So far we’ve talked about reasons I’ve heard for becoming a nurse. Now let’s start with basic nursing care. Basic nursing care includes recording a patient’s temperature, respirations, heart rate and blood pressure (called taking their “vital signs”). This is important to help us gauge how a patient is doing; are they getting better or worse? Are the treatments they are being given helping or not? Are we missing something about the patient’s condition that we hadn’t seen before? A complete physical assessment, or a “head-to-toe” assessment is where we examine the patient from head to toe. Are they alert and oriented to person, time and place? Do they know who they are as well as recognizing family or friends? Do they know where they are, what day it is and who is the current President? We look at the color of their skin. What color is it and is it normal for the patient’s race and age? Is their skin moist, dry, scaly, reddened, or do they have a rash? How is their skin turgor? This is a way of telling how hydrated a patient is.When you gently pinch some skin on their body does it go back to normal fairly quickly or does it stay “pinched up” which is a sign of dehydration. How does the skin on the rest of their body look? Are their mucous membranes (mouth and nose) moist and pink or are they pale or dry etc? Are their eyes clear or cloudy? Are they bloodshot? Are their pupils dilated normally? Are they able to smile at you with both sides of their mouth going up at the same time or is one side lower or drooping? Do they have equal strength on both sides of their body? Can they grip with both hands equally and can they push against your hands with both feet equally? How do their lungs sound? Can you hear sounds in all four lung fields (upper and lower lobes in the chest and the back) and what do you hear? How do their bowels sound? Do you hear noises or not and what kinds of noises? Have they been having regular bowel movements and can they urinate normally? Can they walk, talk, see, hear? Are their “private parts” normal and functioning? Is their sex life normal? Are they eating well? These are things a good nurse checks at least once a day if not more often, especially when the patient is sick. When a patient is first see there are other questions to be asked as well. Do they have food, shelter, clothing and money for all of these things? Do they have any chronic ailments? These are health conditions that need to be treated on a regular basis such as high blood pressure, diabetes, high or low thyroid conditions, high cholesterol etc. Other health conditions are important to consider as well. These can include mental health issues requiring medication and/or follow-up with a psychiatrist, psychologist, counseling or family practice professional. Depression can be the result of or related to the death of family or friends, unemployment, loss of housing, abuse or other reasons. Mental health issues can be genetic (other family members have issues as well), due to substance abuse or because of traumatic injury etc. When you care for a patient you have to know more about them than what brought them to the hospital or doctor’s office. Nursing isn’t simply helping patient’s recover from sickness or injury, it’s helping them get ready to go home and be able to lead a normal life; whatever normal is for them. Nurses follow doctor’s orders for patient treatment but we do so much more than that. We support our patients and their families during times of illness or injury and help them have hope for recovery. If there is no hope of recovery, we help the patient and their loved ones deal with that as well. When you care for the same patient more than once you often develop a relationship with them. The patient and their family become comfortable with you and trust you to do your best for them. If you have taken care of the patient previously you can compare their current health situation to what you know they were like previously. Are they better or worse and what can we do to improve poor health issues?
That’s probably enough for now. Next time we’ll talk about different areas of nursing practice.
Take care and keep looking up