Careplans

I had a nice laugh this weekend when I was organizing my office. I came across my 3-ring binder for Clinicals. I decided I wanted to look at my old careplans. My very first ever careplan says "Impaired physical mobility." That's it. I didn't list a "related to" or an "as evidenced by." I'm surprised I didn't get kicked out of school ;)
My second careplan was a little improved; "Risk for injury releated to disorientation as evidenced by recent falls." I bet you anything that as I wrote that I thought I was so freaking smart and so proud of myself. And now, two semesters later, I just laugh at it.
Now for our most recent nursing diagnosis:
"Risk for impaired skin integrity related to decreased peripheral sensation, decreased physical mobility, imbalanced nutritional state, PICC line in place, and mositure from stool leakage secondary to total parenteral nutrition, diabetes, and stool incontinence."

What a difference a year makes -- even when it comes to writing a careplan.