There are so many things in our profession that could be changed for the better. I know how difficult it is for people to accept change. Some of the things that we continue to do in nursing make no sense to me at all. For example: why in the world are we still forcing students to write care plans? Most hospitals do not use care plans as we once knew them and as we continue to teach. It is very important to teach the nursing process which the care plans are designed around. I think time would be better spent teaching students some assertiveness skills and leadership skills. Anyone agree with me about the stupid care plans? What else do you think we could change?

I have mixed feelings about care plans. I wrote them in school 30 years ago and don't remember them being very painful. Nursing diagnosis came along and that had lots of controversity. I still think these are OK as they pinpoint just what the major problem is....my favorite is "Inefective Coping Mechanisms".
Anyway, goof food for thought.....Overall, I think a good bedside teacher is the best!

cd, this is a bit late but here's what we're doing with care planning at GTCC. We switched to concept mapping last year. The students write their nursing diagnosis statements, goals, expected outcomes, interventions, and evaluations like in a care plan, but they put them on a bubble map. They have to show relationships between NDx, interventions, and so forth. 1st level students start with 2 NDx, but are expected to do multiple NDx by graduation.

We used to have the students turn in their concept maps and the clinic instructor would grade them. It would take the students hours to write them, and the instructors hours to grade them. Everyone hated them.

We are piloting a new method this year with the 1st level students. Each student still has to gather data on their patient and put it into Functional Health Patterns. In post conference, the clinic instructor chooses one. I usually choose the most interesting case, but in theory every student in the group will have their chosen at least once, but possibly more than once. That student must provide a copy of that Functional Health Pattern to every student in her clinic group in a timely manner: either photocopy it at the nurses station (if staff allow), or email it, or however. Usually they have to get it out by a certain time that evening, plus a copy to the instructor.

Then, each student writes 2 nursing diagnosis statements for that patient, including goals, expected outcomes, interventions, and evaluations. They do this as individuals, not as a group. Then in class that week, the entire class breaks into their clinic groups for 30 minutes and make a concept map on a oversized sheet of paper (the kind for presentations before PP). They agree on which 2 NDx to put on the map as a group, and collaborate. This teaches teamwork, shows them different thought processes, and how to work quickly. Then each group presents their case to the class. The class asks questions and adds input. I also make suggestions, and help with prioritization issues.

The students love it. They spend about an hour at home on their NDx. They report less anxiety over paperwork and more time to study and prepare for lab and clinic. Their exam grades reflect learning. The other 3 instructors and I are hoping to make this department wide next year.

Hi Ne01

I am on the last couple of classes on my MSN w a specialization in Education. Over the last six months some of my peers have indicated using care maps instead of nursing care plans and the litereature supports it use as well. It is an online program and one of our lecturers - Michelle Beck has done a great deal of work with care mapping and demonstrated an example that the 4 student group developed and implemented in less than a couple of hours. She would scan them and provide feedback. Sounded great and my 2 peers who use them all of the time love them. While I have been teaching at the academic level for over 10 years, I look forward to teaching all nurses and using this method.

Sue