Develop a person-centred respiratory care plan
Detailed independent learning resource · not an official NMC station
Priorities, SMART goals and person-centred care planning
Use these notes before attempting the scenario. The purpose is to learn why a safe action is appropriate, not memorise an unchecked script.
Learning outcomes
- Link assessment findings to prioritised nursing problems
- Draft realistic, reviewable goals that reflect patient preferences
- Separate nursing observations and supportive care from authorised treatment decisions
The care plan starts with assessment
The earlier respiratory scenario contains several urgent features. A plan is not a wish list: it identifies the patient’s present needs, goals, relevant actions, monitoring and responsibility for review. First acknowledge that acute deterioration requires the appropriate clinical response. A written plan must not delay immediate care. Take account of the patient’s wishes, communication ability, disability, language needs and capacity; if capacity may be impaired, follow legal and local decision-making safeguards.
Set goals that can be reviewed
A useful goal is specific enough that another professional can recognise whether it has been met. Instead of “patient will get better,” a simulation goal could be “patient’s respiratory distress and observations will be reassessed and communicated at the frequency directed by the clinical escalation plan.” The goal must reflect the current clinical orders and avoid inventing numerical treatment targets. Nursing interventions can include explanation, comfort measures, observations, handover and timely escalation within competence.
Plan collaboratively
A patient-centred plan accounts for what the patient feels is most troubling, who should be informed with their agreement and the support required from the multidisciplinary team. An interpreter may be needed. Document what was discussed, consent and any uncertainty. State what the registered nurse can initiate under policy, what requires prescriber authorisation and when the plan will be reviewed. Dignity and communication are not optional extras to the physiological goals.
Visual workflow for this station
Worked clinical example
Practice prompt: Create a brief care plan in the respiratory case while a qualified clinician reviews the patient.
Model reasoning (illustrative)
Priority: possible acute respiratory deterioration. Goal: timely qualified review with ongoing safe monitoring of respiratory status and patient distress. Nursing actions: communicate the concerning observations, follow the approved observation frequency and instructions, support comfort and explanation, reassess for changes, apply indicated infection-control measures and document actions. Review: compare observations and patient experience after each reassessment and escalate if deterioration continues.
Example communication or SBAR
Planning handover: urgent respiratory deterioration recognised; clinician contacted; current observations shared; nursing plan focuses on monitoring, communication, dignity and timely reassessment pending authorised treatment.
Why this approach is safer
The plan links problems, actions, responsibility and review, without inventing a drug, oxygen target or independent procedure.
Simulated OSCE station
Candidate brief
Continue the same simulated respiratory deterioration scenario. A registered clinician is assessing the patient. Your task is to describe a nursing plan while the multidisciplinary team decides investigations and treatment.
Candidate instructions
Identify urgent priorities, appropriate observation, communication, involvement of the patient and methods for reassessing the plan. Explicitly separate authorised orders from independent nursing observations.
Untimed option: Complete the checklist below without starting the timer. For a timed rehearsal, select a duration and press Start. Practice durations are editable and are not official NMC timings.
Formative self-assessment checklist
Tick actions you can clearly explain or demonstrate in supervised simulation. This is self-assessment, not an official NMC mark or proof of competence.
0 / 8 actions reviewed · formative only
Feedback and viva answers
Your checklist completion is a learning tracker, not an examiner grade. A checked action can still be performed incorrectly. An instructor must assess actual technique.
Common mistakes and why to avoid them
- Writing a diagnosis as fact when it is only suspected.
- Setting goals without a measurable review process.
- Ignoring consent, communication or what matters to the patient.
- Including medication changes without an authorised order.
Viva prompts with model answers
How would you prioritise competing problems?
Prioritise immediate threats to safety and timely escalation before longer-term comfort or discharge goals. Reassess priorities as the condition changes.
What is the purpose of a measurable care-plan goal?
A measurable goal permits review of progress and allows the team to see whether interventions and observations are having the intended effect.
When must the care plan be escalated or revised?
Revise after a new assessment, deterioration, a change in authorised orders, or when goals are not being met. Communicate changes and document them.
Key learning point
Planning must follow assessment and current clinical orders, not replace individualised medical decisions.
Read further and verify guidance
Related lessons on My Nursing Hub:
Primary professional sources:
Content is independently authored and awaits qualified clinical review. Always use current official guidance and local policy.