good day everyone so today we will be talking about nursing care plan so this is also one of the most important thing that a student nurse or a nurse should do in terms of caring for their patient so prior to giving care to your patient you need to plan and you should be guided with your nursing care plan so learning objectives after 45 minutes of presentation learners will be able to describe what nursing care plan is differentiate the four different types of nursing care plan translate objectives of nursing care plan distinguish the purpose of nursing care plan systematize the components of nursing care plan and lastly relate to the examples given pertaining to what is a nursing care plan so what is a nursing care plan so it is being defined as a formal process that includes correctly identifying existing needs as well as recognizing potential needs or risk care plans also provide a means of communication among nurses their patients and other healthcare providers to achieve healthcare outcomes without the nursing care planning process quality and consistency in patient care would be lost so in making a nursing care plan we're always been guided with the nursing process in reviewing the nursing process we have the mnemonics at bay so what this advice stands for it's assessment diagnosing planning implementing and evaluating so this can be applied in the nursing care plan because with that application of a certain process or a certain model it could somehow identify the needs that we have to provide to our patient okay probably potential needs actual needs or even risks and at the same time this is a collaborative manner in terms of providing care to our patient because in the intervention section there is this particular part in which we do collaborate with other healthcare professions such as your medical technologist your physical therapist your respiratory therapist and the line so what are the different types of a nursing care plan so we actually have four different types okay so first we have the informal so when you say informal this is a strategy of action that exists in the nurse's mind so if you are categorized as an expert nurse or probably a proficient and well experienced nurse there come a time that you are not anymore writing care plans when you're trying to have your duty in the hospital however in the level of the student nurses in which they are categorized in the novice stage they need to have a certain plan that they should have to provide and they should be checked by their clinical instructors on the other on the other hand there is a type that we called a formal nursing care plan so this is in a written or computerized guide that organized information about the client's care so what student nurses are doing is through documentation some of them are doing it doing it in handwritten or even in computerized manner we nurses should accustom in writing nursing care plans because a nursing care plan is unique to every patient that we have so if we do have a patient in the hospital we certainly provide care plan individually you know so following the smarter format so i hope you still remember what smarter stands for okay this was discussed during the our discussion in f dar so it stands um s stands for specific and for measurable a for attainable r for realistic d is four time bound e is for effective and r is rewarding for a student nurse the second type of nursing care plan is your standardized care plan so this is specifically on the nursing care for groups of client with everyday needs okay so a very good example for this one since this is a group it could be a family type of nursing care plan we happen to know that in a family there come a time now we can categorize them as primary or even as extended family so with standardized type of nursing care plan we can utilize not just focusing more with our interventions with a specific patient or an or one patient but we can have it as a whole or as a group and we also have the very common type which is the individual lines so this is the lord to meet the unique needs of a specific client or needs that are not addressed by the standardized care plan so it's more into individualized so this pertains to in every patient that you have nurses who are working in the hospital should have an individualized nursing care plan because they're also looking into consideration with the type of patients that they do cater especially in their shift okay so say for example in a shift of six o'clock to two o'clock in the afternoon that's a morning shift in the hospital you might be able to care for probably five to six patients in average okay so in every patient that you have you need to have a nursing care plan for for that particular patient and it's unique because we identify different medical diagnosis we're making different nursing diagnosis for every patient so these care plans aren't the same irregardless if the patient have the same condition or same illness same as the other patient does so what is the objective of a nursing care plan so first it promotes evidence-based nursing care to render pleasant and familiar conditions in the hospital or health centers so when you say evidence-based that means to say now we are not fabricating things or it shouldn't be done in our own way of thinking so we are basing it with resources such as referring to books referring to journals through articles or certain research or studies in which we make sure that this is published and at the same time it's being applied because there are already certain researchers have done with a particular study and it seems it's effective in the nursing care profession second support holistic care which involves the whole person including physical psychological social and spiritual in relation to management and prevention of the disease so in focusing the care to our patient we are not just looking into the physical aspect of the patient but holistically so when you say holistically it includes the psychological condition the social and even spirit spiritual we can also consider the mental relation in terms of doing management and prevention next is establish programs such as care pathways and care bundles care pathways would include a team effort in order to come with a consensus with regards to standard of care and expected outcome while care bundles are related to best practices with regards to care given to a specific disease so as what we've mentioned it is unique okay and at the same time in having an ncp you also have to consider making objectives and in making objectives we've always been guided with a pneumonics kasheb this has also been discussed in making an fdar and this can also be utilized as an essential guide for nurses in making so so what this kashab stands for that is knowledge attitude skills habits experience and behavior that we have to consider in nourishing our patient with care another objective is to identify and distinguish goals and expected outcome so goals are being considered here as short-term and long-term goals later i will be talking about how to create a goal and what should what is a goal in the nursing care plan at the same time we also have to consider expected outcome so this can be discussed with the evaluation part of having your ncp okay so your ncp has an evaluation table in which you will be able to identify if goals are met not met or partially met and at the same time doing evaluation is not really intended at the last part of your ncp basically having an evaluation would can also be utilized when you're doing assessment when you are doing diagnosis or diagnosing your patient planning implementation and even re-evaluation should be done at all times you also have an objective to review communication and documentation of the care plan so reviewing communication collaboration and part of which is documentation are important ways of doing so without collaborating with other allied professions such as your doctor you can even collaborate with your colleague with the nurses or even with a with a nursing aides or whoever are there in the bedside of the patient or taking good care of the patient or in the nurse's stations are part in terms of reviewing the nursing care plan okay and lastly it measures nursing care so as what i've mentioned it should be measurable so probably in your interventions you have to consider and you have to measure if these interventions are applicable to that patient you have to base your interventions based on your assessment as well as with your diagnosing and planning so again we are utilizing the model of buying so there are also some purposes of a nursing care plan so one of which it defines the nurse's role we happen to know that the basic role of a nurse is to care but if you are in the hospital setting it's not about just caring however caring can also be labeled as doing nursing interventions giving medications collaborating with the doctor um being a facilitator at the same time being a leader on your own so that could be a very good role and responsibility that you will be that you should have okay second purpose is it provides direction for individualized care of the patient so there there is a purpose in doing so okay the reason why we're making an ncp because we want our care to be organized that's the main reason as to why we are trying to come up with an ncp having that kind of purpose or direction that we are giving to our patient it leads us with our goal on that particular shift okay so you are working for eight hours and sometimes nurses are tasked to have 12-hour shift in that particular day and utilizing your nursing care plan could somehow lead you to your goal at the end of your shift it could be rewarding on your end next it serves as a guide for assigning a specific staff to a specific patient so again since you have a patient and you're assigned to that patient you are entitled to care for that patient for that eight hour shift whether you're a student nurse or you are a nurse practitioner you are caring for that patient for the entire shift continuity of care it's one way for us to continue our care to our patient the previous nurse has a nursing care plan that was being made of course if you are the receiving nurse you have to continue your care and part of which is your endorsement the endorsement between you the previous nurse and you as the incoming nurse okay so with the care that was been provided by the previous nurse that can be endorsed to the receiving nurse and that we can consider that there is really a continuity of care for our patient next is documentation we happen to know that nursing care plan has lots of information that you are going to place or documentations no or certain management or interventions given to your patient no you can somehow utilize your nursing care plan to be translated as an fdar on your nurses notes and you can even check if your nursing care plan is effective is it worth writing in the nurses notes are all interventions given in accordance to what the patient is asking for for your care or for your service and is your plan effective or not okay so from time to time through documentation you are able to consider the things that you have to revise or something that you have to continue and it also defines clients goals okay so again for making an ncp you have to consider a goal-oriented ncp in which it should be client-centered or patient-centered and not nurse-centered so we're doing an ncp because of our patient and it and it's not on our own it's not an and now for our end okay so consider that one as well so what are the components of nursing care plan so first we do have the assessment okay so actually the i'll be giving you an example later as to what an ncp looks like how it is well patterned and how it is um standardized okay so in the first column you'll be able to see there an assessment so this is the first measure in order for you to design a care plan as nurses since first year in our undergrad we are already been trained on how to excuse assess our patient head to toe or the sepal caudal assessment some of us do assess our patient in a specific way so we are trying to review the different systems of the body and with assessment it's really particular it's client assessment is somehow related to following areas and abilities both both holistically not physically emotionally sexually psychosocially culturally spiritually cognitively in a functional way age related economically and environmentally okay so it's information in this area can be subjective and objective so what do you mean by a subjective data when you say subjective data it's more into patient's perspective or your client's perspective whatever is your patient it feels that can be translated as a subjective data we nurses or healthcare practitioners couldn't feel that it's just a patient so usually this is noted through coat and coat or as verbalized by the patient no a very good example of subjective cues are pain anxiety and stress level okay we couldn't feel that but it's just a patient who can feel that we also have the objective data so when you say objective data it talks more about the nursing perspective we are the ones who observed in our end with our clinical eye okay in such a way now whatever we see from our patient is something that we can transcribe or we can write in the objective data later i'll be showing some examples on how to do so next is your nursing diagnosis so a dosing diagnosis is a clinical judgment concerning on human response to health conditions life process processes or vulnerab vulnerability for the response by an individual family group or community so also nursing diagnosis are developed based on data obtained during the nursing assessment and enable the nurse to develop the care plan so a nursing diagnosis is totally different from a medical diagnosis we have to consider that okay in making a nursing diagnosis we tend to follow a certain formula later on the upcoming slide i'll be showing to you what is the formula in making a nursing diagnosis it's really easy however we have to be guided with the nanda book because in the nanda book actually ananda book is considered as our bible and the nurses bible and the nanda book contains all the nursing problems no in which it is accepted so the purpose of nursing diagnosis so first it helps identify nursing priorities and help direct nursing intervention based on identified priorities so incur in choosing a problem it's it should be the actual problem that you have to choose you should not choose those problems that are risks or put patients at risk of getting certain problems but what you see in the actual hand or what you see in the actual situation should be prioritized okay another thing is it provides a common language and forms of basis for communication and understanding between nursing professionals and the healthcare team so we nurses know how to do this so if a nurse could create a nursing diagnosis if a nurse can also read that or the colleague can read that both of them understand what they're doing so it's one way for us to have a communication in which we do understand that particular language and somehow we can refer this one to the doctor and other healthcare practitioners and nursing diagnosis can be for nursing students nursing diagnosis are an effective teaching tool to help sharpen their problem-solving and critical thinking skills because if you're able to create a nursing diagnosis there will be lots of interventions that you can make there are lots of things as to how you can plan as well as evaluating it if it's effective or not or if it was being addressed okay since it's a problem it should be addressed at the end so how to write a nursing diagnosis in pas format so what does pes stands for it sends p stands for problem e stands for ethiology and s stands for symptoms okay so the ps format okay again problem it's the diagnostic label ideology etiology is related factors and signs and symptoms is defining characteristics so using this format it's a diagnostic statement that can be one part two part or three part statements okay so as you can see this is a three part statement okay usually students couldn't able to write a nursing diagnosis and they're just basing it with medical diagnosis which is a no no doctors have different way of doing so we do understand how they create that but as a nurse we have to interpret the medical diagnosis in such a way that we can find a problem okay and explain how these problems were are developed and how it come up and of course its manifestations okay like your symptoms so this is the formula problem plus etiology plus symptoms but you have to connect it with related to from problem to ideology and from etiology to symptoms it should be as manifested by okay so say for example one of the problem in which it is credited to nanda is impaired physical mobility what is the reason behind impaired physical mobility it's because of the decrease in muscle control okay so when you see etiology on what is going on with the problem it describes the problem okay and then you have to advance as manifested by with a particular etiology you have to provide manifestations as to what the patient is experiencing so probably a very good example is inability to control lower extremities so when you read that that's impaired physical mobility related to decreased muscle control has manifested by inability to control lower extremities so i hope this helps in creating a nursing diagnosis again base your nursing problems in nanda okay which are the only accepted nursing problem list there are actually a lot okay and you can choose but you have to choose the actual or potential problem so scientific analysis this is the third column in your ncp okay so it provides the meaning of the nursing diagnosis of the client or patient so looking into the nursing diagnosis we happen to discuss that it has three different parts so we expect that in the nursing day in your scientific analysis column you need to have three paragraphs for ev for every parts of for every part of the nursing diagnosis is being explained so you have to explain the nursing problem explain the ethiology and you have to explain the manifestations okay and do not forget to write your resources in scientific analysis or references okay and it should be in apa 7th edition style okay next is your goal of care or plan of care so when you say goals this is more and described as what the nurse hopes to achieve by implementing the nursing interventions and can be derived from the patient's nursing diagnosis that is correct before you advance to the next column you have to consider the previous column okay so you have to base all your all your inputs to the previous column so since we've already advanced from scientific analysis and even nursing diagnosis then we have to base our goal to those two columns okay i believe that this is the fourth column of the ncp okay so this may be long or short term goal so when you when you say long-term goal this is actually considered um days okay or weeks probably weeks if you're in the community or days if you're in the hospital probably three to four days or even seven days it depends on the clinical rotation that you have okay but usually in our school in swu finma we usually use three to four days or four days because we have four days exposure in a particular week okay and at the same time again goals should be guided with pneumonics of your kasheb again it should be negligible it should have an attitude a skill habits experience and behavior that we can enhance for our patient okay and usually um we have to consider at least identifying that okay because in your eight hour shift okay you have to make sure that there are goals or objectives that you can follow okay having one objective isn't really that measurable meaning to say in an eight hour shift with one objective it's actually achievable but it isn't measurable why because it would it could somehow be achieved in just one to two hours imagine student nurses and nurses are given the chance to be with their patient for eight hours okay so consider making goals that are time bounded as well okay you have to consider the eight hour shift so in the eight hour shift you're expected to be at the bedside of your patient to care for your patient to implement the nursing care plan that you made okay so okay please be guided with this one kashab okay i always teach this one to my students in making your goal of care so the next column that you're going to have is the nursing interventions okay so nursing interventions are activities or actions that a nurse perform to achieve client goals interventions chosen should focus on eliminating or reducing the etiology of the nursing diagnosis or the reason why as to why the particular problem was experienced by the patient okay so you base your nursing interventions on your objectives or goal of care or the plan of care okay so in making your nursing diagnosis you have to follow the smarter format nursing interventions should be specific measurable attainable realistic time-bound effective and rewarding to the student nurse and you have to enumerate at least the nursing interventions for eight hour shift because if you're going to have one or two nursing interventions that is lacking you're not utilizing or maximizing your time or your care with your patient say for example a student nurse has only one patient for the entire shift and providing two nursing interventions it's just easy for you to achieve that okay especially if it's just an independent nursing intervention by the way an intervention or a nursing intervention can be categorized into three we have the independent dependent and collaborative so when you say independent you as a nurse you as a student nurse you're doing it on your own you've learned scientifically based on references such as the in the books in the journals or even in the conferences or meetings okay when you say dependent nursing interventions it has something to do with our dependency with the doctor's order so we have to consider the interventions as ordered by the doctors okay so i'll give you an example later i'll show you um what is an independent dependent and collaborative intervention and the other way around collaborative interventions it's something to do with your collaboration co-lab okay you have the co-lab with the other healthcare practitioners such as your med tech okay your physical therapist your radiologist your um respiratory therapist okay dietitians no that's collaborating okay that's also one of the component that you have to identify so the question here here is how many independent nursing interventions dependent nursing interventions and collaborative nursing interventions should i make so you have to base it with your objective of care it should be time-bound and measurable you could somehow identify at least six or seven independent nursing interventions and then probably two dependent nursing interventions and two collaborative nursing interventions again in identifying nursing interventions the minimum requirement is then okay if you are working in an eight hour shift how much more for staff nurses that there were they are working for 12 hour shift they would reach around 15 to 20 nursing interventions in their nursing care plan okay so next is nursing interventions are risk as for risk nursing diagnosis intervention should focus on reducing the client's risk and factors this is correct no because a very good example of a risk nursing diagnosis is the risk for infection so we are trying to create the kind of nursing intervention thus our intervention nursing diagnosis rather thus our nursing intervention should be related in preventing okay the accumulation of infection to our patient okay so please be guided with this mnemonics in the nursing intervention it should be smarter okay again specific measurable attainable realistic bound effective and rewarding to the student nurse okay so again just to give you a summary of the types of nursing intervention independent it's more into the activities that nurses are licensed to initiate based on their sound um judgment and skills the other way around dependent from the word itself depend we depend okay these are activities carried out under physicians order or even supervision and collaborative these are actions that nurse carries out collaboration with health team members such as your physician social worker dietician and therapists so the next column beside the nursing intervention are your rationale okay so when you talk about a rationale it also know it's known as the scientific explanation are the underlying reasons for which the nursing intervention was chosen for the nursing care plan we have to consider that in making nursing interventions these are guided with scientific explanation okay later i'll be showing you an example as to how you're going to organize your nursing intervention together with your rationale so for every nursing intervention there is a rationale that's very important because sometimes what you're doing is is that your patient might be curious as well especially that this patient is an adult patient okay and can converse okay they usually ask you why are you doing this why are you doing that you're doing that for what so in that way at least you can explain it to the patient the scientific explanation of what you're doing and you are not doing it on your own based on your based on your experience or whatnot okay so everything is guided here okay it should be evidence-based practice and the last column is your evaluation so evaluating is planned ongoing purposeful activity in which the clients progress toward the achievement of goals or desired outcome and effectiveness of the nursing care plan so as what i mentioned earlier you are not doing evaluation at the end of the plan however it's good that you're going to evaluate in every column that you are going to advance you may be able to evaluate with your assessment you may be able to evaluate with your diagnosis your planning and interventions however this can be found at the last part because it's one way for us to know if our interventions are effective thus goals are met not met and partially met in doing so with your evaluation you have to categorize if your goals were met not met and partially met because it's important why because it's one way for us to know that during the continuity of care if the receiving nurse will still have to continue doing that kind of care for the patient okay if the goal is met no need to explain but if the goals are not met or partially met you have to at least provide an explanation for that it's one way for us to communicate and document it okay but then again there is no right or wrong evaluation it could be a good outcome or a bad outcome okay so if you think that your interventions aren't working well your your goals and your plans aren't working well then you have to revisit that you have to revise that and you have to collaborate with the patient talk with the other healthcare allied personnel especially your colleagues the nurses in the station if how they can improve your nursing care plan because in that way our main purpose is to achieve the goal for our patient through care so let me show you a sample of a nursing care plan okay so let me just show my powerpoint now for the sample so this particular example is an example that i have with my students now so this is the output of my students so i took this one in their portfolio and i would like to share it to you because they were able to identify it correctly you know so in the first column as you can see it says in here that the defining characteristics should be categorized into subjective data and objective data okay so quote encode for subjective data it comes from the mouth of the patient from the feelings okay from the experience of the patient so the patient is verbalizing [Music] as verbalized by the patient so do not forget to write as verbalized by the patient because this is a subjective cue it came out from the mouth of the patient verbatimly now in the objective data one of the things that was being observed was the watery vaginal discharge now the question here is as a nurse can you observe a watery vaginal discharge that trips down to the foot or feet of the patient because if yes that could be considered as an objective daughter because you can observe it in your own it's the ner it's in the nurse perspective you're using your senses in having that you're using your sense of sight in observing that remember that in your objective data you are not choosing using your sense of sight but you have to activate your senses okay especially your sense of smell sometimes sense of taste can be used and the sense of feeling next is patient is positive with restlessness so you can see that the patient is restless right and even discomfort okay so there is a discomfort that you can identify now let's go to the second column it's the nursing diagnosis so in here since there is already a premature rupture of membrane we can say that the patient is really at risk of infection okay so ananda risk for infection is it isn't a is an accepted problem list so risk for infection related to rupture of amniotic membrane as evidenced by the watery vaginal discharge let's try to look at it if they're able to hit the formula first nursing problem were they able to identify risk for infection check now they trying to connect it with related to rupture of amniotic membrane okay that's the ethiology so let's check the rupture of amniotic membrane puts the patient at risk for infection okay now they try to connect it as evidenced by again it could be a sign or symptom water vaginal discharge because it's a manifestation coming from the patient or an evidence coming from the patient okay so that's how you do it now if you have an established nursing diagnosis you go directly to the scientific analysis so let's see if they were able to identify at least two to three paragraph explaining the risk for infection related to rupture of amniotic membrane as evidenced by watery vaginal discharge so i just don't want to read the scientific analysis but it seems like that they were able to discuss it properly okay and they also have their sources in apa 7th edition style okay next let's go to the goal of care now the goal of care should always start with after eight hours of nursing intervention the patient will be able to why is it eight hours because you have an eight hour shift if you are working in a 12 hour shift as a staff nurse you can put in their 12 hours of nursing intervention so that is your opening statement okay so as you can see in every number it is not any more redundant that they are using patient will be able to so in identifying the goal of care you have to consider the pneumonics kasheb remember knowledge attitude skills habit experience and behavior okay so let's try to check if they were able to address that one properly so number one first verbalize understanding of individual causative or risk factor of ruptured amniotic membrane so this hits the knowledge of the patient to be enhanced so let's check next manifest positive attitudes toward healthcare personnel and support persons did it hit attitude that is correct number three demonstrate take note of the verb demonstrate techniques in reducing risk of having infection they were able to enhance the patient's skill okay they're actually using this they're actually having these goals because we this pertains to the patient okay so it's patient centered next patient will be able to remain free of infection as evidenced by normal vital signs the absence of signs and symptoms of infection so this can be considered as an experience okay demonstrate ability to perform hygienic measures like proper oral care and hand washing this can be a habit and lastly behavior they're able to hit that's an early in recognition of infection to allow for pump treatment so that can be a behavior in which the patient can be enhanced so again kashab was had hit rather sorry so a long-term goal they say here that after three days of nursing intervention why is it three days because in their fourth day that could be considered as an evaluation day okay so they might not be able to care with the patient anymore because we're already doing our um case studies at that time exams should be provided by the clinical instructor at that time so three days or even four days if ever nursing interventions the patient will be able to so if it's a long term again you have to hit that one for at least a day not just in a shorter period of time so remain free from any signs and symptoms of infection such as a foul smelling um foul smelling or looking vaginal drainage elevated temperature uterus tenderness or rigid rigidness okay so the goal of care was properly constructed okay now let's take a look at the intervention so for the intervention it is more into classification of independent dependent and collaborative i don't want to um read it one by one however it's good that in this particular plan it's properly organized as you can see the identification of intervention is having a rationale beside it okay so make sure that your intervention should have a rationale beside it okay some students are just enumerating all the interventions needed and also the rationale without indenting it or properly aligning it okay so try to take a look with the number two okay so it's really specific measurable attainable realistic and time-bound and even effective and rewarding to the students okay next is third okay observe localizes signs of infection at the one side and you have the rationale next is offer perennial care for hygiene purposes with a patient or let the patient do it number five health teaching about perennial care relating to vaginal discharge educating patient teaching patient educating patients with the signs and symptoms of infection and so on and here in the independent independent nursing intervention they administer medication as prescribed by the physician so what's the rationale behind administering such medication and collaborative refer to the patient to the attending physician if it worsened on the health condition okay so in this they trying to collaborate with the physician through proper if irl so let's go to your um evaluation table so this is a very good example your evaluation table it's being based in the goal of care or the objectives of care okay so after eight hours of nursing intervention the patient was able to that is your opening statement we use once as passport as a past tense it should be in past tense because it is or it already happened okay so we use will and goal of care because we still have to do it it would be a future tense that you're going to use so okay so it's more into verbalization what they're trying to do is they try to evaluate in the goal of care and they just put everything whatever is in the goal of care because at the end of the nursing care plan our goal should be achieved that is our main goal and take a look at it they are able to categorize it if the goal was met okay or not met but i think it came to be effective the nursing care plan came to be effective because everything was met but then again if the goal was not met or partially met still you have to indicate that and you have to explain it then okay even the long-term goal you also have to consider as well as to what's going on with the long-term goal so i think for the long-term goal it's also met okay so i think that is all for the example okay so let's go back to the slides okay since we happen to know a good example of nursing care plan i know guys now you are also required by a clinical instructor to make a nursing care plan this is the time that you can enhance your nursing care plan based on the knowledge that you've learned okay so in summary let us cite again the different steps okay so step one data collection or assessment very important number two step two data analysis and organization okay step three formulating your nursing diagnosis step four setting priorities step five establishing client's goal or decide outcome number six selection or selecting nursing interventions number seven providing a and lastly step eight you have to do evaluation okay so in conclusion creating a nursing care plan begins with a complete assessment of your patient okay get as much information as much as possible from them talk to them collaborate with them tell them what you want what you want from them and they also want to tell you what they want from you you can utilize the chart as well such as laboratory data diagnostic reports physical physician history and physical examination inputs but then again consider this as a great reference or a source of information okay but don't be too dependent to these resources because it should come from your own assessment but these are good supporting resources okay then you consistently build rapport all throughout the process i know that you guys are good with this no since first year you are already taught how to build rapport to your patient every time you're assigned to them okay and have a good communication skills always consider practice and practice and practice because practice makes perfect okay and don't forget to be yourself to ace your ncps don't be afraid to get a low score because if you get a low score in your ncp coming from your clinical instructor that's actually a good sign that you have to improve your writing of the nursing care plan there's still room for improvement for that okay if you experience a lot of nursing care plans that you're making i tell you if you're able to master it and you keep on repeating you keep on doing it again and again and you're able to accept the criticisms as well as with the corrections coming from your clinical instructor then you can somehow ace your ncps in the future okay so these are my references in apa seventh edition okay i base it with don justin vera all right thank you so much for listening student nurses and staff nurses you guys have a great day