Just the Tip(s)

for careplanning of course

Oooooooohh, a separate blog just about tips. You wanted a separate post and here it is!

So here are a couple of advices, suggestions, and tips that can help your careplanning days less dreadful. I learned as my nursing program progressed so I really do hope this helps you! It might not seem like it’ll make the impact, but any little thing can make your careplan days better. I am totally open to anything else that can help so please feel free to send me a message and I am more than happy to add it to the list! :)

  1. Meal prep, meal prep, meal prep

    Meal prep the day before you careplan. This will help so you’re not spending time making food that can be used for careplanning. I remember I would make grilled cheese sandwiches for my best friend because she had no time and she wouldn’t eat all day other than crackers. I ate ramen all the time on my careplan days because I had no other food, no time to go out for food, and didn’t use postmates/uber eats because it was too expensive as a college student. Just make sure you eat something, please do not go a whole day without eating. It’s not good for health. You need to take care of yourself first.

  2. PDFs are lifesavers

    It’s a blessing to find pdf versions of your books. Lab book, medsurg book, and pathophysiology book, nursing diagnoses, etc. Quickly finding your information is essential because using “control+find” for your disease process, lab values, and co-morbidities make careplanning go even faster. I found my books by asking my classmates and they happen to have them. I still have some of mine somewhere in my Google docs, but it might not be up to date for your careplans. But if you’re interested, feel free to DM me on IG @thetinynurseblog.  

3. Sleep early

Sleep as much as you can the day before. You might need to study or do homework but as soon as you finish, take a mental break and then just sleep. I would usually get 3-4 hours of sleep on clinical days. I know some of my peers didn’t sleep at all because they finished super late and had to commute to get to the hospital. It’s crazy to think that we would careplan for hours and hours only to care for a patient for about 5-6 hours. And if you’re a pre-nursing student, enjoy your sleep as much as possible. 

4. Challenge yourself

Pick a new disease process every time you careplan. I know it’s nice to just copy and paste your last patho that you wrote, but this is your time to learn. Also, clinical instructors will call you out to change patients if the disease process is practically the same because they want to challenge you. Don’t be afraid to include pictures. Pictures within your patho is absolutely a great way to help enhance your careplans, especially with ICU careplans, because instructors love the details. 

5. Do. Not. Read. Every. Single. Note.

It’s common to see that patients have been in the ICU for a long time, so there’s a lot of notes to read. I feel like that was the most overwhelming part because I wasn’t sure what to look for and if I should read every single note. I’m telling you not to do that. Look at the H&P, the doctor’s and the specialtyites notes, all the consults, and sometimes the nurses’ notes. You can make a timeline to see how the patient has progressed or deteriorated throughout their stay. Start off with how they got to the hospital and a little bit into their first few days and then look at the most recent notes. I remember feeling like I had to look at every single note but a lot of the notes have the same exact information with minor differences. 

As a working registered nurse, I usually look at their first admission notes, the consults, and the most recent notes because it is what matters now. Especially with ICU, lots of complications have occurred and resolved that are not pertinent to what you need to know now. If I do have downtime, I do read all the notes just to read their timeline. But as a student, I don’t think it’s necessary to read every single note. 

6. Nursing Orders

One thing I didn’t really look at as a nursing student were the orders. I feel like it would be very helpful to take a look at those so you know what the nurses have to do so you can follow them. So you can see if they need sugar checks, I/O hourly or q shift, activity orders, etc.

The biggest thing that helped me the most was writing pathophysiologies (pathos) for the most common co-morbidities and diagnosis that would be seen in the hospital. I wrote them two weeks before I started nursing school. I literally copy and pasted them and tweaked it in certain areas that would be pertinent to my patient. It was also very helpful to highlight in red which areas were very pertinent to my patient to show that I understand what exactly was going on with my patient to really tie it. I know its extra work, but it so so worth it. You’ll thank yourself in the future.

  • Sepsis, the entire process. systemic inflammatory response (SIRS), coagulation cascade, infection, shock, complications of shock, MODS. ALL OF IT, trust me.

  • bacteremia

  • acute respiratory distress syndrome (ARDS)

  • acute respiratory failure (ARF)

  • disseminated intravascular coagulation (DIC)

  • acute kidney/renal failure

  • diabetes mellitus I and II (and the complications)

  • atrial fibrillation

  • hypertension (essential and secondary)

  • hyperlipemia

  • coronary artery disease (CAD)

  • congestion/chronic heart failure (CHF)

  • stroke (ischemic and hemorrhagic, aaannnnd their effects and complications)

  • chronic obstructive pulmonary disease (COPD)

  • arthritis

  • myocardial infarction

  • electrolyte imbalances (K+ especially)

  • chronic kidney disease (and the different stages)

  • cystic fibrosis

  • asthma

  • dementia

  • obesity

  • bone breaking and building (osteoclasts/osteoblasts)

  • sickle cell anemia

  • benchmarks after surgery (voiding, ambulation, having a BM)

  • pneumothorax

  • C. diff. (this was my diagnosis for my first patient ever!)

Most of the time, you don’t have to exactly tie in their co-morbities into their current diagnosis but instructors usually like to see a patho about the co-morbidities. Sometimes you can tie it in perfectly into harmony. Such as “My parent has a past medical history of hyperlipidemia (patho here) which then can lead to CAD (patho here) which eventually caused the patient to have a diagnosis of myocardial infarction (patho here). You don’t always have to tie it in together, but just write something so they understand that you are aware of it.

It’s not wrong to have a small patho either. Sometimes the disease process is simple and can be written in a paragraph or two but as long as you go into as much detail as possible.

Pictures. We love pictures. It makes your careplan even fuller and more detailed. I didn’t start adding pictures until ICU, but I wish I did during med-surg. Especially with pathways. Pictures, graphs, diagrams, all good things.

Your pathos will not be perfect the first time you write it. Do as much as you can, but you will add more on your careplan days, but it will help knock out most of your pathos and save you so much time. It’ll build more and more as you progress through.

That’s really what I can think of in term of careplanning tips. I really hope this help you all and I wish you the best of luck!

<3 Mags

thank you em!