My 96-year-old mother arrived at 1:30 am on a Saturday morning from the ER. At 7 am on that Saturday morning, Megan Tinkham came on duty. Megan bounced into the room, full of enthusiasm, positive vibes, optimism, and confidence and spread that cheer throughout her shift. "This is what we are going to do" wash our hair. "This is when we are going to…" give IV antibiotics. "This is why…" she is getting IV fluids. We tried not to ask too much of her, but always with a smile, she provided another chair, ice chips, answers. Megan gently put cream where my mother had skin irritations and smiled and chatted all the while. She made us feel so very comfortable and that my mother was her only patient. Now we know that's not the case, but she could effortlessly balance her patient load without us thinking we were taking too much of her time.
She was the consummate professional, exhibiting kindness, dedication to her chosen profession and excellence in discharging her duties with compassion and a touch of humor.
My mother was discharged on Tuesday and Megan assisted with the hospice transition. She returned to her apartment at the assisted living where she subsequently passed the following evening. The days preceding her death were better because of the care that Megan provided her and to me.
***
Stroke patients often experience deficits and may not be able to speak for themselves. There were two stroke patients whom Megan has cared for in the past six months during which she has shown exemplary compassion and nursing expertise.
The first patient, Ms. B, who is only 32 years old and suffered a devastating stroke which left her with severe weakness, a permanent trach, and the inability to eat from dysphagia. The patient had been refusing a PEG and had pulled out her NG tube multiple times. Megan was able to develop a rapport with her over a few days to convince her that a PEG tube was in her best interest - a feat we had been trying for well over 3 weeks unsuccessfully. The amount of trust that this patient had in Megan was truly amazing. Megan also was able to get her off the every 4-hour Morphine pushes and to a better pain control plan, which is always a source of fear for our patients. Megan was able to schedule therapy sessions for the patient so she would participate since she had been refusing for days. There were so many opportunities for care in this complicated patient, yet Megan addressed every challenge as a team with her patient. This approach had an amazing effect. Every decision and conversation Megan really partnered with Ms. B and gave her a voice in her own care. I could not imagine a better patient experience than that.
The second patient, Mr. E, had a large stroke and was transferred to our facility for care. He was Spanish speaking only and language barriers with stroke patients are even more difficult as language comprehension is often affected. We were utilizing interpreter services with the patient, but it is challenging to provide excellent experience when you cannot communicate even the basic tasks with the patient. The patient has no family in the United States and was also reluctant to speak with the interpreter and hospital staff. Megan volunteered to take this patient because she had taken some Spanish courses in the past and was able to communicate some with him. I think this personal interaction with one of your caregivers that is trying hard to reach you at your own level means something to patients who are going through such a life-changing event like a stroke.
But Megan's nursing expertise is the second part of this story. From being able to communicate and develop a rapport with this patient, Megan discovered he was having difficulty swallowing. She made him NPO and immediately consulted speech. He has a swallowing test which showed no aspiration, which was great, but that he needed to be on thickened liquids. Megan potentially saved his life - not exaggerating. He could have aspirated any time in the future. Pneumonia (usually from aspiration) is the second leading cause of death in stroke patients, second only to the stroke itself. Megan combined clinical judgment and compassionate rapport with this patient.
Both of these stories are only the tip of Megan's nursing practice. She is a fairly new nurse, with less than 18 months experience, but I know she is destined for great things in this profession. She is truly a role model to her peers and those around her. I am proud to have her as one of our stroke nurses here at SNGH. She is a true DAISY Nurse. She has compassion and gives a voice to these patients who often lose theirs. We would all be lucky to be in her care.