Caring Moment

Fear of the unknown and worries about the risks involved in surgery, no matter how remote, can feed emotions. My belief is that it is the nurses responsibility to inform patients about what is going to happen during their surgery and how they will be cared for post-operatively. This is a story about a patient named "Joe".

Caring Moment

Over the years I have done my share of patient education, preparing each patient before surgery. This period of time can elicit a range of emotions, mostly fear and anxiety. Family members are often included in the conversation. Fear of the unknown and worries about the risks involved, no matter how remote, can feed these emotions. My belief is that it is my responsibility as a nurse that my patients be well informed about what is going to happen during their surgery and how they will be cared for post-operatively. Also important in the conversation is compassion for the patient and family. Being and active listener and observer can help you to pick up on unspoken concerns. Acknowledging those concerns can make a huge difference in your patient’s experience. Close to my heart is a patient named “Joe”. 

Joe was 75 and was a retired Navy seal. Always in good shape for most of his adult life, he never thought he would be facing heart surgery for a valve replacement. He had been frustrated with increasing fatigue and exercise intolerance. Joe started to think maybe he’s just getting old. He was a proud military man and didn’t want to admit he needed help. His wife tried to help by suggesting a healthier diet but he wasn’t feeling any better. Then his symptoms progressed to chest pain and shortness of breath. Fearing he was having a heart attack, he knew he had to see his doctor. His doctor told him it could be related to his heart valve so he referred him to a cardiologist who did an echocardiogram and a cardiac MRI to get a better look to see what the problem was. He gave Joe the difficult news that he had aortic stenosis. Joe had some options, he explained. He could have open heart surgery which involved a long recovery, but he told Joe that because of his good health up to this point that he was a good candidate for the new TAVR (Transcatheter Aortic Valve Replacement) procedure. He explained the procedure and how it is less invasive than open heart surgery with a quicker recovery. Joe decided to have it done.

On the day of surgery, Joe was keeping a brave face for his family. His wife and daughter were at his bedside. I could tell they were anxious and worried. I answered all their questions to lessen their fears and to reassure them that he would be in good hands. It was time to go to the OR and I noticed Joe was holding something in his hand. He reluctantly gave it to his wife at the last second as he was wheeled out. I saw that it was a bracelet. His wife told me he was worried about being without it because he wears it all the time. She showed it to me and it had a bible passage engraved on it. I told his wife I had an idea but had to check with the OR staff first. I called the circulating nurse and explained about Joe’s bracelet. I asked if she could do me a favor and read Joe the passage as he drifts off to sleep before the procedure. She said she would and she did! I found out after the procedure that she whispered the passage in his ear multiple times as he fell asleep.

I was called when he was transferred to PACU and given report that his procedure went well with no complications and that he would be returning to the unit in a couple of hours. He was waking up but was still groggy. His wife and daughter were in his room nervously waiting for his return. I let them know his procedure was done and he was doing well in recovery. I told his wife what the circulating nurse did for me. She teared up and hugged me! What a special moment in my career that I will never forget!

The cardiac surgeon did not work on his own that day. We, as nurses, were his compassionate professional team. It warms my heart to think about Joe and how we all came together to calm his family, feed his soul at his most vulnerable time, and to improve his quality of life. I was off for a few days but found out Joe did well post-operatively and was discharged home.

JeanstarMSN

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I care for my patients by doing my best to be kind/personable, professional, skilled, knowledgeable, efficient and by communicating well.

Apparently my acts of caring are not as warm as what many other people consider caring; that's the impression I've gotten over the years when I read nursing articles and hear what caring means to other people. It bothers me that things like astutely performing nursing skills or making excellent nursing assessments or asking the right questions and the like are not primarily recognized as signs of caring.

I do not aim to internally experience emotional engagement with patients. That is not a necessary element of my act of caring. At the same time, I do have a heart and am significantly intuitive about people. Typically I make solid professional-level connections and do not find the heavy, heartstring-pulling type of connection to be necessary (or necessarily appropriate) as a basic MO.

Communication is the best way to care for a patient.  Take into effect empathy as well.  Just remember not only is the person your patient but also their family are too.  Take time with each person and possibly just by holding their hands and sitting silently is a way to show you are there for them.