Please Nurse: Needing to Feel Human Again in the ICU  

Ruby Vogel circa 1970. Courtesy of Shannon Perry.

The patient perspective below was written by Ruby Vogel in 1976, shortly after she was discharged from the hospital following a cholecystectomy and colon surgery. Her daughter Shannon Perry, PhD, RN, FAAN, professor emerita at San Francisco State University, recently received the document from her sister, also a nurse and former nursing educator, to whom their mother had originally given it.

According to Perry’s sister, who found the document while cleaning out some files, Vogel had thought her daughter could use the information to help her students understand the experiences of patients in the ICU. Some things were different back then—for example, says Perry, a cholecystectomy and colon surgery were major surgeries with several days in the hospital for recovery. But some things stay the same, and this vivid account highlights how patient-centered care—a touch, a hand on the brow—can make the difference. Ruby Vogel died in 1985.

Intensive care put me in a different world—of noises, silly ideas, and feelings. I seemed apart from people. They came and went but I wasn’t people, just that big sore place. I could hear and I could see. People didn’t seem to speak to me nor stay around long enough for my eyes to focus or my lips to form words. In and out. Checking! Checking! Checking! I could see and hear. Family, nurses came in, took a look and left. I was still there.

That awful machine next […]

2017-09-11T10:45:55+00:00 September 11th, 2017|patient experience, Patients|0 Comments

Exploring Irritable Bowel Syndrome

Illustration by Sara Jarret.

Irritable bowel syndrome (IBS) is one of those conditions that is maddening for patients and clinicians alike. Its pathophysiology is unclear, the symptom picture varies widely from patient to patient, there is no test to confirm the diagnosis, and treatment is directed at managing symptoms because there is no cure.

To make things even more difficult for the person with IBS, there is a recognized psychological component of the disease. Therefore some friends, family members, and clinicians might tell people with IBS that their suffering is “all in their head.” And yet there is demonstrable proof (via neuroimaging studies) of differences in central processing mechanisms related to the “brain–gut axis” between people who have IBS and those who do not.

Kristen Ronn Weaver and colleagues explore these and other aspects of IBS in a clinical feature article in AJN’s June issue. The authors review the latest findings related to IBS etiology and pathophysiology, the relationship between IBS symptoms and stress, and the updated Rome IV criteria that help guide diagnosis. Of particular interest is the authors’ presentation of research confirming the value of several nonpharmacologic interventions, including dietary modifications, probiotics, moderately increased physical activity, yoga, and traditional Chinese medicine.

See “Irritable Bowel Syndrome” in the June issue to learn more, and to find out how nurse-led initiatives can lead to long-term health benefits for people with IBS.

 

Those Who Comfort Us

There was only a tiny drop of blood. I was worried, of course, but I went to my OB-GYN for reassurance more than anything else. Maybe she would tell me I was doing too much and needed to rest. Maybe it was just normal. But as soon as she looked at the ultrasound screen, I knew.

Usually when I went for a scan, she immediately turned the screen toward me. Until now, every scan had been great. I had just entered my second trimester. The barrage of tests given to women of “advanced maternal age” had all come back normal. The baby’s heartbeat was strong at every visit, and I was riddled with nausea, something I’d been told was a “good sign.”

This time she stared at the screen for what seemed like forever. Then, quietly, she told me that my baby of 16 weeks’ gestation no longer had a heartbeat. Moments later, the high-risk doctor came in to confirm this. I turned away as he talked to my doctor about the “degradation” he could see, suggesting the death had happened over a week before. Somehow this terrible word—and image—is what stuck with me, even weeks after the event.

Later I entered the ambulatory center where I would […]

Night Watch

Editor’s note: In this tightly observed guest post, a nurse visiting a sick family member experiences the hospital as a kind of foreign country.

Eileen McGorry, MSN, RN, worked as a registered nurse in community mental health for over 30 years. She currently lives in Olympia, Washington, with her husband Ron.

The walkway is hard, the concrete cold, and I am immersed in darkness. Then there is the swish of the hospital doors and whispery stillness. The light over the reception desk shines on a lone head, bent over a book. A clipboard is pushed toward me. The paper on it is lined with names, some boldly printed, others scribbled, the letters unrecognizable. The spacious lobby is filled with individual groups of soft stuffed chairs and love seats. All of it quiet and empty. Over the chairs and sofas, the black of the midnight hour is changed into twilight.

I remember the bustle of the area at midday. Families gathered together, eyes searching the crowd for the green scrubs of surgeons. “She will live,” they say to some, and to others, “We will wait and see.” The frenzy of the day over, the empty chairs wait for tomorrow.

I sign my name in script. I use the old Catholic school script. The script preached by my mother, who is upstairs recovering from heart surgery. I walk past the chairs along walls so white they […]

The Nurse Who Saw Me: Easing the Strain of a Mother’s Vigil

Illustration by Barbara Hranilovich. All rights reserved.

The Nurse Who Saw Me,” the Reflections essay in the May issue of AJN, is by JR Fenn, a writer and lecturer in upstate New York. The author, who is not a nurse, describes a night of uncertainty she spent in an isolation room on a pediatric unit with her sick daughter.

This is the kind of writing that helps a reader understand the perspective of a scared parent in a disorienting and uncomfortable environment. The care is efficient, and the clinicians she encounters all seem to be doing the right things for her baby. But reassurance is not immediately forthcoming, as we see in this passage from near the beginning:

The attending looks at us over her white mask when I ask if my daughter is going to be OK. ‘There isn’t the research for babies this young,’ she says, her eyes so huge I can see my terrified face reflected in them. I can’t ask any more questions because my throat has swelled closed as I fight tears.

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