December 2019
Abbey
Wallace
Chamberlain University College of Nursing (St. Louis Campus)
Jerseyville
,
IL
I have been Abbey's instructor for two different courses. Through both courses she continues to demonstrate a high level of critical thinking in addition to compassion for clients. Due to staffing, I was able to facilitate Abbeys' clinical experience during one day of our course. Abbey was assigned a client who was potentially going for a procedure but, also demonstrated stroke symptoms four days prior. The symptoms were resolved, and the staff were confident the client would go for their procedure. During preconference, we reviewed potential neuro and stroke symptoms. Through review of newer information, Abbey also got the impression the procedure would possibly be cancelled and the client may be discharged. On the floor, following her first assessment, Abbey rushed to me with concerns her client was demonstrating stroke symptoms. We shared these findings with the nurse. Abbey and the nurse escalated the stroke concerns through the charge nurse, and the decision was made to call another STAT Stroke. During this time Abbey demonstrated compassion to the client who was in an altered state of consciousness. Abbey also attempted to console the client's children who were notably upset. Following a physician's review, a test was ordered but did not meet typical stroke protocol. Abbey was aware this was not typical. Abbey attempted several times to advocate for the client, respective of the test which were ordered. Abbey was told the symptoms were not a result of a stroke but, rather another undiagnosed condition. Abbey continued to provide a high level of care to meet the patient's needs even though she questioned if more could be done. Abbey discussed these thoughts with the nurse and charge nurse. She was then encouraged to follow the plan laid out by the physician. In post conference, Abbey shared that she thought the day was going to be boring and did not think the assignment was going to offer much to learn from. She shared how wrong she was in her pre-thoughts and should never judge a given client or situation. She thanked her classmates who frequently assisted with cleaning and turning of the client. She reminded her class to never take any situation for granted, that things can change very quickly. This day alone Abbey learned so much not only from this one client but, also the value of nursing and professionalism. The following week on Monday night I received a text from Abbey. She said she had thought a lot about the client and went to check on her. Unfortunately, the stroke symptoms re-appeared, and the client was diagnosed with an ischemic stroke. Abbey was very upset and requested to meet the next morning to discuss the care of the client. Abbey described the feelings of helplessness when she knew the assessments and tests should have been pushed further. Abbey felt she did a disservice to the client. She questioned how or what could have been different. I reassured Abbey as a student she did everything within her scope to assist the client. We reviewed the situation, we reviewed protocols and we reviewed chain of command. While it was not the result she was hoping for, Abbey provided and advocated for the client. Abbey demonstrated care, compassion and advocacy for her client. Abbey reminds us all that nursing is not just an 8, or 12-hour shift. Nursing is a way of life. Nurses may over think, and nursing may over worry. As the instructor and if I were the patient, I would want someone like Abbey to watch out over me.