Caring for the Patient You Never Had a Chance to Get to Know

“For months, we simply knew him as this often agitated, sometimes unstable, generally nonverbal, nonpurposeful patient whose actual personhood seemed, if I’m honest, unrecoverable. We didn’t even know who we were trying to recover…”

This month’s Reflections essay in AJN is by Hui-wen Sato, a pediatric intensive care nurse in California. This piece is difficult to describe because it fits no clear category; this is also what makes it alive and engaging.

In “Beholding the Returning Light,” Sato explores the the experience of caring for a patient without ever having had a chance to get to know that person. What do you feel for that patient, and how much do you invest yourself in his or her possible future?

The ‘unthought known.’

Such questions and others may exist on a subconscious level throughout an ordinary work day for nurses in a number of settings. Sato, as she traces the sequence of events, her own emotions, and the role of the patient’s family, adroitly brings them to the surface. […]

2019-11-06T13:33:46-05:00November 6th, 2019|Nursing, nursing stories|0 Comments
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End-of-Life Conversations at the 11th Hour

Illustration by Gingermoth

A problem all too familiar to nurses.

How often have we nurses talked to friends, family members, or each other about the importance of making end-of-life decisions well before that decision becomes critical? We see so many deaths that come only after extended and often avoidable suffering, it’s all many of us can do to keep from grabbing a family member’s hand and whispering, “Let her go!” At home, our families are used to hearing us say again and again, “Do not let me die like that!”

If we work in a hospital, chances are that we are confronted over and over again with trying to help families make “11th hour” decisions that will affect how their loved ones die. How do we broach the subject, when time is so short?

Trust prepares the ground.

This month’s Reflections article, “Difficult Conversations,” isn’t a primer to walk us through these conversations, but it offers an example of how we can take our cue from events or changes in the patient’s condition to raise the topic of the inevitable. Author Vanessa Arroyo illustrates how, after we’ve developed a relationship with patient and family and earned their trust, it may become possible to ask the […]

2019-08-19T09:59:07-04:00August 19th, 2019|Nursing, nursing stories|1 Comment
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Bringing the Faces of Addiction—and Recovery—to Schools

Nancy Labov, RN, CADC. Photos courtesy of Nancy Labov.

A nurse speaks from experience.

In nursing school, Nancy Labov felt a kinship with the patients she encountered during a rotation on a rehabilitation unit. She realized that she wanted to spend her career caring for patients like them. Their struggles with addiction struck a chord: alcoholism ran in her family, and she, too, had a substance abuse problem, though she was in denial about it at the time.

In her mid-20s, Labov got sober; she has maintained her sobriety ever since. She’s also persisted in her mission to help people recover from addiction. As an RN and a certified alcohol and drug counselor, she has spent the past three decades working on rehab and detox units across the country.

Labov is also the founder of Alumni in Recovery (AIR)—a nonprofit through which young adults in recovery give talks at schools in the communities they grew up in. As she discusses in the July Profile in AJN, “Helping Students See the Realities of Addiction and Recovery,” the New Jersey-based volunteer organization fights stigma by opening a dialogue about addiction and showing teens a young, local, and relatable face of recovery.

A peer-to-peer approach is key.

“How do we […]

2019-07-11T08:55:16-04:00July 11th, 2019|Nursing, nursing stories, Public health|2 Comments
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A Health Care Proxy and an Act of Moral Imagination

“What would Joanna have wanted?” the ICU fellow (Dr. Smith) asked Sam, Joanna’s nephew and health care proxy, for the second time this week. Sam considered the question, furrowed his brow, and said, “I still don’t know, doc.”

The human costs of indecision.

Uncertainty can at times be better than false certainty. This may even be so, up to a point, when a loved one is on life-support and subject to invasive and painful procedures. It takes time to absorb the reality of a situation.

But any nurse can tell you that, at some point, indecision becomes a decision in itself, one that can lead to many unwished-for consequences.

Seemingly unanswerable questions.It

The quotation at the start of this post is from this month’s Reflections essay, “What Joanna Would Have Wanted” (free until July 15). The story, by nurse Jennifer Chicca, MS, RN, evokes the overwhelming sense of responsibility faced by a thoughtful young man in the role of health care proxy to a beloved aunt.

How is possible to be sure what someone would want, or not want, when their end-of-life wishes have not been clearly spelled out ahead of time? […]

2019-07-01T15:50:47-04:00July 1st, 2019|Nursing, nursing stories, patient experience|1 Comment
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Does Everything Happen for a Reason? One Oncology Nurse’s Perspective

Does Nature Argue Fate? The Acorn Contains The Tree/
charcoal, pastel, and ink on paper/ Julianna Paradisi 2019

The human need to find meaning.

“Everything happens for a reason” is a saying I hear a lot in my nursing practice, from patients and coworkers alike.

The need to find meaning in the events of our lives, good or bad, appears to be a distinctively human trait. Ancient Greeks believed Clotho, one of the Three Fates, spun the lives of humans. In medieval times, Anglo-Saxons may have believed in wyrd, a concept similar to fate in our modern language. Elsewhere, the idea of karma teaches a cause and effect perspective on this life, and on future lives. These are only a few examples.

Learning to ask ‘why’ as a pediatric ICU nurse.

I began questioning if everything happens for a reason as a pediatric intensive care nurse at the beginning of my career. Asking “why?” is a natural response to watching a child suffer. Why is a baby born without a functional left ventricle? Why does an infant contract leukemia or a brain tumor?

Certainly genetics or environmental factors cause some cases. Regardless, it’s difficult to […]

2019-06-27T09:53:05-04:00June 27th, 2019|Nursing, nursing stories, patient experience, Patients|1 Comment
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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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