By AssignmentHelpKit Editorial Team, reviewed by subject experts · · 8 min read
A nursing care plan is a structured, written plan that follows the nursing process: you assess the patient, identify their nursing problems or diagnoses, set measurable goals, choose evidence-based interventions and evaluate whether the goals were met. In an academic assignment you also have to justify each step with evidence, protect patient confidentiality and, often, reflect on your own practice using a recognised model.
This guide walks through both tasks: how to write a nursing care plan that markers can follow, and how to write a clinical reflection that goes beyond describing what happened.
Please note: this is academic writing guidance for nursing students, not clinical advice. Always follow your placement's policies, your mentor or practice supervisor, and current local and national guidance when caring for real patients.
The nursing process (ADPIE) explained
Most nursing programmes teach the nursing process as five stages, often remembered as ADPIE. Some UK programmes use a four-stage version (assess, plan, implement, evaluate) that folds diagnosis into assessment. Use whichever your module specifies.
- Assessment: collect subjective data (what the patient tells you, such as pain or anxiety) and objective data (observations, NEWS2 score, fluid balance, wound appearance, validated tools such as a pressure ulcer risk score or a pain scale).
- Diagnosis: identify the nursing problems, which describe the patient's response to their health condition rather than the medical diagnosis. "Impaired mobility related to post-operative pain" is a nursing problem; "fractured neck of femur" is a medical diagnosis.
- Planning: prioritise problems (airway, breathing and circulation first, then safety and comfort) and set SMART goals for each one.
- Implementation: carry out evidence-based interventions and document them, with a rationale for each.
- Evaluation: compare the outcome with the goal. Was it met, partly met or not met? Then reassess and update the plan.
The cycle is continuous. Markers look for evidence that evaluation feeds back into assessment, not a plan that stops at step five.
Some modules also ask you to frame assessment around a nursing model, such as the Roper, Logan and Tierney Activities of Living model. If so, name the model and show how it shaped the data you collected.
Writing SMART goals for a nursing care plan
A goal must describe the patient's expected outcome, not the nurse's task. Make it SMART:
- Specific: one clear outcome.
- Measurable: linked to a score, observation or patient report.
- Achievable: realistic for this patient's condition.
- Relevant: linked directly to the nursing problem.
- Time-bound: with a clear review point.
Weak goal: "Patient's pain will improve."
SMART goal: "Patient will report pain of 3 or below on a 0 to 10 numerical rating scale within 60 minutes of prescribed analgesia, reassessed each shift for 72 hours."
How to write a nursing care plan: a sample table
The patient below is entirely hypothetical and anonymised in the way your assignment should be. "Mrs J" is a 78-year-old woman, two days after surgery for a hip fracture, with reduced mobility, a pressure ulcer risk score indicating high risk, and reported pain of 7 out of 10 on movement.
| Nursing problem | SMART goal | Interventions | Rationale and evidence | Evaluation |
|---|---|---|---|---|
| Acute pain related to surgical wound, limiting mobility | Mrs J reports pain of 3/10 or below on movement within 48 hours | Assess pain using a 0 to 10 scale at rest and on movement; give prescribed analgesia before physiotherapy; use non-drug measures such as positioning | Regular assessment allows timely, effective analgesia; pain control supports early mobilisation after hip fracture surgery (cite current NICE hip fracture guidance) | Day 2: pain 4/10 on movement, goal partly met; discussed analgesia timing with team |
| High risk of pressure ulcer related to immobility | Skin remains intact over sacrum and heels throughout admission, checked at each reposition | Skin inspection; help to reposition at least every 4 hours (high risk); pressure-redistributing mattress; heel offloading | NICE guideline CG179 recommends repositioning high-risk adults at least every 4 hours and using high-specification foam mattresses | Day 2: skin intact, goal met so far; continue and reassess risk score |
| Risk of dehydration related to reduced oral intake | Oral intake of at least 1,500 ml per 24 hours by day 3, recorded on a fluid balance chart | Offer drinks hourly when awake; place within reach; accurate fluid balance; monitor urine output | Older adults are at higher risk of dehydration, which is linked to delirium and acute kidney injury (cite a peer-reviewed source and local policy) | Day 2: 1,100 ml, goal not yet met; referred to dietitian, plan updated |
Notice that each row links problem, goal, intervention, evidence and evaluation. In your written assignment, expand each row into a paragraph that critically discusses the evidence: why this intervention, how strong is the evidence, and what the alternatives are.
Confidentiality: anonymise every patient
The NMC Code requires nurses, midwives and nursing associates to respect people's right to privacy and confidentiality, and your university will treat breaches in assignments seriously. In practice:
- Never use a patient's real name, initials that could identify them, date of birth, hospital number, ward name or exact dates.
- Use a pseudonym and say so, for example: "To maintain confidentiality in line with the NMC Code (2018), the patient is referred to as Mrs J."
- Don't name the hospital, trust or care home. "An acute surgical ward in an NHS trust" is enough.
- Don't include photographs or copies of real charts, even with names removed.
- Anonymise colleagues as well: "my practice supervisor", not their name.
Clinical reflection in nursing: choosing a model
Clinical reflection papers ask you to analyse an experience from placement and show what you learned. Reflection is also part of NMC revalidation, so it is a professional skill, not just an assignment format. The three models you will meet most often are:
| Model | Stages | Best for |
|---|---|---|
| Gibbs' Reflective Cycle (1988) | Description, feelings, evaluation, analysis, conclusion, action plan | Longer reflective essays where you need to show detailed analysis and emotional awareness |
| Driscoll's model | What? So what? Now what? with trigger questions for each | Short reflections and practice logs; quick to structure |
| Rolfe et al. (2001) | What? So what? Now what? as a framework for reflexive practice | Reflections that move from description to theory to changed practice |
Driscoll and Rolfe both build on Borton's earlier "What? So what? Now what?" questions. Use the model your module names; if there is a choice, Gibbs works well for 1,500 words or more because it forces you to evaluate and analyse separately.
Gibbs reflective cycle in nursing: a short example
Here is how the analysis stage might read for the pain example above:
"On reflection, I initially accepted Mrs J's statement that she was 'fine' without using a pain scale. Older adults, particularly those with cognitive impairment, may under-report pain, and structured assessment tools improve recognition. Using the numerical rating scale before her physiotherapy session revealed a score of 7/10, which explained her reluctance to mobilise. This experience showed me that assessment must be systematic rather than conversational, and that communication with the physiotherapist about analgesia timing directly affected her recovery."
That paragraph links an event to evidence and to changed practice, which is exactly what markers reward. For a full walkthrough of each stage, read our guide to writing a reflective essay using Gibbs.
Linking your care plan and reflection to evidence
Nursing markers expect current, credible evidence for every intervention:
- National guidance: NICE guidelines (for example CG179 on pressure ulcers), plus relevant national policy and your local trust policies (described generally).
- Peer-reviewed research: search CINAHL, PubMed/MEDLINE and the Cochrane Library. Prefer systematic reviews and recent primary studies, usually from the last five to ten years.
- Professional standards: the NMC Code and the NMC Standards of proficiency for registered nurses.
- Textbooks: fine for definitions, but don't rely on them for the evidence behind interventions.
Critically appraise sources rather than listing them: mention sample size, setting and whether findings apply to your patient group.
Common mistakes in nursing care plans and reflections
- Writing goals about what the nurse will do rather than what the patient will achieve.
- Mixing up nursing problems and medical diagnoses.
- Leaving out the evaluation column, or writing "goal met" with no evidence.
- Too much description and not enough analysis in reflections.
- Accidentally identifying a patient, ward or colleague.
- Using outdated guidance that has since been replaced.
Getting help with nursing assignments
If you'd like a model care plan to learn from, help finding current evidence, or proofreading and feedback on your reflection, AssignmentHelpKit's nursing assignment help team supports students at every level. Share your brief on WhatsApp for a free quote and expert guidance.
Frequently asked questions
What are the five steps of a nursing care plan?
The five steps follow the nursing process, ADPIE: assessment, diagnosis, planning, implementation and evaluation. Some UK programmes teach a four-stage version (assess, plan, implement, evaluate). Use the version your module specifies and show how evaluation leads back into reassessment.
Do UK nursing students use NANDA nursing diagnoses?
NANDA International diagnoses are widely used in the USA and some other countries, but many UK programmes describe "nursing problems" or "nursing needs" instead. Check your module guidance; if NANDA-I is not required, write clear problem statements that link the patient's response to its cause.
Which reflective model is best for nursing students?
Gibbs' Reflective Cycle is the most common choice for longer assignments because it separates evaluation from analysis. Driscoll's model suits shorter reflections and practice logs. Rolfe et al.'s framework works well when you want to emphasise how reflection changes future practice.
How do I keep a clinical reflection confidential?
Use a pseudonym, remove anything that identifies the patient, colleagues, ward or organisation, and state that you have done so in line with the NMC Code. Describe settings generally and never include real documents or dates.