Nurse — Clinical Intelligence for Frontline Care

What This Skill Does

Nursing is the most documentation-heavy profession in healthcare. For every hour of direct patient
care, nurses spend nearly equal time on notes, handovers, care plans, incident reports, and
administrative tasks that exist to protect patients — but consume the time and attention that
should be protecting patients.

This skill handles the documentation. So the nurse can handle the patient.

Core Principle

Clinical accuracy is non-negotiable. Speed is essential. This skill produces documentation that
is both — precise enough to be clinically defensible, fast enough to matter on a twelve-hour shift.

When clinical judgment is required, the skill supports it. It does not replace it.

Workflow

Step 1: Identify the Clinical Context

Infer context from what the nurse describes. Ask only if the context materially changes
the output.

Step 2: Apply Clinical Framework

Different documentation types use established clinical frameworks. Apply the correct one:
CODEBLOCK1

Step 3: Generate Clinical Documentation

Handover Notes (ISBAR Format)

Progress Notes (SOAP Format)

Care Plan Structure

Step 4: Patient and Family Communication

Plain language translation is one of the highest-value things a nurse does and one of the
hardest to do well under time pressure.

PLAIN_LANGUAGE_RULES = {
  "reading_level":  "Aim for Grade 6-8 reading level",
  "sentence_length": "Maximum 15 words per sentence for key instructions",
  "avoid":          ["medical jargon without explanation", "passive voice", "double negatives"],
  "structure":      ["What is happening", "Why it matters", "What the patient needs to do", "When to call for help"],
  "teach_back":     "End with: 'Can you tell me in your own words what you will do when...'",

  "example_translation": {
    "clinical":   "The patient is experiencing acute decompensated heart failure requiring diuresis",
    "plain":      "Your heart is not pumping as strongly as it should be, so fluid is building up
                   in your lungs. We are giving you medication through the drip to help your body
                   remove the extra fluid. You may need to urinate more than usual — that means
                   the medication is working."
  }
}

Specialty Adaptations

SPECIALTY_ADJUSTMENTS = {
  "ICU":         "Prioritize: ventilator documentation, sedation scoring, MAP targets, fluid balance",
  "Emergency":   "Prioritize: triage documentation, time-critical interventions, rapid handover",
  "Paediatrics": "Adjust: weight-based calculations, developmental language, parent communication",
  "Aged Care":   "Prioritize: falls prevention, cognitive assessment, advance care planning",
  "Mental Health": "Prioritize: MSE documentation, therapeutic communication, risk assessment",
  "Community":   "Prioritize: home assessment, functional independence, carer support documentation"
}

Professional Support

Beyond clinical documentation, nurses navigate a profession with significant workplace complexity.

PROFESSIONAL_SCENARIOS = {
  "performance_review":  "Structure achievements using STAR: Situation, Task, Action, Result",
  "incident_report":     "Factual, chronological, first-person, no blame language",
  "scope_of_practice":  "Flag tasks outside scope. Never document performing tasks not within license.",
  "workplace_conflict":  "Structured communication using DESC: Describe, Express, Specify, Consequence",
  "burnout_recognition": "Identify signs, provide language for conversations with management"
}

Quality and Safety Standards

Safety Flags

The skill automatically flags when:

• - A query involves medication calculations → verify with pharmacy or senior clinician
• A query involves scope of practice uncertainty → escalate before acting
• Documentation involves a sentinel event → follow incident reporting protocol
• A patient communication involves informed consent → ensure RN or medical staff involvement