Amber Robson is an outstanding patient advocate and demonstrates expert caring for our patients on the TCV PO ICU at UVA. I had the privilege of receiving report from Amber and taking care of a patient who had received her wonderful care overnight. While Amber is just completing her first year as a nurse, she is often recognized by her peers for her ability to deeply connect with patients and families to transform their care experience. I was touched when a specific patient whom we both cared for went on to describe in great detail, and with great gratitude, the care that she had received from Amber.
This was a female patient who had already been with us in the ICU for over two weeks. Her open heart surgery had been complicated by significant bleeding post-operatively. She had prolonged intubation and once she was finally extubated, it was a few days before she got her voice back.
While this patient was making progress and heading towards discharge to a rehab facility, she was feeling overwhelmed by the complexity of her care, and the constant disruptions to her sleep. She had many wounds that were weeping serous fluid almost continuously. Her skin had developed moisture-associated breakdown, which the patient found to be immensely painful and concerning.
According to the patient herself, Amber was the standout nurse from her lengthy admission that had truly made breakthroughs in her care. I asked my patient what it was that set Amber apart. What had she done that meant the most?
"She listened, and listened, and listened." My patient went on to tell me that with all of the providers and teams that entered her room, few stayed long enough to hear her, to truly listen to her experience, or to understand what it was like to wake up every day with her condition, not just in this hospitalization, but for the past few years. "But Amber did," my patient smiled. "And she empowered me."
Our patient had begun to feel like her body was not her own. Nurses, providers, therapists were always doing things "to me," she described, "telling me that if we don't do this, then we aren't treating you, you need this, you have to have this, and it's always like that." But not with Amber. "She helped me navigate a really tough situation that happened overnight."
That night our patient had been told she needed to wear a Bi-pap mask again for suspected sleep apnea. During the day she had been oxygenating well on room air, but her providers ordered Bi-Pap at night. While "non-invasive," Bi-Pap can be very anxiety-inducing, especially for someone unaccustomed to wearing it.
My patient said that when she wore the Bi-Pap mask, she'd wake up frequently in a panic, feeling as though she couldn't escape from the mask and its straps.
"I was so tired of having it strapped to my face, I just wanted to have one night where I could try to breathe on my own, and at least have a shot at waking up without being tethered." When she declined the treatment, some team members met her with resistance, explaining that she "needed it" and "would have to tolerate it."
But Amber told this patient that she understood her fears. She told her "you know your body best, and what you need to get well" and that "if tonight you need rest, I'll back you up." "After all," Amber told her, "you get to be in charge of your care, this is your body, and I'm here to support you however I can." This meant so much to the patient. She told me that this was the moment in which her autonomy was restored.
Additionally, Amber went above and beyond to provide evidence-based skincare and greatly improve the comfort level of this patient. When I assessed my patient's groin drain site and sensitive skin, I found the cleanest, driest, and most intact dressing I'd ever found! Amber had fashioned a beautiful solution and it was clear she had frequently reassessed and provided interventions to minimize the effects of the moisture from which our patient had been suffering. My patient explained how safe she felt when Amber was caring for her, and that she could tell she truly cared. She said that she hadn't felt this comfortable or slept this well anytime else during her admission. Amber even put in a wound consult overnight, just to ensure that the patient would receive close attention in the days that followed.
This story is representative of the excellent care Amber always seeks to provide. It was a privilege to learn of her exceptional care from the patient herself, who said she would have nominated her for the award herself had she been in a position to do so. Amber is a true DAISY Nurse.