my classmates don't sleep at all! And they expect us to provide safe patient care. I just don't understand. As much as I've tried to convince myself that I don't, I do learn from doing these care plans, but I think I would learn more if I only had to do one or if they were less involved because by the time I'm done I'm a zombie. I can only imagine how bad it will get the next two semesters.

I have seen posts about care plans that lead me to believe a lot of you don't have to do quite as much as this. I basically just want to know how many of you are in the same boat. Does anyone have it worse than this?

I think it's absolutely ridiculous that if all 3 of your patients are d/c'd you get less than a day to write 3 new careplans considering you just wrote 3 careplans for the d/c'd patients. In fact I think it's ludicrous...I can't tell you how many times I have had D/C patients...

Our care plans differ in size and length depending on the class. I have had anywhere from a 30 pager to a 6 pager. The further we go in the program the shorter ours get as they want us to pay more time actually HANDS ON caring for the patient for criterion then wasting 12 hours writing a paper. The only thing that still ticks me off is that the amount of time we put into them FAR exceeds the measely 5% of our grade they are always worth. It's been almost to the point with me as in "why bother" trying to write an A criteria paper when I have so many hours of free time to do these and studying for the exam is more of a priority at the time. Ugh. But, somehow I manage to keep pumping out A papers- it has gotten easier the more I do.

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Our care plans do not count towards a certain percentage of our grade. They are pass/fail. I don't know exactly how they decide if they are satisfactory overall, but if I have a 100 average in my class and I don't do well enough on my careplans then I'm out. I don't know of anyone this has happened to. We have to revise them after they have been graded, so I think unless we just didn't fix them then we won't fail because of them. I don't know. I'm not gonna be the one to find out. I'll just do the work even if it kills me. (And it just might.)

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Specializes in Adolescent Psych, PICU.
And I imagine you have more than 12 hours to write these papers.

Yes! I'm thinking here, how much can you even learn when you are cramming care plans like that? I am really sorry your having to deal with all that stress.

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I will set the stage. I am in third semester of a four semester RN program. We are in psych. Our care plans are scanty. We just need one nursing diagnosis, three interventions! I still complain!!!! Our clinical instructor is soooo nice!

Feeling guilty....

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Just curius - what tools (software) can be used to speed up care plan

designing or is is mostly written by hand ?

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Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
Just curius - what tools (software) can be used to speed up care plan

designing or is is mostly written by hand ?

I type my care plans in Word. I have a template of colums...Diagnosis, Goal, Interventions, Evaluation. I have a Comments column just because that's what our instructors had on the sheet they handed out but I never use it.

For my concept map I use power point. I just make 1 slide for the map. I use a circle for the center and squares for the outside. I do it in color with the diagnoses being boxed in 1 color and the center another. I usually try to coordinate the color with the color I use for the heading in the care plan.

I bought a program for making concept maps. It was awful. I hated it. I had very little control over what I was doing and ended up with concept maps that I'm sure were acceptable but when I did them without the program they were much nicer.

So just creating a template in word helps.

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Dear SAHStudent

Yes word templates are good for this and I used it for years.

As I am also Computer Analyst (and Nurse) I wrote my own Care Plan

software tool for my PC. This utility saves me lot of time.

I am sure there are some other tools around (such as for PDA,s) but I need to search more on internet.

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Specializes in CICU.

I'm sorry that it is so much work, my care plan days are over, I graduate in five weeks and couldn't care less if I never see a nursing diagnosis again. The hospital I am going to work at has Meditech which kind off designs a care plan for you. In my humble opinion nursing diagnoses were invented by nurses who wish they could have been doctors but weren't smart enough!

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Hi brisse

Ok so what do you do when working as a Nurse in ward.

You must come up with something - 'plan'.

Nursing diagnosis are not so bad - until we have something better.

The main question is how do we mesure our work - If you read hospitals annual report then there is always good report on how much

doctors have been doing - because they have good data (can be mesured).

Nurses have been trying to implent data so their work could mesured but

maybe it is not godenough - and we are still trying

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Specializes in CICU.

Nurses did fine before nursing diagnoses came along.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
I'm sorry that it is so much work, my care plan days are over, I graduate in five weeks and couldn't care less if I never see a nursing diagnosis again. The hospital I am going to work at has Meditech which kind off designs a care plan for you. In my humble opinion nursing diagnoses were invented by nurses who wish they could have been doctors but weren't smart enough!

Reality check here! I'm sorry you feel this way and I hope you didn't express this same sentiment at your job interview. :imbar I think I can safely guarantee that a nurse at Meditech, or the facility you will be working at, had significant input into the care plan skeletons that are stored in the computer program so that you merely have to press a button in order to have the computer spit it out for you. You will be "thinking" care planning for the rest of your career as a nurse. If not, then I'm going to wonder what kind of knowledge you are coming away from your nursing program with. A care plan is nothing more than the written expression of the nursing process which any graduate nurse should know is the critical thinking pathway that we nurses go through ALL THE TIME when solving patient problems. And, that's what licensed nurses do--solve patient problems, stamp out fires, all shift long. It is a fact that nursing diagnoses were developed by nurses to interface with the SNOMED computer coding system developed by the College of Pathologists. They were, in part, designed to aid our sister advanced practice nurses in billing clients for the services they provide so they can be paid for what they do. They were given the kiss of approval to do this by none other than Medicare who pays for many of the services that advanced practice nurses provide. More and more our nursing practice is feeling the effects of the work that Medicare is doing with regard to the collection and trending of healthcare information. Collection of information on medication errors and suggestions for safe medication practice is an example. So, I guarantee you they are not going to go away. Because they are paying the bills, big time, they are making the rules. And, the baby boomer generation is just coming into the healthcare system for care. FYI, federal law Title 42 Part 482 (Medicare Conditions of Participation for Hospitals) requires that a plan of care written by an RN must be a part of every acute hospital inpatient's chart. So, as long as you work in an acute hospital (and there is a similar law for nursing homes) you will, by pushing a button on a computer or actually handwriting it, be responsible for seeing that a care plan is in place in each of your patients charts. Before you nonchalantly dismiss something your nursing program put emphasis on learning, :imbar you might want to cogitate on WHY there was so much emphasis put on it in the first place.

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Specializes in ER, Medicine.

Care plans...my last one I did was around 34 pages more or less. Very very VERY time consuming. Things must be referenced and cited correctly. Minumum of 4 nursing dx, and 4 interventions, etc. I can't tell you how many I've done...:yawn:

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