Today, reading old writings from years past. The big hiedy-ho moment? When I realized nothing is changing in Nursing. Way back in the training period of '81-83, having to write by hand, those silly care-plans.....knowing at that moment, that P.O.C. really stood for piece of crap.............About every 10 years, I check the landscape, and we're still dragging around that POC anchor. You find me a nurse, who thinks these POC things really have value (not just something that gets audited, so that's why we do it), and I'll show you a nurse who wants to join management, because they groove on these concepts.

On that cynical note, here are my words from around 1993:

The Care-Plan Stomp

As nurses of these modern times

We're guided by the rules,

The policies and procedures

Designed by greater fools,

And every working moment

We must document our actions,

Despite the ever present risk

Of paperwork impaction.

The bedside nurse's duties

Are defined by job-description,

A lengthy boring manual

That's written in Egyptian,

There's a universal format

We call the P.O.C.,

Officially named the Plan of Care

It's a Piece of Crap, to me.

There isn't any doubt

There was once a worthwhile goal,

But in the interpretation process

It's been lost in some black hole,

Burying the spirit

By the wording of the plan,

It astounds the simple logic

Of any thinking man.

In the unit that I work

The P.O.C. is simple,

We're training adolescents

How to cultivate a pimple,

So all we have to document

Is how they wash and eat,

We write, “Alteration in Nutrition”

And right there, I claim defeat

Each and every problem

We address by intervention,

If we documented properly

We'd be forced to place attention,

On the paperwork itself

Instead of sick old Joe,

Who'd be swirling down the drain

With a documented glow.

I've worked in many hospitals

I'm care-plan oriented,

But the way this thing is going

I'll soon become demented,

And the hospital will be forced

To pay me Workmans Comp.,

Because I suffered mental injury

Performing the care-plan stomp.

Fibril_late;

circa: 1993