A Competent Nurse's Notes
by: MJ Salonga, RN
S: “Patience with our patients is the key.”
O: Found this nurse in the unit, ambulatory, busy-looking. More or less oriented to time, place, and person. With dry oral mucosa, on nothing per orem since the shift started. With symmetrical chest expansion, noted to be tachypneic, almost struggling for breath. Abdomen flat, not distended. Pulses full, bounding at +2. No contraptions noted but seen holding used intravenous tubing, urinal, dry and wet cotton, and medication tray. Skin cold to touch, pale in color. Due to void.
A: Risk for Caregiver role strain related to multiple demands of patients
P: For the nurse to sustain competent and compassionate nursing care and for her to function best albeit the demands placed to her.
I: (in the making…) :)