Kevin has been described by his co-workers as clinically strong, dedicated, and performs with a willingness to handle various situations. One nurse wrote, "Kevin takes pride in establishing a great working relationship with his patients. He takes the time to get to know each patient, which helps him to tailor his approach with each patient and provide the best care possible. Kevin goes out of his way to make sure patients and families are comfortable with their medical care". Another nurse stated, "Kevin brings a very confident work ethic to the unit. He has a broad knowledge base, which is in part due to his strong military background. With that in consideration, he is always willing to jump in and lend a helping hand".
Kevin exhibited his compassion, empathy, and patience with EP 4-6 patient Mr. R who has had a reputation in the hospital for being not only sick but also behaviorally challenging. Kevin approached this situation never having cared for Mr. R but did not let this patient's history guide how his impression of the patient. He went into Mr. R's room and introduced himself and to his surprise, he did not seem as irritable and difficult as everyone made him sound. Kevin explained all his medications, took his vital signs and did his assessment and then the patient asked for a favor in taking out his breakfast tray, cleaning up his bedside table and grabbing him another pitcher of ice water. Kevin said, "Sure Mr. R, I can do all that for you. I will be right back." He brought out his dirty tray and grabbed him a new pitcher of ice water and promptly returned to him. He said, "Thank you." Kevin asked him if there was anything else he could do for him before he left and Mr. R. stated he was all set. Kevin started charting and checking in on the other nurses and one mentioned that Mr. R never says thank you to anyone and that he was lucky, or he must be off. Little did Kevin know that those little gestures of addressing him as Mr. R and his thank you would set the tone for the relationship that would develop between Mr. R and Kevin.
Fast forward a couple of weeks and it was right after Thanksgiving and Kevin had just returned from being off for several days. Kevin had Mr. R assigned as one of his patients every day that he worked. They had established a rapport and had quite a good relationship. At one point he even told one of the respiratory therapists that Kevin was his favorite nurse. Kevin had been able to begin to anticipate his needs, when he would need his prn medications and his daily schedules of how and when he would like certain things. Kevin developed the process of bringing in a new pitcher of ice water every morning upon updating his whiteboard. Mr. R always thanked Kevin for everything he did and thanked him for the respect that he paid him. It was about this time the 4-6 team began to discuss the discharge situation with him. He was nearing medical readiness and we were beginning the process of placing him. It was at this point that he began reporting increased SOB. Kevin took his vitals and showed him everything looked perfect, and that his O2 saturation was 100%. The team ordered a chest x-ray and ran several other tests, including putting in a pulmonary consult for him. All the tests proved to show pulmonary improvement and even pulmonology had signed off. All the while he was still complaining of SOB and DOE. Kevin recognized that this was not actually SOB.
Kevin sat down with Mr. R and began to have a lengthy conversation with him. As they talked it became apparent that he was, in fact, experiencing anxiety and it was manifesting as his SOB. Kevin listened with empathy, patience, and kindness; sitting eye level with Mr. R and allowing him to express that he was afraid of dying if he went home, where he lived alone. After ascertaining that he could feel this coming on, Kevin worked on deep breathing exercises with him that could help him calm down. They even practiced together and Kevin even gave him a back rub to help him calm down.
Kevin's dedication to this patient both with his mind and his body was exemplary. Mr. R expressed his deepest gratitude and continued working on deep breathing. The morning after Kevin's relaxation technique education, the night nurse had overheard him talking to himself at night telling himself to calm down and using the deep breathing techniques to calm himself down. The patient stayed on 4-6 for several more weeks and Kevin cared for him every day that he worked. They had built such a great relationship and Mr. R looked forward to every day that Kevin worked. Mr. R so desperately wanted a Dunkin Donuts coffee, and Kevin went out of his way into work and brought him the coffee and he was sincerely thankful. This was New Year's Eve. He was so happy that Kevin received in report the next day he was up dancing with the staff at midnight celebrating. All of this never would have happened based on his 'reputation'. They always tell you to never judge a book on its cover or to make your own opinions about something. Mr. R and Kevin built a relationship based on mutual respect and sincerity. All it took was some time to sit there and truly listen to the patient and truly hear him. Kevin demonstrated that no matter what, taking the time to listen to someone, provide compassionate care and truly be sincere, the clinician-patient relationship can flourish, no matter how 'difficult' one may seem.