By Amy S. Jacobs, BSN, RN, CCRN. The author works as a critical care nurse in Tampa, Florida.
Why does it usually take a personal experience of having a family member become a patient to make us see our patients in a new light—to see them as someone’s grandmother, father, sister, or spouse and not just a room number?
I’ve been a nurse in critical care for the past 10 years. Three of those years were spent as a travel nurse working short-term contracts in intensive care units across the country. And most of my ICU experience has been in trauma units.
I’ve watched a family come to grips with the fact their son is now brain-dead after a car accident.
I’ve comforted the husband and children of a patient who suddenly developed an infection and died after an apparently successful two-year treatment for cancer.
I’ve witnessed a daughter realize her dad is never going to be the same after a stroke takes away his mobility and speech.
I’ve seen a patient realize that, while he’s lucky to be alive after his motorcycle accident, he’s going to have to learn to navigate a new world without one of his legs.
As nurses we see these situations. We have sympathy for our patients and their families. We try to keep in mind the emotional support our patients need while also taking care of their physical problems. But we don’t know what these patients were like before their accident or illness brought them to our unit. We don’t know what’s important to them or how much this hospitalization has changed them.
“For my shift, I treat them as my own.”
Patients throughout my career have affected me in big ways. But nothing helped me really see what the patient and family side is like until my father became sick. He was diagnosed with mild cognitive disorder (a precursor to Alzheimer’s disease) in his late 60s. Fairly soon after this, he wasn’t safe being left alone and needed a companion. Later, a companion wasn’t enough and he needed full-time care.
When Dad was hospitalized, I started to understand the perspectives of patients and their family members. I found it incredibly frustrating to know that, even if the nurse taking care of Dad was the most compassionate of nurses, he or she still didn’t know the real him. They only saw a 71-year-old male with dementia. Impulsive. A high fall risk. He would pull out his IVs. Fidget with ECG leads. Grab onto your arm and not let go if you were trying to change his gown, because he didn’t understand what you were doing.
Basically, he was the patient that you don’t want back for consecutive shifts because no matter how patiently you work with him, his behavior stays the same.
But if you’d known how he was before this diagnosis, you’d notice occasional sparks of his awareness come through. Maybe some of his dry sense of humor would appear in a small joke. When we laughed, he would look incredibly pleased with himself. Or you’d hear him sing along to familiar hymns although totally unaware he was doing so. He could always connect with music, even when he was unable to communicate.
But these small glimpses didn’t come close to revealing his true personality and character. This is what I take with me now as I care for my patients. I realize I’m only seeing a small part of them and I’m seeing them at their worst. I now always ask my patient or their family what I should know about them that would help me with their care.
Sometimes it’s something simple like a food preference, and other times the thing I should know is that they suffer from PTSD and need the curtains open so they can always see out of their room.
These small things I learn about my patients allow me to care for them more fully and remind me that they are not just a room number. My patient is someone’s family—and that means that for my shift I treat them as my own.[image: julie kertesz/ via flickr creative commons]