Advocacy and Caring..

Long Term Care Columnist / Guide · Oct 8, 2006

These questions read like a nursing-school assignment.

:stone

suzy253, RN · Oct 8, 2006

These questions read like a nursing-school assignment.
:stone

:yeahthat:

Antikigirl, ASN, RN · Oct 8, 2006

Yes they do....OP share yours first please!

athena55, BSN, RN · Oct 8, 2006

One example:

My patient was dying from CML. She was the breadwinner in the family (a pediatric physician) and her husband was a carpenter. They have 2 children under the age of 12.

The husband was beside himself with grief and he was acting out a bit, very angry: cursing the Gods, cursing the medical and nursing staff, stating he was going to bring in his gun and shoot us if his wife died.

The day shifts response to him and his anger and fear was to call in security. Sigh. I came in (working 12 hour nights) and asked security to leave. Asked the husband what he knew about his wife's prognosis. Yes, he knew she was dying but he was still in denial.

Asked him if he would like to help me care for his wife. Would he like to help me suction her bloody secretions, care for her trach, help with her hygienic care, assist in turning her, etc. He jumped at the chance. While he was in the room with me that entire 12 hour shift he spoke about his love for his wife. How he couldn't believe how fast the leukemia was taking her from him and their children. We talked about her low platelets and how that made her bleed from almost every orifice. We talked about what he would do all over again (in regards to his relationship with her....) and we talked about her eventual death.

His cultural background is Italian. I allowed him to vent, curse, and scream as long as he didn't harm himself, his wife, or me. I allowed him to lie next to her while she was dying, and he helped me do PM care on her.

Sometimes we need to bend the rules a wee bit in order to be a better patient (or family member) advocate. Also trying not to be so ethnocentric helped in this and other instances/examples.

Six months later I received a very warm letter from him. After his wife died he brought her body back to Italy where he was raising his children. He thanked me for allowing him to "cry and die" with his wife.

Thank you for this thread. It reminded me why I am still a Nurse and a patient advocate after all these years

Athena

Kelly_the_Great · Oct 8, 2006

Just to high-jack the thread for a second, since this is a school assignment there's something valuable to be gained from Athena's story that I want to point out.

See how Athena brought "healing" through her caring? That's a good nurse right there. This patient wasn't "cured," no, she wasn't cured of the cancer. But she and her family were healed. All because of one smart and caring nurse who advocated for her patient's husband to be allowed to participate in her care.

solumedrol · Oct 8, 2006

Here is my example.

Last Thursday, I was assigned a patient who had total knee replacement surgery performed. She stated she was allergic to morphine. Upon doing my first round of vitals, I noticed he was tachycardic (P = 130), blood pressure was140/79, temperature was 37.4, O2 sat was 98% RA, and R= 22. Patient had history of high blood pressure and was being controlled by hydrochlorothiazide relatively well.

I asked the patient if she was in pain, because I first suspected that she was in pain leading to tachycardia. Patient stated she was in minimal pain as she had taken Tylenol 3 with codeine 2 hours ago. I notified my preceptor that I am a little concerned with her pulse because it had been rising from the last 2 days according to her progress reports. Together, my preceptor and I went to her MAR and checked what medications have been given to my patient; and all his heart medications were all given in the morning.

I asked my preceptor if her condition was due to any reactions to Tylenol 3 as she had been receiving it for 1.5 days. My preceptor suddenly remembered that one of the narcotics converted itself to morphine in the body. We checked, and Tylenol 3 indeed converts to a form of morphine; and the patient IS allergic to morphine. We stopped giving her Tylenol, and my preceptor gave her 2 tablets of percocets to control her pain (prn). 1 hr later, I checked her vitals, and her pulse has lowered.

Sonn · Oct 8, 2006

Caring is the essence of nursing and advocacy is part of the role that we as nurses demonstrate by respecting and supporting the basic values, rights and beliefs of our patients. Athenas story outlines clearly how she as a nurse repected and supported her patient by advocating for her patients husband to be included in her patients plan of care. Caring for a patient is not just caring for their pathophysiological stability but also their psychosocial wellbeing. This is holistic care and this is what nursing is all about.

muffie, RN · Oct 9, 2006

help a student out for goodness sake without judging the motive

Long Term Care Columnist / Guide · Oct 9, 2006

help a student out for goodness sake without judging the motive

Sorry you feel that way, but in the days before the Internet, we had to figure out our own answers...........:uhoh21:

muffie, RN · Oct 9, 2006

one can gain from another's insight and experience

let's help each other be better people/ nurses

Sonn · Oct 9, 2006

In a normal day at work in the OT, Preoperatively I care about whether my patient is comfortable and if anxious I will try to find out why (eg fear or pain etc) and will listen and address my patients concerns as best as I can. I care for my patient by ensuring that my patient gets the best "Duty of Care" that they have a legal right to. This means putting into practice legal standards of care that ensure patient safety (check consent form, ensure standard intraoperative monitoring, respond to changes in vital signs etc). While my patient is anaesthetised I act as my patients advocate by making sure the patients dignity is maintained and if I saw a break in the sterile field I would alert the srub nurse or surgeon.

What about you Miffie? Why don't you help out too?