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Using the Power of Story to Improve Patient-Centred Care
"I also felt conflicted because I was in need of comfort and reassurance, but felt it was pointless to ask."At 73 I fractured my femur and shattered my kneecap. My injuries were severe enough that I required two surgeries. I was nervous going into surgery but felt very supported by an exceptional operating room nurse who helped me during both surgeries with my fear, holding my hand and taking the time to explain everything that was happening. Her compassion and attention to my questions made me feel very safe and I went into surgery knowing that my pre-op care had been excellent. Post-op, I was transferred to a nursing unit and, while I was heavily sedated, I was aware enough to know that my experience was unpleasant.
When I awoke, I learned that I was admitted to a mixed gender room, contrary to policy, with two men and a woman suffering from advanced dementia. I was uncomfortable in this situation, feeling that my privacy and safety were compromised. After both surgeries which were 3 days apart, I was heavily sedated, in substantial pain and unable to move. I was vulnerable, scared and did not have the wherewithal to ask to be moved. I kept my curtains closed for privacy, but it was hot and it left me feeling quite isolated. In my already vulnerable state, being removed from human contact only added to my loneliness, depression and stress. I had the sense the men across the room were staring at me when the curtains were open. I was exposed and humiliated.
As a retired RN, I fully understand the demands that nurses face each day when providing patient care. It's a lot to juggle and it's a hard job. When I write that my post-op care was not patient-centred, lacked empathy and was devoid of any sense of trying to meet my needs, I do so knowing how overwhelmed a nurse can feel if he/she has limited supervised practical experience before graduating.
It saddens me to say that I spent the majority of my stay being treated dismissively and as if I was invisible. There was little to no eye contact or effort to build a therapeutic relationship. I remember a nurse telling me about her upcoming vacation. I expected she would ask me a question or two about my accident, but didn't. I felt like I was being talked 'to' and not 'with.' Aspects of my care such as ensuring that I had enough drinking water, that I could reach my bedside table, helping me with my bed bath, ensuring my space was free of clutter, or engaging in conversations was largely non-existent. Whenever I required a nursing procedure, be it starting an IV, removing and reinserting a urinary catheter, being given a bed pan etc., I felt like I was being done to not for, and spoken at not with, and it was very disconcerting. While I know this may sound petty and like 'small-things,' in comparison to other aspects of my recovery, as a patient these were the things that I expected from my nurse and they were important to me in my recovery. The lack of empathy made me feel alone and isolated in my discomfort and pain. I also felt conflicted because I was in need of comfort and reassurance, but felt it was pointless to ask.
While my experience on the whole was not good, I do want to emphasize that there was one nurse who for one day of my week-long stay, exemplified the patient- centred nursing care I did not see from others. I think about her and wonder why she was so different than the others? Are we teaching enough empathy and compassion in our nursing curriculum? I also ask myself how we can help to create a system and structure where the patient-centred care she showed can become the standard.