Andy Paulson
December 2015
Cardiac and Vascular Intermediate Care
Oregon Health & Science University
United States




Andy helped created a tool for Charge RNs to understand the intermediate care criteria better and he recently helped with the setup of the Heart Failure University room. He is one of the most experienced charge nurses and serves as a preceptor for both new hires and nursing students. Andy not only takes on formal leadership roles, even working as interim manager at one time, but he also makes a huge difference at the bedside. He was a pioneer when we first started taking care of VAD patients and pulling sheaths and is always the "go to" nurse in times of crisis. He's the front runner for early adoption of new methods, is always smiling and positive.
People often say that Andy is a "Healing Journal" on our unit and that he connects with his patients in a way that is unlike any other nurse. He is the role model on our unit for therapeutic relationships and the importance of making your care "personal" and individualized based on the patient needs.
An example of this is when Andy was recently caring for patient that was young with a small child and spouse at home. The patient had a significant event that almost ended his life. When taking over care for this patient, he recognized immediately subtle indicators that the patient's recovery was being limited and that our current plan of care was one of the primary barriers. This patient was very afraid, traumatized, and lacked the coping mechanisms needed to recovery. He was scared to push himself, and could not recognize his own progression. In our effort to focus on his safety, he heard us telling him, "we must be present to help you", "do not get up without our help", assisting him with care and our use of the bed alarm which were all making him feel less confident in his ability to manage his care or complete his own ADLs.
At the beginning of the shift Andy took some time to listen to him tell his story and observed his anxiety and fear. He answered some questions and they set goals together. The patient's apprehension was obvious and he welcomed suggestions for goals. Andy's primary goal was to help the patient gain confidence in his ability to take care of himself. He worked throughout the day to help decrease the patient's fear and the weight of being hospitalized. He wanted him to understand the experience, but prevent him from being crippled by it. Some of the interventions that he put in place uniquely for this patient included: he used duct tape and made the word "Champ" on the back of his robe. Then for his first 2 walks in the hallway he played the theme song to Rocky and Eye of the Tiger to motivate the patient to meet his goals. He gave the patient space to try to complete activities more independently, and validated the patient with positive messages. He assisted the patient in "hosting his family members" rather than having them wait on him in an effort to create some normalcy, as well as demonstrate his ability to care for himself.
He focused on the patient's goals as being "going home" and helped him to believe that was a possibility. He reached out to other services including Social Work to assist in helping the patient manage some additional stressors and gain resources and support systems. The way that Andy knew his plan was working was that the patient more actively engaged in his ADLs, he told Andy that he was feeling more confident, he was sharing care with his spouse rather being reliant on her. Further the patient updated his Facebook profile for the first time since being hospitalized with a description of his first "win"—his walk out of the room. This was the first time he reached out to his social contacts since his hospitalization.
I believe this is only a glimpse of the amazing care that Andy provides daily to our patients. His unique style, ease with care, and critical thinking allow him to demonstrate and promote the nursing profession. We are truly lucky to have him on the 11K team and at OHSU.