By Shawn Kennedy, AJN editor-in-chief—This weekend, I saw an article about Charla Nash, the Connecticut woman who was viciously attacked in February 2009 by a friend’s chimpanzee. (Click image at left for article and video at CNN.) She had suffered terrible injuries to her face and hands that left her without hands and eyes and severely disfigured. Last month, she received a face transplant at Brigham and Women’s Hospital in Boston. She also received hand transplants, but they failed to take and were removed because of sepsis.

It’s truly a tragic story. Christine Moffa, our clinical editor at the time, wrote a few blog posts about Charla back in 2009. She’d seen Charla’s brother Steve on the The Today Show, where he’d reported that the first thing his sister had said upon waking from her coma was the name of her nurse, Lisa. As she wrote in that first post, “Steve Nash attributed her response to the nurse to the fact that the nurses had always talked to

[Charla] as if she were awake.” (Subsequent posts by Christine included photos of Charla that her brother had been kind enough to share.)

A small thing perhaps, that mention of a nurse, but apparently important to Charla, and it underscores that we may not always know what our patients take away from our encounters. I recall a cancer patient telling me that one thing that helped her get through chemotherapy was a conversation she and I had at her first treatment. I didn’t remember the conversation (apparently, I told her that she seemed like a strong-willed person, and that was half the battle of persevering through treatment . . . or something to that effect), but she did, and it made her feel she could handle the ups and downs of chemotherapy. We need to be aware of our interactions and work at being “present”—being “in the moment” and consciously attending to what’s happening is an important part of therapeutic encounters.

Often, the best nursing happens in small moments: private conversations with patients, supporting patients as they struggle with secret fears, performing intimate tasks in ways that preserve a patient’s dignity. What may seem an inconsequential action can have profound effects.

Charla Nash has considerable obstacles to overcome. Lord knows this woman has suffered too much already. I hope she can continue to look to her nurses to be present for her and provide her strength to continue her long recovery.

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