Scene 1
- PN – Good morning Molly – I see that you are in for your wound dressing today before I get started and dress your wound- how are you?
- Molly – Not great
Scene 2
- PN – I didn´t think you looked as well as last time I saw you. Is there something in particular that is making you feel not well?
- Molly – I´m feeling strange, tired and it feels like I can”t get a breath all the time. My legs are killing me and it doesn”t appear to be coming to an end!
Scene 3
- PN – I´m sorry to hear that, lets get you comfy on the couch and have a look at your leg and you can tell me about more about it
- There is no reply from Molly because she is so breathless on minimal exertion which is an indication of fluid overload in class NHYA 3. This will alert Practice nurse that something is wrong ie worsening of heart failure symptoms.
- PN thought bubble – this ulcer looks terrible, her legs are leaking and swollen and she´s not usually this pale and breathless. None of this was recorded 3 months ago at her last diabetic review..
Scene 4
- PN – Molly I am slightly concerned about how you are today – how are you coping at home?
- Molly – I am not doing too great at the moment. I am finding it hard to get out the house because my water tablets always make me need the toilet. sometimes I just dont take them when I need to go out – like today…..
Pulse point
Using motivational interviewing techniques including open questions and encouraging the patient to tell their story can open the consultation to address particular patient concerns or underlying medical issues.
It is important to do a holistic assessment to determine what is happening. How would you approach the situation and what would you say to Molly to gain the whole picture.
Page last reviewed: 28 Jul 2020
