Raven was a student of mine during her Chronic Care clinical rotation in Nursing 12. One particular day, she was assigned to a patient who had a history of mental illness, was homeless, an IV drug user, and was admitted for diabetic ketoacidosis. She was recently transferred from the intensive care unit (ICU) to the medical floor. Upon arrival to the unit and discussing patients with the charge nurse, the charge nurse requested that a student be assigned to this particular patient, as she was difficult to console throughout the morning and was "yelling" for the nurses throughout the day.
Shortly after we arrived to clinical, I could hear the patient the charge nurse was referring to, who was also Raven's patient, yelling unintelligible words. Raven approached me and said she was concerned about her patient. She explained that due to this patient's history perhaps her "behavior" had not been taken as seriously as it should have been. She went on to describe her assessment findings and her concern that the patient was in ketoacidosis again. She described her "fruity breath" and her labored breathing, as well as her altered level of consciousness. At this time, Raven stayed by the patient holding her hand, telling her everything was going to be okay, and that she was there and listening to her, as the patient laid yelling and attempting to get out of bed. Raven delegated to another student to get the vital sign machine to obtain vitals, and another student to get the Accucheck machine to check a blood sugar, and another student to notify her nurse, while she comforted her patient. She held the patient's hand and told her she was going to help her. It was evident the patient was decompensating quickly. The respiratory rate was significantly elevated, she was tachycardiac, and hypotensive. The blood sugar was in the 600's, and her mental status continued to deteriorate. At that time a rapid response was initiated. The patient required an insulin bolus, insulin drip, sodium bicarbonate, multiple fluid boluses, and was transferred to the ICU.
I am confident that Raven made a significant impact on the patient due to her excellent patient-centered care, advocacy behaviors, leadership skills, impeccable communication skills, clinical reasoning, and detailed thorough assessment skills. While all of those behaviors impressed me tremendously, what impressed me even more was her compassionate care she provided to her patient. The fact that she treated her with the utmost respect and dignity is commendable.