The patient in the next bed by mynameisharsha  / Harsha K R, via Flickr

The patient in the next bed by mynameisharsha / Harsha K R, via Flickr

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

How do you want to be cared for?

Have you written your own personal nursing care plan? I’m not asking about your health care proxy or living will; most nurses have seen enough disastrous end-of-life scenarios to understand the need for formal advance directives. But if you become comatose or unable to communicate, what small pleasures would ease your suffering? What sights and sounds would promote healing for you, or ease your dying?

I’m often dismayed by the thoughtlessness of some staff regarding what their patients see and hear. Nurses will tune an unconscious patient’s television to the staff’s favorite soap opera, or blast the music of their own choice from the patient’s radio. I’ve witnessed staff talking on cell phones, and even arguing loudly with other staff, as though the person in the bed weren’t even there. When did we lose our attentiveness to patients as unique individuals?

The best defense against this kind of caregiving may be a good offense. Plan ahead! Make your own very specific “comfort” wishes known to family and friends in advance. (And while you’re at it, encourage them to do the same thing.)

  • What are your most cherished music or spoken word recordings?
  • Do you want to be read to? From what books or newspapers or blogs? By whom?
  • What radio or TV programs do you want to hear? Do you like sports? Old radio dramas?
  • Do you have a favorite skin lotion, scent, aftershave, deodorant?
  • Would you like someone to brush your hair or massage your scalp?
  • Do you like fresh flowers? The smell of wood or incense, garlic or motor oil?

Maybe if we think about these things while we’re still on this side of the bed rail, we’ll keep trying to individualize our patients’ care, too. Nondigital and difficult to measure, real caregiving is being marginalized in today’s brave new world of health care.

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