Thank you for your kindness and compassion today as my team and I cared for our fellow nurse and her family in her final hours. As we talked this afternoon, I could see this was very hard for you, as your friend reached out for help knowing she was going to pass away in our hospital.
You commented to me on feeling bad about her being admitted to our "make-shift ICU". I want to reassure you that while our temporary SICU may not be the most aesthetically beautiful space, I know in my heart that what mattered most is how we cared for her and her family on this most difficult day. For three years, my team has made the space we now call home healing, caring and compassionate environment for many patients and families. We long ago stopped telling them we were in a temporary location or explaining our surroundings because we do not see it as a barrier. It is not the geography, but the character of the people that makes a difference in the lives of those we care for. And there is no group of nurses I would rather want to care for me or someone I love than those I have the privilege of having in my unit.
I especially want to use this occasion to share how successful I believe the PARTNER program and the UPMC Experience can and should be for situations just like this. Prior to PARTNER, we would likely have deferred to the physicians to talk with the family and dictate the plan. But PARTNER has empowered nurses to take on a new, more prominent role. I want to recognize the amazing work my staff member did today as the PARTNER nurse who made all the difference. As I spoke with Kelsie this evening as she ended her shift, she too recognized she acted differently now because of PARTNER. Let me explain...
Kelsie had no idea of the patient's background or that she was a fellow nurse or that leadership was involved when she encountered her family and friends in the hallway outside CTICU. The waiting room was full and they were all standing in the hall clearly upset. She knew only that we were getting a young patient from the ED with a poor prognosis and that her skills as a PARTNER nurse would be needed.
She felt empowered to initiate contact with them as they stood in the hall, introduced herself and said something profound to them. She reassured them that the patient was in the best possible hands with her bedside nurse and that she would provide all the care the patient needed. She then explained to them that she was there solely to support them and would be with them every step of the way. Imagine how comforting it must have been for her husband to hear that. He was faced with telling his two young sons that their mom was dying today and prepare them to see her one last time. She gave him the means to be able to do that with dignity. She made an immediate connection with him and provided him a private place to talk with his boys and to cry. Once they were ready, she contacted me to be able to bring the boys back with their dad and ensure we were prepared to provide them the type of environment they needed for such a pivotal moment. This coordination was amazing and essential. She escorted them back and then stood respectfully at a distance while they spent time together.
Meanwhile, the physicians continued to discuss the options they could offer to the husband in the nurses' station. We had hoped to separate the family visit from the family meeting and first give them time together before talking about end of life decisions. But the heme/onc team went in and began to talk to the husband in the room. Kelsie entered the room and became an advocate for the husband. She guided them all out of the room and stayed with him for the discussion. When her husband made it clear he was choosing to pursue comfort measures, she immediately offered him support in how he could tell their parents and siblings of his decision. She explained to him that he did not need to go out and address the large number of people who were gathered. All he needed to do was talk with those in her immediate family and she would again provide him with a private space and protection from interruption to do so. She escorted them to the consult room in CTICU, closed the door so they could be alone and then stood respectfully outside the door to ensure no one would interrupt this moment.
Once she knew the needs of the immediate family were cared for, she took the initiative to support the other gathering friends and extended family. She offered them an alternative waiting space, walking them down to the surgical family lounge and letting them know they could wait there and gather together if they desired. Meanwhile, the nurses in the unit and my HUC began to organize their own comfort cart for the family. Patient Relations came and provided meal tickets and parking. I called the dietary supervisor and requested their support to bring the Palliative Care comfort cart to the room even though this patient did not have a palliative care consult. I explained the unique circumstances and without hesitation or questioning, they agreed to help, and the cart was at the room within thirty minutes.
The influence of both our PARTNER training and our UPMC Experience work was clearly evident today. I know this example will illustrate to you how engrained in our actions the work you are leading has become. I cannot take any credit for what transpired today. The credit belongs to this person and the nurses who cared for this patient at the bedside throughout the day. I am incredibly proud though to have seen them at work and to share this story with you.