Plan of Care

I appreciate everyone’s input (both here and on facebook) and it gave me a lot of things to think about.  Housework gives a woman a lot of time to think about things.  Sometimes it’s one of my least favorite things, but I appreciated it yesterday.

Nurses make a LOT of care plans, especially student nurses.  They’re taking a holistic approach to each patient.  So, here’s my plan of Care for for Conner, I’m only doing it here in order to have a way to document it and I also had some people wanting to know what I’d end-up doing. :) I’ll give in SBAR format, just like we do at the hospital.

Situation:  9 year old male stealing treats

Background:  Male was provided with plenty of healthy treats including string cheese, yogurt, banannas, pretzles, carrots, tomatoes.  Male stated (after some pressure applied) that he was stealing because he was mad at us and he could prove that he could.  Male also had a treat bag of his own that he had full discretion of if he took care of it properly (aka, not leaving them all out where P could eat them).

Assessment:  Main issue is a lack of trust.  He’s obviously not overweight (although it could be an issue in the future) but when all these things are available for consumption he still chooses something that’s not available to him.  Male is aware that if he talks to us, a treat may be an option.

Recommendation:  Male spent a day making his own meals, and was only able to do things that I trusted him to do.  I no longer trusted him to cook, hence he had a yogurt for breakfast, PB&J for lunch and cereal for dinner (and we had pizza, RN noted some liquid discharge beneath his eyelids during the dinner hour).  Spoke with male about trust issues, and I am restricting him from things that require trust.  Holding baby, staying at school to play, allowing him to be in his rooom alone, to go outside.  Male also will not have treats in his lunch or after school but will be offered a healthy snack.

Will make further assessments daily and as indicated.

He obviously does want to earn my trust and it’s a big issue for me.  Did anyone go to Band Leadership Training and play the 1 and 2 game?  Essentially, everyone wins if they keep playing 1’s, but once anyone plays a 2, that person gets more points and the other person loses.  BUT, if both people play a 2 then everyone gets no points.  I think I may play this game with him at FHE.

Thanks for the help blog peeps.

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Comments

  1. says

    That SBAR format is cool!

    Your plan sounds good. I have a few questions, as I’m always curious about this kind of stuff.

    Why is Conner mad at you guys? Does he feel like he doesn’t have enough freedoms, so he is trying to rebel?

    I might try a totally opposite approach. Again, what is he mad about? How could you make him feel like he is more a person worthy of trust? Could you look for opportunities to build him up, and give him the evidence of success of how much he is growing and how trustworthy he is?

    I tend to be more of a softie (!) So everyone may not agree. I had an issue with some students this year who were using profanity. The more I made a big deal of it, and enforced punishments, it seemed the more they felt compelled/challenged to do it. After consulting with our school counselor, I took a different route, talking to the boys just very quietly and privately about it, and dialing down the ‘drama.’ I stopped enforcing punishments except for telling the boys parents. : ) It totally went away!

    I also recommend talking to our school counselor. Any parent can come to him with a question. He has such good advice – things I don’t think of.

    Keep us posted!

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