Nursing_Reflection

Describe an experience of a time when you provided care Caring is essential to human development, growth and survival; furthermore caring is responsibility to self and others. The whole concept of human caring in nursing is not just emotions, concerns, or attitude, a caring person understands the needs of others and responds to them appropriately. I have always viewed nursing practice as a team effort, and my view has proven correct on many occasions. I have worked on Intensive Care Unit for the last fifteen years, however one particular event that sticks out in my mind occurred during my second year as a nurse. It was my day off however my unit was short staff and I decided to sign up for additional night shift. My charge nurse was very grateful to have enough nurses for the shift and told me “ I will give you two easy patients because I know you worked already three shifts this week”. I can remember sitting down at the nurses’ station taking report on a 52- years- old woman fresh status post left carotid endarterectomy. I was told that patient has been complaining of discomfort since she arrived from PACU and she is difficult to deal with. I value and respect my coworkers however personally I never liked the idea of a report starting this way because it sets oncoming nurse up for possible false impression. In my initial assessment patient appeared to be uncomfortable and anxious, she was complaining that she was unable to breath. I noticed that her oxygen saturation was 99% on 2 liters of oxygen, she was swallowing ice chips without choking or coughing, her blood pressure was within her baseline, and heart rate was regular at normal rate. The neck dressing was dry and intact without any swelling, JP drain in place with scant amount of serous-sanguineous drainage, the neurological assessment was intact and she reported only mild tenderness on the left side of her neck. Although the assessment appeared normal, I did not want to ignore her complain however I could not even make an educated guess as to what my patient was experiencing. My “gut feeling” was telling me that something was not right and the monitor numbers did not reflect what my patient was feeling. I called respiratory therapist to come and look at my patient hoping to get some hint how to solve this puzzle. The therapist suggested administering pain or anti-anxiety medications to my patient. I placed call to the surgeon and asked the charge nurse to stay with the patient while I was getting pain medications. At this point I felt nervous and overwhelmed, the surgeon was not calling me back and I decided to call the supervisor who provided me with his cell phone number. Unfortunately I was getting only a voicemail. When I came back to my patient’s bedside her heart rate was increased and blood pressure was dropping, the left side of the neck was very tender. I had placed her on 100% oxygen non-re-breather mask and run IV fluids wide open. I called Emergency Department physician because at this point we were ready for emergent intubation. The patient’s demeanor proved the she was going into a shock. Meanwhile the supervisor got in touch with surgeon who was already on his way to the hospital and order to prepare the patient for emergent hematoma evacuation surgery. The intensity was rising so quickly that every nurse on the unit was involved in patient’s care. While my coworkers were transporting intubated patient to OR I called my patient’s daughter. I explained that her mother was taking back for emergent surgery to evacuate hematoma. After the initial shock and tears I tried to calm her down and reassured that I stay with her in the surgical waiting room till the surgery is over. My patient returned to ICU just before my shift was over, she remained intubated for another two days then transferred to surgical floor without any further complications. It was strong team effort that saved my patient’s life and provided emotional support for family in moments of despair and unknown future. My patient’s family sent the letter to the hospital CNO and ICU director stating how grateful they were for care, compassion and respect they experienced while their loved one was a patient on our unit. An intentional nursing practice is practice grounded in caring. Furthermore, it is practice creating a healing environment at all levels, physical as well as nonphysical.