Elliott has been a nurse since 2013 and has worked on 5A/5C at OHSU since April 2016. Elliott has served as Charge Nurse and as a preceptor for new hires. Elliott's peers describe him as an advocate for his patients and his colleagues, and as someone who is very open and self-reflective about his growth. He has volunteered with children for many years, including co-founding a free childcare program for financially disadvantaged and single moms in his nursing program. In his own words, Elliott is "passionate about nursing, advocacy, justice, servanthood and integrity."
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I am new to 5A/5C; I am in the role of Interim Professional Practice Leader, working alongside another PPL. As I am getting to know the nurses on this complex duplex?unit, I find myself amazed at the exemplary care that is being given. One of the most compassionate care?giving moments I have seen was by Elliott.
The patient was "medically stable," but incredibly complex, as he had a series of brain injuries, multiple surgeries on his brain, and dementia/delirium. His mentation waxed and waned abruptly and severely. He had become aggressive with staff multiple times (causing some fear and anxiety for staff). Additionally, his wife was very anxious and sometimes increased agitation for the patient when she visited.
TheMed/Psych PPL and I had been trying to assist the 5A/5C nurses in developing a care plan for this vulnerable patient for a number of days when Elliott assumed care. When I visited in the morning, Elliott had cared for the patient over the weekend and had made great strides! Recognizing that the patient was vulnerable, Elliott utilized the Cognitive Pyramid to help identify what interventions might be successful with the patient, which often meant adapting quickly as the patient waxed and waned. The patient did become aggressive over the weekend, and had to be put into restraints for safety, but what Elliott noticed was key: the patient calmed down and seemed less anxious when he was put into restraints or when healing touch was utilized. When we discussed this with the Med/Psych PPL, she recognized that the patient may respond positively to sensory input and may benefit from a weighted blanket, a novel intervention for us.
Elliott also built a relationship with the wife of the patient, and gently discussed realistic options for the next level of care after the hospital, allowing the patient's wife to express her fears about skilled nursing facilities. As I was discussing all of this with Elliott, the sitter opened the patient's door as the patient came out of his room, pushing his chair, mumbling incoherently, and appearing to be agitated. With the brain trauma that this patient had experienced, he was not always able to formulate his thoughts into words, often increasing his agitation. It was the transformation in Elliott that astounded me. As he turned away from me and towards the patient, the calm compassion that he directed towards the patient was phenomenal. The patient saw Elliott, and it was as if he was in a foreign country and just identified a translator; he clearly relaxed, knowing this person would understand him. Elliott quickly assessed the patient's mental status by asking a few gentle questions, and then once he deemed it safe, gently placed his hand on the patient's arm. The patient was further comforted. Elliott stayed with him, offering him words of comfort and acknowledgement, meeting the patient exactly where he was cognitively at that moment. They then went on a short walk, ordered breakfast, and the patient returned to his room to sit in his chair.
The patient, although unable to articulate with words, was able to have his needs met because of the time and care given by Elliott. In a situation that could have escalated, Elliott performed compassionate, patient?centered, exemplary care that decreased the patient's anxiety and kept everyone safe. In the bigger picture, he didn't look at a patient who was "medically stable" and decide that they were "stable;" he recognized that the patient was very vulnerable in his moderately unstable cognitive state, and developed care plans around that instability.
Additionally, Elliott recognized that the wife needed a lot of support in her acceptance of the patient's next steps, and provided her with a space to process. I have continued to see Elliott not only support his patients in phenomenal ways, but he has grown into a huge support for his coworkers and is currently training as Charge RN. He exemplifies nursing care at OHSU, and is most definitely deserving of a DAISY Award.