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Nurse and Patient

Nursing graduates share significant clinical experiences

The May 2013 Nursing graduates were instructed by their professors to write about a significant moment during their clinical rotations this past academic year. What came from that assignment is a compilation of touching moments between a nurse and his or her patient that give a glimpse into the compassion and devotion nurses provide their patients every day.

Professor Joan Timalonis writes, “these exemplar stories are a testimony to this courageous and healing spirit of Nursing. They reveal the calming presence you provided to families and their loved ones.”

These are the stories written by the May 2013 nursing graduates.

*please note that the names of all patients have been changed for confidentiality.

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Exemplar

by Danea Hauck

I walked into the first day of my practicum experience expecting a relaxed day where I would be able to orient to the unit and take my time getting to know the nurses. I was not expecting to be faced with something that some nursing students never face, and something that some nurses are not comfortable addressing, a patient death. The day started off at a decent pace. Even though my preceptor stated that this day felt as if it were going to be relaxed, we had two patients and a third that was rushed to us within the first hour that I was there. We finally felt that we were getting everything in order when my preceptor, who was the charge nurse that day, got a call around 1100 that there were two young trauma victims on their way to the hospital and we needed to get ready for them. The unit was full, so my preceptor needed to transfer patients to other floors and prepare the rooms. Over the loud speakers in the hospital I heard the traumas announced. As a student nurse, first day in practicum, I was not sure exactly what I could do to help. My preceptor was trying to transfer patients to other floors, while other nurses were either taking care of their critical patients or helping with other patients to enable the nurses prepare for the new trauma patients. The floor seemed a little crazy, but each nurse was able to take their own role and go from there.

The younger patient, who was more stable, arrived on the unit first. They then brought up the older patient who did not have a good outlook. I remember my preceptor stating “They are saying she more than likely won’t make it”. This shocked me a little. I knew that there are times that the patient just cannot be saved but I had never actually been in a situation like this. A few minutes after the patients came up family members started flooding in. I heard everything from weeping , to “I want to see them”, to “No, I don’t want to see them like this”. Due to the amount of care that needed to be provided, I noticed the nurses took more of a caring role for the patients. One doctor was in the room giving orders, while other doctors came to talk to the parents about the severity of the injuries that were sustained in the motor vehicle accident. I do not remember exactly what my preceptor and I were doing at the time but a family member came up to us and stated “They need an ambu bag in room 3)!” My preceptor instantly ran to the supply room and grabbed an ambu bag and rushed to room 3 only to find that the equipment was needed for room 8*. We rushed into the room to witness one nurse performing chest compressions and the doctor ordering epinephrine. While in the room I was instructed to pump air into a pressurized IV bag and also told to run and grab things from the supply room. I needed to find things quickly. The day had been so busy I barely had even gotten a tour of the unit, so finding the needed equipment was a challenge.

The patient was resuscitated and the doctors then discussed with the parents about signing a do not resuscitate for the patient. After this was signed, the patient was pronounced dead within 30 minutes. I was able to be there with the patient and family during the last moments of life and be a witness to death. During this time, I was in shock. In that moment I was surprised at how fast the whole situation transpired. I had begun to feel tears form in my eyes while watching the family during the situation and realizing that not only is a nurse there for the patient but there for the families as well. I was then told by my preceptor to stay in the room and help the nurse with the postmortem care.

Patricia Benner (2001) describes “providing comfort measures and preserving personhood in the face of pain and extreme breakdown” as part of the helping role. Even in death, a nurse can provide comfort to the patient and family, and must face the fact that sometimes there is nothing that the nurse or anyone else can do to prolong life. The nurse and I were able to provide the patient and family with comfort by aiding the patient in keeping their dignity and in post mortem care. In post mortem care the nurse and I were able to clean the patient and prepare her for the family to say their last goodbyes. Bathing and covering the patient allows comfort to the family during their final moments with the patient. The nurse and I also made hand and feet prints, this fits into the helping role of a nurse by helping the family remember the patient and helps in the grieving process. Keeping the patient’s dignity and bathing the patient also allows for the patient to keep their personhood. Presencing, or being with the patient, is another concept that Benner describes. I exemplified this concept by being a witness to the patient’s death and being there after death. Our use of touch during the postmortem care fits into the helping role by keeping the patient’s personhood even in extreme breakdown. By still utilizing the touch aspect of care we were able to keep the personhood of the patient. I believe that even after death, touch helps the patient and improves the care that we provide (Benner, 2001).

I chose to write about this experience for my exemplar, because I felt that I made the most impact on the patient’s care as well as the patient made the most impact on me. Through my nursing experience at Cedar Crest College I have had many patients who I feel have impacted me, but this patient, on this day, really changed my thoughts of nursing, my patients, and myself. Although the patient never saw my face and may never have heard my voice, I was there for the patient during death and after. I was able to be with the patient during a very scary time, even if the patient was not aware of what was going on. During post mortem care, I distinctly remember a moment the nurse and I shared where she stated “Oh sweetie, I hope you didn’t feel much pain” as we both were holding the patients hands and reflecting on our feelings internally. I believe there is a place after death and I believe that even though the patient was not with us, she knows the care we provided to her. Through much reflection over this eventful experience, I have found that I helped the patient and the patient also helped me. Without this experience I do not feel that I could be the person, or nurse that I am today and the nurse that I will become in the future. This experience will forever stay with me as an exemplar I can reflect on and realize just how much one patient can impact me as a nurse.