Ashley Guiler

Ashley Guiler

Ashley Guiler, BSN, RN, PCCN, CCRN

Cardiac Surgical ICU - 4 Ross
Wexner Medical Center at The Ohio State University
Columbus, Ohio
United States

Ashley not only is an exemplary nurse in both her skill and knowledge, but she also brings the art of nursing to the bedside as well in the form of empathizing for her patients and their family members. I am a new employee on 4 Ross and I had the esteemed privilege to have Ashley as my preceptor. During our time together, Ashley showed extraordinary compassion for both our patients and their families each and every single day. However, one day in particular stood out among the rest.

We had a very complex patient that had cerebral edema and was not responding well to treatment. Even though we tried exhaustively to correct the imbalance through multiple therapies whether it be a hypertonic saline infusion, CVVHDF, diuretics, we were unsuccessful. Throughout all of this the patient's family was very distraught about what course of action they should pursue, whether it be to continue the fight in hopes their loved one would recover or to withdraw care. The family was bombarded by a slew of doctors that told them varying prognoses and ideas that only made the decision more difficult to choose. With all the information bombarding the family, Ashley answered every single question that they had and tried to summarize the information presented before them as best we could; mainly so I could focus on taking care of the patient.

She even sat down several times with the family and made sure that they understood everything that they were being told - as most of the information they were hearing was not familiar to them. After a meeting with the primary surgeon, it was decided that the family would make the patient a DNR. Understandably so, the family, especially the daughter and husband, were very tearful. Ashley made sure that they were as comfortable as possible and had as much support as we could provide (including plenty of tissues). After more tests and more doctors evaluations palliative medicine stepped in and tried to put the pieces together and it was decided that we would withdraw care on the patient.

Immediately Ashley stepped in to console the family and comfort them as much as possible, even holding crying family members' hands at times. Ashley ensured that pastoral services were contacted and met with the family and arranged for nutrition services to bring a bereavement tray. When we arrived at the moment to withdraw care - the dying process was not instantaneous and was actually drawn out over several hours. When it was apparent that the patient was not going to pass, Ashley volunteer to stay over her scheduled shift to stay with the patient and their family saying "I can't leave them right now. It wouldn't be right."

Not only did the family thank Ashley extensively for the support that she provided, but you could see a sense of calm and appreciation in their eyes when they thanked her; furthermore looks of peace about the situation. In this moment I saw just how caring and amazing my preceptor was. I often think how lucky patients are when I see Ashley assigned to them as their nurse. I know that there is not a better, more skilled, knowledgeable, and compassionate RN that could be caring for them.