About Hui-wen Sato, MSN, MPH, RN, CCRN

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog.

The Pitfalls of Being the ‘Nice’ Patient: A Nurse’s Perspective

Image Brent Keane/via Pexels

I have often heard health care professionals in various environments say, “If you’re nice to the nurses and doctors who take care of you, you’ll get better care.” As a bedside nurse myself, I understand the sentiment. No busy health care worker loves being met with antagonism or pressing demands that don’t strike us as critically urgent.

But when my husband and I both became patients with serious illnesses last year, we learned the clinical pitfalls of being the nice patients. I am left wondering how patients should be expected or permitted to advocate for their own care without worrying that they will be frowned upon or brushed off because they’re perceived as “difficult.”

First cautionary tale.

In early 2022, I discovered a small lump under my right breast that I initially wrote off as a cyst. Surely, I told myself, as a woman in her mid-40s with no risk factors for breast cancer, this had to be benign. A screening mammogram in May 2022 gave me an all-clear, and I went on my way.

But by November, I knew the lump had grown. I reached out to my PCP to ask for a diagnostic mammogram, and he emailed back a casual reassurance. “I know you’re worried, but […]

2024-02-07T16:57:09-05:00February 6th, 2024|Nursing, nursing stories, patient experience, Patients|15 Comments
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Honoring the Personhood of Brain-Dead Patients: A Delicate Approach

A dandelion alone in a field suggests the fragility of life. Photo by RIDVAN AYRIK/ Pexels

In the past month, we had a couple of patients in our pediatric ICU who had suffered tragic neurological injuries and were declared medically brain-dead. In the state of California as in most states, a pronouncement of brain death is equal to a legal pronouncement of death, and the medical team then possesses legal permission to remove mechanical support from the physical body that has remained under intensive care.

In both of these cases in our ICU, the parents struggled to accept the terminal implications of brain death and pushed back to varying degrees for more time to see if their children might still somehow find a way to recover. In these types of cases, the actual moment-by-moment practice of bedside nursing care becomes complicated. How do we honor the personhood of the patient as we provide intensive care for the body prior to removing mechanical support, and at the same time gently help the parents accept that their child has medically died?

The potential for misunderstanding nursing care

The interactions nurses have with family members as we care for their brain-dead child present many opportunities for either […]

2023-06-21T13:06:54-04:00June 21st, 2023|end of life, Ethics, family experience, Nursing|1 Comment
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Primary Nursing of Medically Complex Children in the ICU Increases Parental Trust

Differing views about quality of life.

Photo by Pat Smith/Pexels

As medical care has become increasingly advanced in its ability to prolong life in the face of serious, chronic illness, it has also presented complicated challenges for both the caregivers and care-receivers alike. This holds especially true when we venture into the thorny, subjective realm of “quality of life.”

Sam was a patient with serious chronic illness and severe developmental disability who had been in and out of our pediatric ICU for many years. His most recent nine-month hospitalization had been the most frightening and uncertain thus far, and the gap between the perspectives of the medical team and Sam’s mom had became more apparent. The medical team speculated whether Sam was approaching the end of his life, while his mom asked us to continue doing all we could to maximize Sam’s physical longevity.

Unspoken questions also involved our struggle to measure what exactly comprises “enough” quality of life to justify the continued offering of health care resources. It’s an inevitable struggle with scarce resources and the monetization of quality of life, particularly with a chronically ill, severely disabled child who can feel so “other” to those of us living “normal” lives.

Parents come to our unit seeking care for […]

2022-09-14T10:01:23-04:00September 14th, 2022|family experience, nursing roles, pediatrics|1 Comment
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Loss from Nurse Attrition Goes Deeper than Numbers

On watching familiar colleagues leave your unit. 

Photo by Javier Allegue/ Unsplash

It feels as though every week, I hear of yet another one to two colleagues who are leaving our pediatric ICU (PICU).

Reasons colleagues leave.

They’ve been at all kinds of experience levels. Some have only been in our unit for a couple of years, and some have been with us for anywhere from eight to 15 years. Some leave because they realize as young nurses that they don’t want to be around so much pediatric death and dying in the long-term, so they move on to other positions where they can care for healthier populations. Some leave because they’ve already been around so much pediatric death and dying for so long by now that it’s time to practice in different kinds of spaces for their own mental and emotional well-being. Some leave for the significantly higher pay offered by travel nurse positions, and some leave to be closer to family in other states. A smaller percentage leave quietly without ever really disclosing the reasons why.

Every departure hurts on a numbers level.

In a time when nurse staffing seems to be at critically low levels everywhere, raising our workload and stress levels to new all-time highs, every departure hurts on a sheer numbers […]

2022-06-29T10:48:07-04:00June 29th, 2022|Nursing|2 Comments
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How to Support the Nurse in Your Life, May 2022

Photo by Dương Nhân from Pexels

A few years ago, I wrote a blog post directed towards friends and family members of nurses, entitled “How to Support the Nurse in Your Life.” While the ideas in that post still hold up today, so much in nursing has changed, the COVID pandemic being the obvious main factor. With nurses in more need of support than ever, I find it important to revisit this idea of helping friends and families supporting the nurses in their lives at this unique point in time.

1. Listen to what the nurse is actually distressed about in the moment, and stay with them there.

In normal, non-pandemic times, nurses already have many people, situations, and issues to tend to in addition to the actual patient. There are so many unique aspects of the nurse role that challenge us, all of them rolled into a tangled ball in the course of a 12-hour shift. If we are distressed about one particular aspect, please stay with us in your focus on the actual issue at hand so we have time and space to unpack it without all the other competing stressors vying for all our attention.

For example, we might be upset one day […]

2022-05-02T09:19:45-04:00May 2nd, 2022|Nursing|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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