Health Care Planning Process: Function & Member Roles

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

Nurse aids function as an important part in the care planning and implementation process. Read this lesson to learn more about the interdisciplinary team and how nurse aids help accomplish team goals.

It Takes a Team

Jillian looks forward to starting her career as a nurse aid and is currently finishing her training at a local hospital. She works very closely with the nurses on the unit, but also receives direction from physicians, social workers, and therapists. Now that she is spending some time in the actual work environment, she notices that it takes a team of care givers to plan care for the patients and then implement the plan and carry it out.

The Patient's Care Plan: Where Does It Come From?

Jillian quickly overcomes the tasks required by her role as a nurse aid, receiving joy and fulfillment from providing direct patient care. She learns that her responsibilities are either routine duties or are directly communicated by the nurse. She begins to wonder if there is a bigger plan in place, and asks her primary nurse how care is determined for each patient.

The nurse explains that a collaborative and interdisciplinary team gets together as often as necessary to address the needs and goals of each individualized patient. The interdisciplinary team is a collection of direct and indirect caregivers that make decisions regarding the patient's plan of care. This team usually consists of:

  • Physicians or medical providers: Typically consists of physicians, physician assistants, or nurse practitioners who order medical tests or drugs to treat patient ailments
  • Nurses: A group of professionally trained caregivers that directly oversee nurse aids
  • Physical, occupational, speech therapists: Therapists who provide exercises and techniques to promote safe mobility and movement
  • Nutrition or dietary consultants: Professionals who note special dietary concerns
  • Spiritual leaders: Religious leaders who attend to spiritual and religious needs
  • The patient and their family members: Express whether they feel their care plan needs adjustment

Together, the team meets to discuss interventions or specific activities that will achieve the goals of each patient's care plan.

Moving Towards Collaborative Care

Sensing that Jillian is ready to learn more about the patient's care team and how the care plan is created and implemented, the nurse invites her to the care plan meeting being held on the unit today. She is excited to understand the process, and ensures she tends to each patient prior to leaving for the meeting.

Reviewing the care plan may occur either in person or through a shared document within the patient's medical record. The care plan is kept within the patient's record to promote individualization and protect patient privacy. On Jillian's unit, the care plan is an electronic document that is brought to the patient's room for discussion.

While inside the patient's room, Jillian observes the team discussing the patient's expectations along with what can realistically be accomplished in the hospital. The physician shares the progress the patient is making medically, the nurse discusses observations regarding activity and daily function, and the social worker shares his concerns regarding the discharge process.

The Nurse Aid's Role

The team shares its experiences regarding the patient's progress and the nurse encourages Jillian to speak to the team regarding observations and concerns. She shares information regarding:

  • General status and mood of the patient
  • Difficulty with meals and bathing
  • Concerns she has regarding the patient's safety

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