- Email: [email protected]
Curin & Caring
Carmg W
Barbara Peterson Sinclair, M N , RNC, OGNP, FAAN, is chair of the division of health sciences at California State Universiiy, Dominguez Hills,and editor in chief of AWHONN Lifelines.
February/March 2007
e have often heard the adage that physicians cure and nurses care. I’ve conscious but in and out of alertness. He had a recent opportunity to examine that was finally stabilized with his blood pressure concept at very close range. Just before just a little low and his temperature just a Thanksgiving, I returned to my university little high. office after a midday meeting and checked Two days after admission, the first my voicemail. I heard my husband’s culture grew a small number of Staphylococmessage, his weak-sounding voice saying he cus aureus; however, the numbers weren’t was not feeling very well. I called home sufficient to be conclusive. He had an immediately and John said he was “cold, echocardiogram, but it too was inconclusive. shivering and felt terrible.” He denied any By the next day, subsequent cultures I pain or difficulty breathing, demonstrated colonies of S. but even so, I suggested aureus and the diagnosis of calling the paramedics. He bacterial endocarditis was Nurses who will be refused, saying his condition made. Additional antibiotics wasn’t that bad. I raced home were instituted, and he had a long remembered are wondering exactly what trans-esophageal echocardiothe ones recognized could be wrong as I rememgram to determine if surgery bered the overwhelming was needed to replace the not only for their situation of two and a half graft and valves. It was not knowledge and skill years ago when John had a conclusive. He then had an late-diagnosed aortic disseciridium scan with the hope but also for their tion requiring emergency that the radtioactive isotopes ability and willingness would determine the degree surgery, aortic graft and an aortic valve replacement. and location of organism to provide oldOur daughter, Jennifer, clusters. The results were not fashioned TLC. had arrived home a few absolute, but they looked minutes before me and after a encouraging. We decided to quick assessment, we realized wait even though - there was that John was really quite ill. We took him frequent discussion regarding whether to the emergency department: his temperasurgery was indicated. He improved, albeit ture was over 104 degrees and his blood very slowly. pressure was dropping. The doctors were After 10 days in the CCU, he was well quite concerned and repeatedly asked about enough to be transferred to a regular unit. his prior condition. His blood was drawn He was discharged after two weeks of for counts, analysis and cultures. Tylenol hospitalization and was sent home with a and Vancomycin were given, and he was dual lumen peripherally inserted central packed in ice. He started to stabilize and catheter (PICC line) so that several IV was transferred to the cardiac care unit. antibiotics could be administered several With every temperature spike, more blood times a day for the next six to eight weeks. was drawn for culture. We waited. He was He continues to improve.
A W H O N N Lifelines
7
The physicians we encountered were excellent. They completed the diagnostic analyses that were needed; they monitored John‘s progress and modified their regimens based on the findings. They responded to my advocacy and certainly we wanted him to get well. We greatly appreciated their cffyts.Obviously, their actions were imbrative in moving toward a cure. However, what made an uncomfortable and frightening situation tolerable for John, for me and for our family were the nurses. They smoothly handled John‘s physical needs, they explained what was going on, they smiled and cajoled as they encouraged him to carry out activities that were unpleasant yet necessary, they were flexible when it benefited him,they were knowledgeable and skilled, and they didn’t mind admitting when they didn’t know something but assured us they would go find the answer. The nurses were exceedingly helpful to me also. They kept me informed, and they offered suggestions regarding how I could help with therapies. They were kind and considerate, for example, providing a softer chair, a cup of tea, a gentle word. They respected my concern and my need for knowledge and went out of their way to be supportive and pleasant. They did the same for our children. The nurse educator was one of the best I have ever observed. Considering that I barely knew what a PICC line meant, I certainly wasn’t ready to administer medications through one. However, she patiently and thoroughly taught me until I felt confident that I would correctly do whatever was necessary. We are home now, and I am indeed comfortable using two methods to deliver antibiotics through the peripheral catheter into the superior vena cava. The nurse had called to see how both of us were doing. Thanks to God, John continues to improve. The idea to share this story with you actually came from John. The first night home he was telling me how pleased he was with the care that he had received; he attributed it to the fine nurses assigned to him. He then shared the story of a young woman who was wearing a white coat and was in his hospital room very early that morning. Thinking she was a physician, he said that she must be early for her rounds. She replied that she wasn’t a doctor, “only a nurse.” John told me he immediately
8
A W H O N N Lifelines
responded, ‘Ne~eragain say ‘only a nurse.’ Nutses hosphls and doctors can’t do their jobs well without them, and patiens like me would be absolutely miserable without their caring attention.” He told her that she must proudly say that she is a nurse, and when possible, add -a damn good one, too.” For a long time, I thought about the situation my family had so recently encountered and then reviewed my own philosophy of nursing. I didn’t negate the healing properties of nursing functions. Rather, I centered on the caring component with the absolute certainty that caring crucially assists patients to meet whatever health care challenges are put before them. Although my epiphany occurred as a result of my husband’s heart condition, the caring by nurses is just as meaningful in every clinical area. Frequently, nurses are identified by their theoretical knowledge and clinical skills. However, the nurse who will be long remembered is the one recognized not only for knowledge and skill but also for the ability and willingness to provide oldfashioned TLC.I urge you to maintain caring as part of your nursing armarnentarium, and I formally thank you on behalf of all patients and their families who will most certainly benefit from yourcaring.
+
Volume 5, Issue 1
Barbara Peterson Sinclair, M N , RNC, OGNP, FAAN, is chair of the division of health sciences at California State Universiiy, Dominguez Hills,and editor in chief of AWHONN Lifelines.
February/March 2007
e have often heard the adage that physicians cure and nurses care. I’ve conscious but in and out of alertness. He had a recent opportunity to examine that was finally stabilized with his blood pressure concept at very close range. Just before just a little low and his temperature just a Thanksgiving, I returned to my university little high. office after a midday meeting and checked Two days after admission, the first my voicemail. I heard my husband’s culture grew a small number of Staphylococmessage, his weak-sounding voice saying he cus aureus; however, the numbers weren’t was not feeling very well. I called home sufficient to be conclusive. He had an immediately and John said he was “cold, echocardiogram, but it too was inconclusive. shivering and felt terrible.” He denied any By the next day, subsequent cultures I pain or difficulty breathing, demonstrated colonies of S. but even so, I suggested aureus and the diagnosis of calling the paramedics. He bacterial endocarditis was Nurses who will be refused, saying his condition made. Additional antibiotics wasn’t that bad. I raced home were instituted, and he had a long remembered are wondering exactly what trans-esophageal echocardiothe ones recognized could be wrong as I rememgram to determine if surgery bered the overwhelming was needed to replace the not only for their situation of two and a half graft and valves. It was not knowledge and skill years ago when John had a conclusive. He then had an late-diagnosed aortic disseciridium scan with the hope but also for their tion requiring emergency that the radtioactive isotopes ability and willingness would determine the degree surgery, aortic graft and an aortic valve replacement. and location of organism to provide oldOur daughter, Jennifer, clusters. The results were not fashioned TLC. had arrived home a few absolute, but they looked minutes before me and after a encouraging. We decided to quick assessment, we realized wait even though - there was that John was really quite ill. We took him frequent discussion regarding whether to the emergency department: his temperasurgery was indicated. He improved, albeit ture was over 104 degrees and his blood very slowly. pressure was dropping. The doctors were After 10 days in the CCU, he was well quite concerned and repeatedly asked about enough to be transferred to a regular unit. his prior condition. His blood was drawn He was discharged after two weeks of for counts, analysis and cultures. Tylenol hospitalization and was sent home with a and Vancomycin were given, and he was dual lumen peripherally inserted central packed in ice. He started to stabilize and catheter (PICC line) so that several IV was transferred to the cardiac care unit. antibiotics could be administered several With every temperature spike, more blood times a day for the next six to eight weeks. was drawn for culture. We waited. He was He continues to improve.
A W H O N N Lifelines
7
The physicians we encountered were excellent. They completed the diagnostic analyses that were needed; they monitored John‘s progress and modified their regimens based on the findings. They responded to my advocacy and certainly we wanted him to get well. We greatly appreciated their cffyts.Obviously, their actions were imbrative in moving toward a cure. However, what made an uncomfortable and frightening situation tolerable for John, for me and for our family were the nurses. They smoothly handled John‘s physical needs, they explained what was going on, they smiled and cajoled as they encouraged him to carry out activities that were unpleasant yet necessary, they were flexible when it benefited him,they were knowledgeable and skilled, and they didn’t mind admitting when they didn’t know something but assured us they would go find the answer. The nurses were exceedingly helpful to me also. They kept me informed, and they offered suggestions regarding how I could help with therapies. They were kind and considerate, for example, providing a softer chair, a cup of tea, a gentle word. They respected my concern and my need for knowledge and went out of their way to be supportive and pleasant. They did the same for our children. The nurse educator was one of the best I have ever observed. Considering that I barely knew what a PICC line meant, I certainly wasn’t ready to administer medications through one. However, she patiently and thoroughly taught me until I felt confident that I would correctly do whatever was necessary. We are home now, and I am indeed comfortable using two methods to deliver antibiotics through the peripheral catheter into the superior vena cava. The nurse had called to see how both of us were doing. Thanks to God, John continues to improve. The idea to share this story with you actually came from John. The first night home he was telling me how pleased he was with the care that he had received; he attributed it to the fine nurses assigned to him. He then shared the story of a young woman who was wearing a white coat and was in his hospital room very early that morning. Thinking she was a physician, he said that she must be early for her rounds. She replied that she wasn’t a doctor, “only a nurse.” John told me he immediately
8
A W H O N N Lifelines
responded, ‘Ne~eragain say ‘only a nurse.’ Nutses hosphls and doctors can’t do their jobs well without them, and patiens like me would be absolutely miserable without their caring attention.” He told her that she must proudly say that she is a nurse, and when possible, add -a damn good one, too.” For a long time, I thought about the situation my family had so recently encountered and then reviewed my own philosophy of nursing. I didn’t negate the healing properties of nursing functions. Rather, I centered on the caring component with the absolute certainty that caring crucially assists patients to meet whatever health care challenges are put before them. Although my epiphany occurred as a result of my husband’s heart condition, the caring by nurses is just as meaningful in every clinical area. Frequently, nurses are identified by their theoretical knowledge and clinical skills. However, the nurse who will be long remembered is the one recognized not only for knowledge and skill but also for the ability and willingness to provide oldfashioned TLC.I urge you to maintain caring as part of your nursing armarnentarium, and I formally thank you on behalf of all patients and their families who will most certainly benefit from yourcaring.
+
Volume 5, Issue 1