Lian McDonagh exemplifies what it means to provide compassionate care amid the harrowing environment of the acute section of the MGH Emergency Department, where some of the sickest and most clinically unstable patients arrive in the middle of the night. A recent example illustrates Lian's skill, clinical acumen, and patient advocacy as a nurse. I went to admit a patient with an advanced, rare muscular dystrophy. Lian saw me enter the patient's room. The patient was confused, critically ill, and unable to speak due to life-threatening metabolic derangements. Since this patient was so critically ill and unable to voice his concerns, and his family was not present, Lian served as this patient's voice and advocate. She relayed the key details shared by the EMS squad that transported the patient to the hospital. She also helped to highlight the essential diagnostic and therapeutic interventions that the emergency medical team accomplished before I met and assumed care of this patient. Lian traced the patient's clinical trajectory and shared her concerns.
Lian and I then assessed the patient together. She advocated for a family meeting to ensure that we were providing care in alignment with the patient's goals and wishes. Because of Lian's advocacy, we were able to reach the patient's family and prevent iatrogenic harm from reaching this patient. We were able to gather the patient's family members and have a family meeting in the early hours of the morning that clarified the patient's wishes. Because of Lian's care, this patient – nearing the end of life and actively dying – received compassionate and comfort-focused care – and his family had the opportunity to spend precious time with him.
I am so grateful for Lian's advocacy for, and bedside nursing care of, this patient. This exemplary nursing care is even more remarkable and worthy of praise considering that it transpired in the busiest and sickest part of the MGH Emergency Department, Acute. Thank you, Lian, for your care of this patient and all patients.