Many years ago, I was given the greatest gift by a patient who had no idea he would change my life and define my professional outlook as a nurse. While not every nurse will be fortunate enough to have such an explicit experience of the effect of the care they provide so early in their career, I believe that each patient you come in contact with is changing your life as much as you are changing theirs.
Quantity of Care vs. Quality of Care
Nursing has evolved into a highly technical profession grounded in scientific evidence, a profession that works to improve patient outcomes and shorten hospital stays. Research and technology support this work in innumerable ways.
But while nurses must be technical experts, drug experts, and efficiency experts, they must also do their best to alleviate the suffering of those in their charge. These many concurrent demands can result in high burnout rates among nurses as well as fragmented care for patients.
The quantity of care today’s nurse provides must go hand in hand with the quality of care. My own definition of quality care is focusing on patients as more than just a set of signs, symptoms, numbers, and processes in need of monitoring and adjustment. Recognizing patients as individuals and making our time at the bedside meaningful is often as important as accomplishing our clinical goals.
Caring with Kindness
When I entered nursing, due to many personal constraints I was required to advance within the profession step by step, from medical assistant to licensed vocational nurse to registered nurse, until ultimately obtaining my master’s degree in nursing.
During the time I was in my registered nursing program, the hospital where I worked as an LVN experienced a strike by the registered nurses. The LVNs like me were asked to take varied duties. Since I was also in an RN program and close to graduating, I was placed under the direct supervision of an RN and physician to provide care in the ICU. The patient to whom I was assigned was a young man who had broken virtually every bone in his body in a motorcycle accident, had casts, open wounds, and was comatose.
While he definitely needed an ICU level of care, he was considered a “safer” choice for an LVN becoming an RN. Each day, his open wounds needed care and, despite his casts, he needed regular repositioning. I had never before cared for a patient with so many complex needs on a regular basis.
Each day, as I tended to his body, I talked to him. I would tell him what I was doing, explain whether or not it might hurt, and talk him through each procedure. It was physically hard work. But I tried to be cheerful and supportive during all tasks—I knew he couldn’t respond, but had no idea whether might be able to hear or understand me.
I cared for this young man for less than two weeks. The strike was settled and I returned to my regular job. During my care, he never regained consciousness. Several months later, I completed my RN training, passed our state boards, and began working in our hospital’s emergency department. One evening, approximately a year after my stint in the ICU, I was at work and called a patient to be assigned to a room.
As I turned toward the patient I had called, a deep voice from behind me called, “Excuse me, miss.” I turned to look up at a very tall man who appeared to be in his twenties.
“I’m sorry to bother you,” he said, “but just wanted to know if you happened to be working in the ICU about a year ago?” It took me a second to remember his face, then the memories flooded backed to me as I told him that I had.
“I will never forget your voice, and just wanted to say thank you for all the kindness and care you showed me,” he said. “I’ll never forget you talking to me every day. You’ll never know how much your gentleness and kindness meant to me. Thank you.”
Then he walked away. My eyes had filled with tears while this now very healthy looking young man was talking.
An Early Memory as a Source of Strength
I’ve remembered this young man many times throughout my career when I was tired or frustrated, and I’ve shared the story with many young nurses who wanted to focus on the procedures rather than the patients. Nursing is more than the science. It’s a life-altering, two-way, personal interaction that will forever change you.
To all nurses who feel they are too busy to make a personal connection to patients: in fact, you are doing that already. The only variable is the quality of that connection. Just a few minutes, a gentle touch, or a kind word can change a life.
You may not be as lucky as I was to have someone seek you out to tell you this. But in your heart, you’ll know. To that young man, wherever you may be, thank you. Because of you, I became a better nurse.
Dawn Gould, MSN, RN, CNS, CPHRM, a former director of risk management and patient safety at Kaiser Hospital in Sacramento, California, is now retired.