Utilizing Care Plans and Admits Questions to Facilitate Optimal Care of the Critical Patients
Despite nursing care plans (NCPs) and bundles being an accepted part of human nursing, there is still some reluctance to use care plans within the veterinary setting. However, when nursing complex and critical patients, these documents can be invaluable.
One stark contrast is that within the human field, the patients are an active part of the care planning process, unless they are unable to be so, and it’s reported that the process of planning can be more valuable than the end product. This process enables the patient and their family to strengthen bonds with each other and the clinical teams.1
Whilst the patient isn’t actively able to contribute within our profession, consideration must be given to the benefits it brings by the professional interdepartmental conversations that need to occur with our critical patients. Thought could also be given to the value that could be given to our clients if we were to actively involve them in the care planning process.
With a critical patient it can be easy to become focused on the more urgent care needs and some care needs may be overlooked.2 Those needs can impact the patient’s recovery and transition home so we cannot afford to not consider them.
A large part of critical nursing is the reassessment with the goal to return to normality, but if we do not know what normal is, what are we aiming for? Establishing what normal looks like for a patient can require questioning and discussion with the patient’s owner.
This stage is the start point of any NCP, but with patients who present in an emergent state, it can be challenging to pinpoint the time to do this. It is worth remembering the human field has identified this process as one that is comforting to the loved ones.
We should not underestimate the benefit of an NCP. Particularly with a complex case, a systemic and analytical approach to patient care will allow us to consider all aspects of the patient’s care and encourage active discussion. It has been concluded that the benefits to the patient far outweigh the time taken to complete an NCP.3
References
1. Reassessing advance care planning in the light of covid-19. BMJ. 2020;369:m1927. doi: https://doi.org/10.1136/bmj.m1927.
2. Aldridge P, O’Dwyer L. Practical Emergency and Critical Care Veterinary Nursing. Oxford: John Wiley and Sons; 2013.
3. Welsh P, Wager C. Veterinary nurses creating a unique approach to patient care: part two. The Veterinary Nurse. 2013;4:9.