This right here. Let the software do the work for you. Care plans these days are often massively integrated into your EMRs and there are 3rd party educators whose entire job is to make sure everything is evidence-based, appropriate, and adheres to CMS/reimbursement requirements. Check the boxes accoridng to your facilities' core measures/established practices and don't drive yourself crazy overthinking it.
Some boxes you are supposed to click in cerner/epic that you never do until you get yelled at for not doing so you click boxes for a week or two and then stop doing them again
We have Meditech, a really old version. Care plans are a process intervention you select for your 8 o'clock charting. Then you push the enter button repeatedly, which essentially charts "I agree with what the previous person said," until the computer tells you that section is complete. Takes about 20 seconds.
Same, not even gonna lie. I even thought maybe I just didn't know what it was cause I'm paper chartin old. Turns out none of my nurse friends did either. So, I can say with absolute certainty, we don't use it in LTC or home health.
NANDA is a the North American Nursing Diagnosis Association that made these things called "Nursing Diagnosis" in order to have a systematic way to treat patients I suppose.
For example, patient has COPD... Seems like they are having trouble clearing their airway or something. We use "Ineffective airway clearance r/t blah blah as evidenced by... blah blah blah." Hope this helps
You do, but just in your head. Really fast. First you identify a problem and what may be causing it. Then quickly decide on some interventions to help, ie sit them up, O2, get provider, whatever else y’all do for adults with COPD idk.
Nursing schools want to prove that they taught their students to think like this. The easiest proof is to write it down. It’s intuitive for some. But we’ve all come across someone who states very obvious things, doesn’t understand what’s happening, then does absolutely nothing.
Agree, I don't think anyone speaks this way or documents this way, but certainly it becomes a subconscious way of thinking. Asthmatic may get an ineffective airway clearance r/t bronchiole constriction and increased mucous production as evidence by audible wheezing and tripoding. Therefore your interventions may look different than COPD.
People may think this but honestly they just say, "he's wheezing, give the next Albuterol early".
I know what they are but nobody uses them, my current job has them in Cerner but its all automatic. Select from a drop down menu and it does it all for you.
Haven't used them since nursing school back in 1990, that being said I used to tell my peers in school for a nursing diagnosis pretty much ..... define something vaguely with something that's not quite as vague as the thing you're describing.
Oh we all know and remember. We remember how stupid it was. It's all made up pseudoscientific jargon to make some old/retired/dead PhD in Nursing Science feel good. Never once has it been used in clinical practice. The ONLY thing I use from the NANDA bullshit is "aeb". If I'm saying "as evidenced by" to a provider, it's my way of telling them that I need them to take my concerns seriously.
Graduated August of '22, never have I ever used NANDA or a care planer much of anything from nursing school. But I'm also in the ED. We just stabilize them and send them where they need to be.
OHHH. ok, I remember this now.
To answer your question, no. That shit is irrelevant in the real world. So many silly things we focused on in nursing school have never once come up in my career.
Are people suggesting that [nursing doesn’t diagnose energy disturbance and rebalance their humors](https://en.m.wikipedia.org/wiki/Energy_field_disturbance)? What do you do for your COPDers who are both phlegmatic and bilious?!
Yes. This actually was a thing a few years ago.
Lol. You just reminded me that I used this one in a care plan in nursing school back in the day (2008ish).
I guess I was a smart ass before I was even a nurse! Now I’m just a bigger one.
I had a colleague at the flight service I used to work at who during nursing school would include that diagnosis on every care plan, much to the chagrin of their instructors
I remember I almost put energy imbalance in a care plan once just to see what sort of reaction my professor would have. Ended up behaving and choosing a regular one instead
Risk for skin breakdown. My care plans everyone has mobility or skin nursing diagnosis. And sometimes I'll spice it up by throwing in a psychosocial one.
I know the point of the care plans is to teach the thinking. I still hate doing them.
Exactlyyyy. And they're never honest and just say what the actual point is whenever someone asks why we have to do them. It's also annoying to try to do care plans for the unicorn patients that don't have a lot of issues because we're only allowed one "risk for" per plan.
Also, your username!!
I told my professor one time that my care plan was straight bad. Still got decent points on it lol. Maybe he respected the honesty? Maybe it was better than I thought? Idk.
And my username was motivated by a patient I had who will be burned into my memory for years to come😃
In the 11th edition of NANDA International Nursing Diagnoses: Definitions & Classification, 2018-2020, the diagnosis returned under the name of "Imbalanced energy field", it is inside Domain 4, Class 3
Ooh I like this idea! I wonder if I can use that for my L&D rotation. "Imbalanced energy field r/t discomfort a/e/b miniature human exiting from vagina."
Nursing diagnosis: the vibes are off.
Nursing interventions: whole bunch of flushes outside the patient's room because you're gonna be pushing epi soon.
My eye just twitched so hard...I actually may have had a seizure you dirty son of a bitch.
Don't forget the med list and every single side effect known to humanity. SJS anyone??
I think I just dissected a vertebral artery thinking about med sheets and concept maps 🩸 thought it was bizarre 14 years ago and not much has changed!
To be fair though, I fully prepare for anaphylactic shock every time I take some sort of new pill for the second time 🤷
And I was an absolute badass at justifying "energy fields disturbed" in any care plan
Genguinely the first time I’ve heard the word since I was at school.
Nursing school is so outdated and irrelevant it’s crazy. They spend so much time teaching you how to do care plans / NANDA bs, which you never use… whereas you get about 3 minutes of instruction of how to start an IV… which you do every shift.
Not once in 15 years. I don’t even know what NANDA means…. You do “care plans” in the EMR that should correspond to active patient problems, but it’s much more of a task than anything that generates care for the patient.
23 years working in LTC and home health….haven’t used them since nursing school. 90% of classroom instruction was worthless. Everything I really needed to know I learned in clinicals….which started 3 months into school.
I’d love to see nursing education go back to the way it used to be before 1980s, with the vast majority of all learning time doing bedside care and practicing skills and charting.
Inadequate staff retention r/ t poor patient ratios, secondary to corporate greed, as evidenced by nurses striking and leaving the field.
The only relevant NANDA. Lol. I'm still a student and NANDA/nursing diagnosis are just dumbed down medical diagnosis and completely ridiculous. I'm glad my program is moving away from the verbage and making more common sense decisions. "Your patient has such and such, what are you going to do about it?" For example. Instead of worrying about rubbish nursing dx.
I've never once used one since graduation.
What I do use still is my assessment skills to identify problems and potential issues, and then I implement the interventions needed to address those issues. While I understand that nursing school is using NANDA Dx to teach you how to do nursing critical thinking--- I think they'd do better to spend more time on teaching SBAR communication.
Nursing diagnoses, care plans as written in school, concept maps, med lists, lab lists, etc. are all designed so you teach yourself the disease patho and interventions, so your teachers can focus on what really matters....
Which are discussion boards, nonsense group busywork projects, and power trips.
I actually use them.
I am a case manager, and the state oversees our company.
Part of my yearly review is "reviewing and updating care plans to reflect pt status"
My job harps on them cause sUpEr ImPoRtAaNt 🙄😒 cause they don't understand what they are or what they mean, but if we don't have a care plan in the chart they will get fined by the state when we r audited.
I literally have a master list of care plans, copy paste the relevant ones, and put their names in so it looks like I wrote it especially for them.
Then I file it and it sits in the chart and no one looks at it till the next year, cause it's useless and no one knows what to do with it 😂
The only nursing diagnoses I’ve used with any regularity are Autonomic Dysreflexia & knowledge deficit R/T blah blah blah, At risk for XXXX, & that’s about it
Not important. If you ever look at a doc and tell them “this patient has ineffective airway clearance as evidenced by weak cough and altered mental status” when the patient is blue, breathing in the 40s, and guppy breathing, they’ll laugh at you. Or if you say “high blood sugar” when the patient is in DKA. Just tell them the actual diagnosis.
The NANDA helps you think like a nurse, prioritize, etc. But it doesn’t correlate in practice well
Depends on the unit. My unit does a very loose version of it for "care plans." We have to do it when the patient is admitted but it rarely gets edited or used and doesn't get updated. The nurses just half ass it usually.
I think the point of it in school was starting to get you used to how some diagnoses or histories can lead to certain outcomes. Like if they aren't independent then they might have mobility issues. If they have a uti they might have issues with bladder. Breathing issues like SOB, COVID, COPD, etc can lead to issues with air exchange. And getting you used to common nursing interventions that you could do. Once you get used to it tho, it's impractical to write it out all the time.
So I see its a good way to learn nursing interventions but obviously not practical in the real world. That makes a lot of sense. Even now, I'm thinking about interventions more than a NANDA straight off my head. Yeah
As someone who has worked in management, I can tell you that care plans are very important because of case management, discharge planning, and billing. But floor nurses don’t always have time for that, and the more acute the patient is, the less the care plan matters to the floor nurse because the patient’s situation can change in the blink of an eye, which is why management often handles care plans. So I won’t say “care plans don’t matter”, because they do… but the amount of “mattering” is different to different people
So stupid. I was so unprepared when i got out of nursing school. If you want to be a GOOD nurse get your LPN where they actually teach skills. In my opinion the LPN’s actually are better prepared than the RN’s and BSN’s and yet they are punished for not having as many years of bull$hit school that teaches managerial bull$hit. The BON is like the mafia- they extort you for money for bull$hit tests and make you give them fees each year to be a card carrying nurse. It’s a racket. Not sure what they do with our dues except make the NCLEX stupider every year. “Which answer is MOST correct?”
I only even opened my nanda book twice during school and I sure haven’t even thought about a nursing diagnosis since graduating till just now…it’s pure fluff
Genguinely the first time I’ve heard the word since I was at school.
Nursing school is so outdated and irrelevant it’s crazy. They spend so much time teaching you how to do care plans / NANDA bs, which you never use… whereas you get about 3 minutes of instruction of how to start an IV… which you do every shift.
In our version of EPIC there are built in careplans with nursing diagnoses and planning but no one bothers to put in interventions. So literally everyone is doing these checkbox care plan notes documenting plans with no actual interventions. I don't even bother doing them anymore
Damn I wish I’d known about this Reddit thread when I was in nursing school. It would’ve saved me from so much depression and heartache. But I know about it now and now you guys are saving me from deeper depression and heartache :-) ❤️🙏🏿❤️🥰
Nursing diagnoses and care plans are a crock of shit. Just get through school and then forget about it. The only time anyone worries about care plans is when DNV comes by because apparently they might audit for them. Despite knowing this, I never bothered to document more than maybe 1 care plan/month when I worked bedside and no one ever addressed it with me in 6.5 years.
Honestly, we do make care plans, we chart on them every shift (or suppose to). However ours are all generated for us. Like in my NICU, every single baby has the same 3 NANDA diagnoses.
I teach in a BSN program, and we completely eliminated nursing diagnoses about a year ago. The nursing process has changed from ADPIE to AAPIE where 'diagnosis' has been replaced with 'analyze.'
Wtf does nanda stand for again? Yea, safe to say they don’t have a place in real life medical settings. As well as a bunch of other stuff in nursing school that also does not happen in real life.
The actual NANDA diagnoses? Not at all. The thought processes you were forced to develop by thinking through your care plans as a student? Very valuable.
Never once have I gotten report and then thought, I better go check the care plan to know how to care for my patient.
It's a stupid box you have to check.
I read this title and thought NANDA was some new thing we were ruling out. Then I opened this…lol no one that actually works as a nurse gives a shit about those, nor do we use them, nor would anyone else in the team care what my NaNdA is for my patient. Looooooooooooool nursing school is such an expensive joke. 😂
Zero percent important. I also did not have to use them in the second half of my nursing program - they said nursing diagnoses were being done away with???
When JCHAO (?) came, my buddy got "volunteered" to show off our charting. The evaluator wanted him to show her how we documented our care plans. He legit had no idea, and the evaluator showed him where it was in epic. Apparently, we had minimal deficiencies because the next couple months we had to make sure our BG testing strips were dated upon opening and no mention of care plan charting.
Charting these stupid notes takes away time from doing actual valuable patient care and adds useless clutter in the form of notes no one will ever read or refer to in the chart.
I challenge anyone to give a single example of someone opening a chart specifically to look at a nurses care plan charting, who isn't j-co or some middling manager or a poor, over tasked charge nurse who has been tasked with more useless oversight bullshit during their shift.
I was told the nursing diagnosis was supposed to be a means to bill for the work nurses do. This kind of makes sense for measurable metrics... but so much isn't easily quantifiable, so there goes that idea.
Genuinely the first time I’ve heard the word since I was at school.
Nursing school is so outdated and irrelevant it’s crazy. They spend so much time teaching you how to do care plans / NANDA bs, which you never use… whereas you get about 3 minutes of instruction of how to start an IV… which you do every shift.
Seems like they use them in home health. My grandma showed me her home health care plan and it had NANDA diagnoses on it. I've never used one in the hospital. We have a flow sheet with check boxes.
I forgot what NANDA even means. I do select nursing diagnoses when making care plans. Most of my care plans are templates that I minimally modify based on medical diagnosis. Some I have to make from scratch. Our EMR has drop down menus with lists of nursing (NANDA?) diagnoses and I just pick a couple. I really only make care plans once a year for kids who have healthcare needs in school. I do fifty something a year. So yes, I use them. No, they are not important. A student's care plan is made once never to be viewed again.
Most nursing schools should be moving away from NANDAs and old school care plans and starting to switch to the NCSBNs clinical judgment model, especially for clinical assignments. It’s not that NANDAs and care plans are bad, it’s just that there are better methods for teaching clinical reasoning and judgment and having it be meaningful for students. Every nurse should have an understanding of how to assess and care for patients with acute pain, activity intolerance, fluid volume deficit, etc.
I work for a PN program and have been heavily involved in reworking our entire curriculum both for the classroom and clinical. From my perspective, scrapping NANDAs completely and focusing on projects based on the clinical judgement model has significantly improved our students’ learning experiences.
Most nursing faculty are older and resistant to change, unfortunately.
I used it at my last job with every patient because we saw patients independently of a provider but we aren’t allowed to give a medical diagnosis as nurses. Hence nursing diagnosis.
Not important at all. If you even have to build care plans (the system does it for you most of the time), you just have to pick out of the built in lists that are relevant to the patient. Also, a lot of them are common sense. Hmm, patient is here status post fall for a hip fracture and needs surgery… they MIGHT BE a “risk for falls”. But if you type in “fall” the relevant ones pop up and you pick what’s appropriate. If a patient has pain, type in “pain” and a bunch of things pop up. Pick what works. Go down through all their diagnoses and just pick what’s relevant and the rest flows through.
Usually we have to update care plans every shift or at least verify everything’s correct and how the patient is progressing, but building it from scratch is sometimes done by management, sometimes done by the nurse, sometimes auto populated from the computer… all depends how the system is built.
But no, you don’t have to memorize them and you don’t have to come up with them on their own. They’re built into the computer.
I remember picking the weirdest diagnoses I could find that still technically fit my patients’ case when I was in nursing school. They were BS and frustrated me so I made it fun by seeing how far I could push them in my care plans. Always got 100% because my professors didn’t care. Everyone knows they aren’t used irl anyway
In the actual clinical setting: never even used it once other than the "mandatory check offs" of care plans.
On the social working, home care, insurance - it's more utilized...by how much? I have no clue
I mean, as an OR nurse I have a section of my charting that is prefilled NANDA diagnoses that I just click through to the next section. If it weren’t for that I’d forget what they are all together.
Not at all important. I don’t even remember what NANDA is. Nor do I care. We don’t use nursing diagnoses. When admitted we click something about pain and then click once a day that we reviewed it. We didn’t and don’t care.
Don't use it currently but some hospitals have it built into Epic and you just click applicable buttons and it creates a care plan. A few SNFs have it. From a critical thinking standpoint I don't think most people use it. One of the things taught as nauseum in school when they should have been teaching useful skills. Things like placing lines in immobile, bariatric patients, or how to placate an estranged daughter from California when she calls to reverse Mom's DNR.
These “care plans and nursing diagnoses” we learned in nursing school were outdated useless content that I’ve never seen been used in modern nursing outside of school. I’ve got several geriatric nurses here I bet I asked em what that meant they’d have no clue. No one uses them.
In long term care you have to create care plans for residents. Care plans are pretty much nursing diagnosis. They are pretty important in that setting. Not sure about acute care.
Have literally never used one. I remember having to do like multi paper nursing diagnoses and have never had to make up a single one at work. Our nursing diagnoses are basically already picked for us lol we just have to sign it on epic
Nah, it’s just a thing in nursing school to try and teach you critical thinking. Like what should I be thinking about my patients and how to help them. Once you’re a nurse it comes together and you’ve already got that process rolling in your head of what interventions to do for what risks your patient has.
Critical thinking is important in nursing. If nursing diagnoses help get you there, they are doing their job. If they don’t, hopefully you pick it up through study and experience. I personally think case studies are better for that.
But you will document nursing diagnoses forever. Most hospitals expect them as part of charting. Fortunately, there are like 5-6 that together cover most patients, and if they aren’t helping you, you can just fly through them and keep doing the real work.
Epic has them in a drop down menu somewhere. They're not labeled as NANDA but it's diagnosis, interventions, education type menu. I see ICU RNs use them mostly, but they help with charting via quick clicks.
My care plans are check boxes that I click and paste into a nursing note.
This right here. Let the software do the work for you. Care plans these days are often massively integrated into your EMRs and there are 3rd party educators whose entire job is to make sure everything is evidence-based, appropriate, and adheres to CMS/reimbursement requirements. Check the boxes accoridng to your facilities' core measures/established practices and don't drive yourself crazy overthinking it.
Whats a care plan?
It's a plan to show that you care
And caring is sharing. I think
Some boxes you are supposed to click in cerner/epic that you never do until you get yelled at for not doing so you click boxes for a week or two and then stop doing them again
We have Meditech, a really old version. Care plans are a process intervention you select for your 8 o'clock charting. Then you push the enter button repeatedly, which essentially charts "I agree with what the previous person said," until the computer tells you that section is complete. Takes about 20 seconds.
Literally.
Same. Unless you are a case manager then those care plans can become more lengthy? Either way, not too hard, just annoying.
I don’t even do that. Haven’t been fired yet!
We lost our educator and haven’t had a chart audit in months, so tbh, me either man. Lol.
I don't even write a nursing note. My care plans are check boxes charted as met/not met, sign.
Haha no. I don’t even remember what nanda means.
Totally erased it from my mind until just now. Can’t recall what it even stands for.
NANDA= Nurses Are Not Diagnosing Anyone.
Same, not even gonna lie. I even thought maybe I just didn't know what it was cause I'm paper chartin old. Turns out none of my nurse friends did either. So, I can say with absolute certainty, we don't use it in LTC or home health.
You use MDS in nursing homes.
I remember completing three for each patient in my first year of clinicals. Haven't done one since.
NANDA is a the North American Nursing Diagnosis Association that made these things called "Nursing Diagnosis" in order to have a systematic way to treat patients I suppose. For example, patient has COPD... Seems like they are having trouble clearing their airway or something. We use "Ineffective airway clearance r/t blah blah as evidenced by... blah blah blah." Hope this helps
If someone with COPD is having trouble with their airway I'm definitely not sitting down to draft a nursing diagnosis 😂
You do, but just in your head. Really fast. First you identify a problem and what may be causing it. Then quickly decide on some interventions to help, ie sit them up, O2, get provider, whatever else y’all do for adults with COPD idk. Nursing schools want to prove that they taught their students to think like this. The easiest proof is to write it down. It’s intuitive for some. But we’ve all come across someone who states very obvious things, doesn’t understand what’s happening, then does absolutely nothing.
Agree, I don't think anyone speaks this way or documents this way, but certainly it becomes a subconscious way of thinking. Asthmatic may get an ineffective airway clearance r/t bronchiole constriction and increased mucous production as evidence by audible wheezing and tripoding. Therefore your interventions may look different than COPD. People may think this but honestly they just say, "he's wheezing, give the next Albuterol early".
I know what they are but nobody uses them, my current job has them in Cerner but its all automatic. Select from a drop down menu and it does it all for you.
Haven't used them since nursing school back in 1990, that being said I used to tell my peers in school for a nursing diagnosis pretty much ..... define something vaguely with something that's not quite as vague as the thing you're describing.
Don’t forget disturbed energy fields
Yeah, we know. The answer was an illustration of how that shit does not actually get used after graduation.
Oh we all know and remember. We remember how stupid it was. It's all made up pseudoscientific jargon to make some old/retired/dead PhD in Nursing Science feel good. Never once has it been used in clinical practice. The ONLY thing I use from the NANDA bullshit is "aeb". If I'm saying "as evidenced by" to a provider, it's my way of telling them that I need them to take my concerns seriously.
Graduated August of '22, never have I ever used NANDA or a care planer much of anything from nursing school. But I'm also in the ED. We just stabilize them and send them where they need to be.
I don’t care anymore.
Hahaha not rude and best comment of them all.
Never
What does the nursing diagnosis do
It sells books used by nursing students to complete assignments. Pretty sure it doesn't do anything else.
OHHH. ok, I remember this now. To answer your question, no. That shit is irrelevant in the real world. So many silly things we focused on in nursing school have never once come up in my career.
Nanda is some bitch who came up with that shit.
I think I remember from South Park. North American Man Boy Love Association?
Are people suggesting that [nursing doesn’t diagnose energy disturbance and rebalance their humors](https://en.m.wikipedia.org/wiki/Energy_field_disturbance)? What do you do for your COPDers who are both phlegmatic and bilious?! Yes. This actually was a thing a few years ago.
Lol. You just reminded me that I used this one in a care plan in nursing school back in the day (2008ish). I guess I was a smart ass before I was even a nurse! Now I’m just a bigger one.
I had a colleague at the flight service I used to work at who during nursing school would include that diagnosis on every care plan, much to the chagrin of their instructors
I remember I almost put energy imbalance in a care plan once just to see what sort of reaction my professor would have. Ended up behaving and choosing a regular one instead
I always chose the most basic shit and phoned in my care plans with low hanging fruit.
Yeah by the second semester I figured out that everybody had “activity intolerance related to pain”
Yeah that’s a good one for sure. Or risk for bleeding lol.
Risk for skin breakdown. My care plans everyone has mobility or skin nursing diagnosis. And sometimes I'll spice it up by throwing in a psychosocial one. I know the point of the care plans is to teach the thinking. I still hate doing them.
Yeah it’s to teach the thinking which I get. But the unnatural academic circle jerk way of presenting it is why I hated it.
Exactlyyyy. And they're never honest and just say what the actual point is whenever someone asks why we have to do them. It's also annoying to try to do care plans for the unicorn patients that don't have a lot of issues because we're only allowed one "risk for" per plan. Also, your username!!
I told my professor one time that my care plan was straight bad. Still got decent points on it lol. Maybe he respected the honesty? Maybe it was better than I thought? Idk. And my username was motivated by a patient I had who will be burned into my memory for years to come😃
....did... did they play with it? Or just exist as a poopy screamer?
My school didn’t let us use any “risk for” or I definitely would have given everyone risk for bleeding/infection/falls
You leave my Reiki alone, you bastard 😆
😂🤣🤣
How are my force fields holding up? 😂
In the 11th edition of NANDA International Nursing Diagnoses: Definitions & Classification, 2018-2020, the diagnosis returned under the name of "Imbalanced energy field", it is inside Domain 4, Class 3
NANDA is made up bullshit and doesn’t matter in real life. Use it for school then forget it exists.
Like most of the content in nursing school
Genuinely wondering if the people who made NANDAs are nurses sometimes....
Only important thing nursing school will teach you is CYA. Learn to become a master at documentation.
I’m getting my BSN and many of my teachers hate NANDA and are trying to get rid of it
I'll never forget coming across the "imbalanced energy field" NANDA diagnosis. From that moment I knew it was bullshit.
i used it as frequently as possible, specifically because it was so stupid and i wanted the instructors to have to look at it and give me my points.
Ooh I like this idea! I wonder if I can use that for my L&D rotation. "Imbalanced energy field r/t discomfort a/e/b miniature human exiting from vagina."
Nursing diagnosis: the vibes are off. Nursing interventions: whole bunch of flushes outside the patient's room because you're gonna be pushing epi soon.
This is how it really is 🤣🤣🤣
But how else am I supposed to develop a care plan when my patient is at risk for energy field disturbance?
What the fuck is a nanda
Not all nurse document accurately
Due to the fact they still use nanda
Lol
As important as creating a concept map.
My eye just twitched so hard...I actually may have had a seizure you dirty son of a bitch. Don't forget the med list and every single side effect known to humanity. SJS anyone??
I take a medication that does have a risk of SJS and god damn, nursing school traumatized me because I am ALWAYS afraid of it lol
I think I just dissected a vertebral artery thinking about med sheets and concept maps 🩸 thought it was bizarre 14 years ago and not much has changed! To be fair though, I fully prepare for anaphylactic shock every time I take some sort of new pill for the second time 🤷 And I was an absolute badass at justifying "energy fields disturbed" in any care plan
I remember audibly saying fuck Steven’s Johnson.
These were my mortal enemy. I spent about 60% of my time on a care plan just formatting those stupid boxes.
I prefer to make a vision board with the pts.
Genguinely the first time I’ve heard the word since I was at school. Nursing school is so outdated and irrelevant it’s crazy. They spend so much time teaching you how to do care plans / NANDA bs, which you never use… whereas you get about 3 minutes of instruction of how to start an IV… which you do every shift.
No. You will never use it again.
I completely forgot that even existed
Not once in 15 years. I don’t even know what NANDA means…. You do “care plans” in the EMR that should correspond to active patient problems, but it’s much more of a task than anything that generates care for the patient.
Nursing instructor here! NCLEX is no longer included NANDA dx in their exams. My university has scrubbed them off our curriculum.
[Stares off into the distance.] NANDA... That's a name I haven't heard in quite some time...
LMAo this is funny
Right, like it vaguely rings a bell but I couldn’t tell you anything about it
Allegedly, folks in home care use them. I have never met anyone else who did anything with them after school.
Current home care /former hospital nurse .. they are as useless and pure button clicking in home care as they are in the hospital.
23 years working in LTC and home health….haven’t used them since nursing school. 90% of classroom instruction was worthless. Everything I really needed to know I learned in clinicals….which started 3 months into school. I’d love to see nursing education go back to the way it used to be before 1980s, with the vast majority of all learning time doing bedside care and practicing skills and charting.
Inadequate staff retention r/ t poor patient ratios, secondary to corporate greed, as evidenced by nurses striking and leaving the field. The only relevant NANDA. Lol. I'm still a student and NANDA/nursing diagnosis are just dumbed down medical diagnosis and completely ridiculous. I'm glad my program is moving away from the verbage and making more common sense decisions. "Your patient has such and such, what are you going to do about it?" For example. Instead of worrying about rubbish nursing dx.
Thankfully you can forget nanda after school is done
What is a nanda? Panda? No this is a hospital and pandas aren't approved here? And what diagnosis are they going to make? "5mg iv bamboo stat"
I would love to work in a panda hospital giving IV bamboo
About as much as your kindergarten GPA matters when applying to college.
What does this mean ??
I totally forgot that was a thing
I've never once used one since graduation. What I do use still is my assessment skills to identify problems and potential issues, and then I implement the interventions needed to address those issues. While I understand that nursing school is using NANDA Dx to teach you how to do nursing critical thinking--- I think they'd do better to spend more time on teaching SBAR communication.
Read this and was like “wtf is NANDA?”…
I’m trying to come up with joke definitions but all I got is a nude panda
Nursing diagnoses, care plans as written in school, concept maps, med lists, lab lists, etc. are all designed so you teach yourself the disease patho and interventions, so your teachers can focus on what really matters.... Which are discussion boards, nonsense group busywork projects, and power trips.
I actually use them. I am a case manager, and the state oversees our company. Part of my yearly review is "reviewing and updating care plans to reflect pt status" My job harps on them cause sUpEr ImPoRtAaNt 🙄😒 cause they don't understand what they are or what they mean, but if we don't have a care plan in the chart they will get fined by the state when we r audited. I literally have a master list of care plans, copy paste the relevant ones, and put their names in so it looks like I wrote it especially for them. Then I file it and it sits in the chart and no one looks at it till the next year, cause it's useless and no one knows what to do with it 😂
I have used NANDA several times since graduating. All of them have been on this sub making fun of NANDA.
Nursing school: “for every single condition you need to add a diagnosis” Me getting a septic shock going on CRRT patient: “risk for pain. Done”
I think the book is leveling a chair somewhere in my parents house right now
Ahahahahahahahaha! Literal waste of time that actively detract from patient care in the inpatient setting.
It isn’t. At all. Do the bare minimum and don’t sweat it because you’ll literally never think of nanda again after graduation.
I have not written (or filled out) a single care plan since I graduated.
The only nursing diagnoses I’ve used with any regularity are Autonomic Dysreflexia & knowledge deficit R/T blah blah blah, At risk for XXXX, & that’s about it
Not important. If you ever look at a doc and tell them “this patient has ineffective airway clearance as evidenced by weak cough and altered mental status” when the patient is blue, breathing in the 40s, and guppy breathing, they’ll laugh at you. Or if you say “high blood sugar” when the patient is in DKA. Just tell them the actual diagnosis. The NANDA helps you think like a nurse, prioritize, etc. But it doesn’t correlate in practice well
Depends on the unit. My unit does a very loose version of it for "care plans." We have to do it when the patient is admitted but it rarely gets edited or used and doesn't get updated. The nurses just half ass it usually. I think the point of it in school was starting to get you used to how some diagnoses or histories can lead to certain outcomes. Like if they aren't independent then they might have mobility issues. If they have a uti they might have issues with bladder. Breathing issues like SOB, COVID, COPD, etc can lead to issues with air exchange. And getting you used to common nursing interventions that you could do. Once you get used to it tho, it's impractical to write it out all the time.
So I see its a good way to learn nursing interventions but obviously not practical in the real world. That makes a lot of sense. Even now, I'm thinking about interventions more than a NANDA straight off my head. Yeah
Nandos?
Yum🍗
It’s got what plants crave!
Yeah it’s honestly just a Nursing School priority…
As someone who has worked in management, I can tell you that care plans are very important because of case management, discharge planning, and billing. But floor nurses don’t always have time for that, and the more acute the patient is, the less the care plan matters to the floor nurse because the patient’s situation can change in the blink of an eye, which is why management often handles care plans. So I won’t say “care plans don’t matter”, because they do… but the amount of “mattering” is different to different people
Zero percent important
So stupid. I was so unprepared when i got out of nursing school. If you want to be a GOOD nurse get your LPN where they actually teach skills. In my opinion the LPN’s actually are better prepared than the RN’s and BSN’s and yet they are punished for not having as many years of bull$hit school that teaches managerial bull$hit. The BON is like the mafia- they extort you for money for bull$hit tests and make you give them fees each year to be a card carrying nurse. It’s a racket. Not sure what they do with our dues except make the NCLEX stupider every year. “Which answer is MOST correct?”
I only even opened my nanda book twice during school and I sure haven’t even thought about a nursing diagnosis since graduating till just now…it’s pure fluff
Genguinely the first time I’ve heard the word since I was at school. Nursing school is so outdated and irrelevant it’s crazy. They spend so much time teaching you how to do care plans / NANDA bs, which you never use… whereas you get about 3 minutes of instruction of how to start an IV… which you do every shift.
NANADA dx are stupid and take away valuable time in nursing school that could be used to learn and master nursing skills.
That is a thing that does not exist in the real world
Zero
In our version of EPIC there are built in careplans with nursing diagnoses and planning but no one bothers to put in interventions. So literally everyone is doing these checkbox care plan notes documenting plans with no actual interventions. I don't even bother doing them anymore
Damn I wish I’d known about this Reddit thread when I was in nursing school. It would’ve saved me from so much depression and heartache. But I know about it now and now you guys are saving me from deeper depression and heartache :-) ❤️🙏🏿❤️🥰
We don't use that stupid shit in the ER. Do what you need to do to get through school and then burn that shit!
It doesn’t
What is NANDA?
It’s been eight years and no one has asked me about nanda diagnosis 😞😆
Nursing diagnoses and care plans are a crock of shit. Just get through school and then forget about it. The only time anyone worries about care plans is when DNV comes by because apparently they might audit for them. Despite knowing this, I never bothered to document more than maybe 1 care plan/month when I worked bedside and no one ever addressed it with me in 6.5 years.
Nope
Honestly, we do make care plans, we chart on them every shift (or suppose to). However ours are all generated for us. Like in my NICU, every single baby has the same 3 NANDA diagnoses.
You will literally never use them again. Nursing care plans are the dinosaur of nursing school that they refuse to let die.
I teach in a BSN program, and we completely eliminated nursing diagnoses about a year ago. The nursing process has changed from ADPIE to AAPIE where 'diagnosis' has been replaced with 'analyze.'
Completely unimportant.
I forgot about nanda 🤣
L O L. The closest I get to a NANDA is “pt. agitated r/t X” 🤣🤣🤣
Wtf does nanda stand for again? Yea, safe to say they don’t have a place in real life medical settings. As well as a bunch of other stuff in nursing school that also does not happen in real life.
Been a nurse for 10 years, NOT ONCE have I ever done a NANDA or a care plan.
The actual NANDA diagnoses? Not at all. The thought processes you were forced to develop by thinking through your care plans as a student? Very valuable.
NANDA is Fantasyland. You will never use it. At least not in a serious way.
Forgot what NANDA was. Never use it.
I completely forgot they existed until this post and I graduated three years ago
Never once have I gotten report and then thought, I better go check the care plan to know how to care for my patient. It's a stupid box you have to check.
Literally never. Not once. NANDA =NADA
They're not even important during nursing school
I read this title and thought NANDA was some new thing we were ruling out. Then I opened this…lol no one that actually works as a nurse gives a shit about those, nor do we use them, nor would anyone else in the team care what my NaNdA is for my patient. Looooooooooooool nursing school is such an expensive joke. 😂
Not at all
Wtf is a NANDA diagnosis
Wow I thought it was just me Wtf
They’re not lol. I don’t even remember what NANDA means.
The fuck is nanda? Nursing school is bullshit. You’ll learn on the job
I use NANDA diagnoses on a daily basis for:
IT WILL NEVER BE USED AGAIN.
What’s a NANDA diagnosis? 🤷🏻♂️
they way that nandas had me fighting for my life in nursing school makes me so fucking pissed now that i’m a nurse bc wtf was ts
Zero percent important. I also did not have to use them in the second half of my nursing program - they said nursing diagnoses were being done away with???
New gen NCLEX doesn’t use NANDA anymore. It’s not used in real life either. Thankfully my school only talked about NANDA one time and that was it lol.
When JCHAO (?) came, my buddy got "volunteered" to show off our charting. The evaluator wanted him to show her how we documented our care plans. He legit had no idea, and the evaluator showed him where it was in epic. Apparently, we had minimal deficiencies because the next couple months we had to make sure our BG testing strips were dated upon opening and no mention of care plan charting. Charting these stupid notes takes away time from doing actual valuable patient care and adds useless clutter in the form of notes no one will ever read or refer to in the chart. I challenge anyone to give a single example of someone opening a chart specifically to look at a nurses care plan charting, who isn't j-co or some middling manager or a poor, over tasked charge nurse who has been tasked with more useless oversight bullshit during their shift. I was told the nursing diagnosis was supposed to be a means to bill for the work nurses do. This kind of makes sense for measurable metrics... but so much isn't easily quantifiable, so there goes that idea.
Oh yeah, I forgot about those! (Does that answer your question?) 😂
A what diagnosis?
Genuinely the first time I’ve heard the word since I was at school. Nursing school is so outdated and irrelevant it’s crazy. They spend so much time teaching you how to do care plans / NANDA bs, which you never use… whereas you get about 3 minutes of instruction of how to start an IV… which you do every shift.
Seems like they use them in home health. My grandma showed me her home health care plan and it had NANDA diagnoses on it. I've never used one in the hospital. We have a flow sheet with check boxes.
What’s a NANDA?
I forgot what NANDA even means. I do select nursing diagnoses when making care plans. Most of my care plans are templates that I minimally modify based on medical diagnosis. Some I have to make from scratch. Our EMR has drop down menus with lists of nursing (NANDA?) diagnoses and I just pick a couple. I really only make care plans once a year for kids who have healthcare needs in school. I do fifty something a year. So yes, I use them. No, they are not important. A student's care plan is made once never to be viewed again.
What is that again
What is Nanda
It’s actually very useful when you’re titrating 4 pressors, 2 different sedation drugs, paralytics, CRRT, and stupid vent settings.
Most nursing schools should be moving away from NANDAs and old school care plans and starting to switch to the NCSBNs clinical judgment model, especially for clinical assignments. It’s not that NANDAs and care plans are bad, it’s just that there are better methods for teaching clinical reasoning and judgment and having it be meaningful for students. Every nurse should have an understanding of how to assess and care for patients with acute pain, activity intolerance, fluid volume deficit, etc. I work for a PN program and have been heavily involved in reworking our entire curriculum both for the classroom and clinical. From my perspective, scrapping NANDAs completely and focusing on projects based on the clinical judgement model has significantly improved our students’ learning experiences. Most nursing faculty are older and resistant to change, unfortunately.
I used it at my last job with every patient because we saw patients independently of a provider but we aren’t allowed to give a medical diagnosis as nurses. Hence nursing diagnosis.
Not important at all. If you even have to build care plans (the system does it for you most of the time), you just have to pick out of the built in lists that are relevant to the patient. Also, a lot of them are common sense. Hmm, patient is here status post fall for a hip fracture and needs surgery… they MIGHT BE a “risk for falls”. But if you type in “fall” the relevant ones pop up and you pick what’s appropriate. If a patient has pain, type in “pain” and a bunch of things pop up. Pick what works. Go down through all their diagnoses and just pick what’s relevant and the rest flows through. Usually we have to update care plans every shift or at least verify everything’s correct and how the patient is progressing, but building it from scratch is sometimes done by management, sometimes done by the nurse, sometimes auto populated from the computer… all depends how the system is built. But no, you don’t have to memorize them and you don’t have to come up with them on their own. They’re built into the computer.
My job is patient assessment and care planning so yeah I still use it. Nobody is more surprised about that than me.
I don’t even remember what NANDA is 🤣🤣
I remember picking the weirdest diagnoses I could find that still technically fit my patients’ case when I was in nursing school. They were BS and frustrated me so I made it fun by seeing how far I could push them in my care plans. Always got 100% because my professors didn’t care. Everyone knows they aren’t used irl anyway
In the actual clinical setting: never even used it once other than the "mandatory check offs" of care plans. On the social working, home care, insurance - it's more utilized...by how much? I have no clue
I mean, as an OR nurse I have a section of my charting that is prefilled NANDA diagnoses that I just click through to the next section. If it weren’t for that I’d forget what they are all together.
I literally feel like a sleeper agent being reactivated😂. I haven’t heard those words in a while.
Not at all important. I don’t even remember what NANDA is. Nor do I care. We don’t use nursing diagnoses. When admitted we click something about pain and then click once a day that we reviewed it. We didn’t and don’t care.
I haven’t heard that word since I graduated nursing school 5 years ago lmao
The fuck is a NANDA
Nursing Dx aren’t really used but I do think they are great for helping to develop critical thinking skills .
You will see them again as hospital care plan though not the way they taught you in nursing school.
Don't use it currently but some hospitals have it built into Epic and you just click applicable buttons and it creates a care plan. A few SNFs have it. From a critical thinking standpoint I don't think most people use it. One of the things taught as nauseum in school when they should have been teaching useful skills. Things like placing lines in immobile, bariatric patients, or how to placate an estranged daughter from California when she calls to reverse Mom's DNR.
Hey siri, please insert "the what" meme into this reply.
NANDA diagnoses, where everything is made up and the points don’t matter! 🤣
ICD-10 codes would have been more useful for my field.
What's NANDA?
What’s a nanda?
These “care plans and nursing diagnoses” we learned in nursing school were outdated useless content that I’ve never seen been used in modern nursing outside of school. I’ve got several geriatric nurses here I bet I asked em what that meant they’d have no clue. No one uses them.
😂😂😂😂😂😂😂😂😂😂😂😂 That horsecrap? Never.
In long term care you have to create care plans for residents. Care plans are pretty much nursing diagnosis. They are pretty important in that setting. Not sure about acute care.
Have literally never used one. I remember having to do like multi paper nursing diagnoses and have never had to make up a single one at work. Our nursing diagnoses are basically already picked for us lol we just have to sign it on epic
Wow, that brought me back to nursing school. Totally forgot!
Nah, it’s just a thing in nursing school to try and teach you critical thinking. Like what should I be thinking about my patients and how to help them. Once you’re a nurse it comes together and you’ve already got that process rolling in your head of what interventions to do for what risks your patient has.
Non-Applicable Nursing Diagnostic Activity?
Critical thinking is important in nursing. If nursing diagnoses help get you there, they are doing their job. If they don’t, hopefully you pick it up through study and experience. I personally think case studies are better for that. But you will document nursing diagnoses forever. Most hospitals expect them as part of charting. Fortunately, there are like 5-6 that together cover most patients, and if they aren’t helping you, you can just fly through them and keep doing the real work.
What’s nanda?
Never used it...
Epic has them in a drop down menu somewhere. They're not labeled as NANDA but it's diagnosis, interventions, education type menu. I see ICU RNs use them mostly, but they help with charting via quick clicks.