Catherine Coates has been a nurse in the MICU for the past 4 ½ years. In this short period of time, she has made a significant contribution to the overall environment of compassion as well as the clinical care of patients in the MICU. Catherine is not only a strong clinician with excellent assessment and critical thinking skills but she is also a fearless patient advocate. She consistently has her patients' best interests at heart and without hesitation tirelessly advocates for whatever they may need to be comfortable, happy and well cared for. Catherine's impact is readily recognized by her peers and leadership team because her daily work and behaviors enhance the culture of caring on the unit. She is always looking for opportunities to contribute to the daily work of providing exceptional care experiences to patients and their families. She is a true role model for nursing excellence and compassionate care and goes above and beyond to instill this same thoughtfulness and caring in those around her, especially in those she precepts.
In collaboration with pastoral care, Catherine started the MICU Remembrance Service on SRC to remember and honor patients who have passed away in the unit. She honors these deaths with a ceremony in which staff can reflect and share their feelings in taking care of these patients at the end of their life. The staff is able to share their feelings of sadness, emotional and moral distress and compassion fatigue when taking care of patients and their families in these very difficult, emotionally challenging times. These ceremonies give staff an emotional outlet to express their thoughts and emotions around end of life care. Catherine's commitment to this remembrance service truly supports nurses whose tireless work and commitment to compassionate care will never go unnoticed. She is a true role model and her dedication and commitment to patients and families serve as an example to all of us.
Recently, Catherine responded to a code blue on a medical floor. The patient was a 93-year-old male whom Catherine had previously cared for in the MICU. When she arrived to the code the patient needed life-saving measures, including CPR. Being one of the first to arrive, Catherine, by instinct and training, began chest compressions honoring the patients advanced directive. Resuscitation efforts were successful and Catherine accompanied the patient to the MICU where he required 1:1 nursing care. Catherine was emotionally distraught over the patient's condition. She had gone above and beyond to help save the patient's life and honor his wishes by following his advanced directives. She did everything that was clinically expected of her and more. She spent time comforting his family and reassuring the patient that he was receiving the best possible care. Still, behind closed doors and away from the patient's room, she was distressed. She was upset not because she had done something wrong, everything she had done was exactly as she had been taught. She was upset because she was concerned that by doing chest compressions she had caused the patient discomfort. That the same action that caused the patient to live had also potentially and inadvertently caused him harm or pain. The idea of causing a patient any level of discomfort was more upsetting to her than the relief she might have felt knowing that those actions were successful, that she had unerringly done what the patient commutated he wanted. Catherine's compassion for her patients knows no bounds. Catherine demonstrates the type of skillful and compassionate care that serves as an excellent example for those around her.
There is no shortage of examples in which Catherine has made special connections with patients and their families. Recently Catherine cared for a critically ill 23-year-old patient who was admitted to SRC MICU following a cardiac arrest. Unfortunately, our critical care interventions could not save this young man and 2 days later, he was pronounced brain dead. At this time, his family made the difficult decision to honor their loved one's wishes to be an organ donor. Catherine took care of this young man on the day that they scheduled him to go to the OR for organ procurement. She provided extensive emotional support for the family during this very difficult time. She listened to his mom's stories of his incredible life, sharing moments of joy and tears with her. That night, Catherine led the entire staff of SRC MICU in a "walk of honor" to the operating room for this patient and his family. In addition, at the family's request, Catherine stayed with him in the OR, providing a sense of comfort to the family since they truly bonded with Catherine and felt a sense of peace that he was not alone during this process. As much as Catherine had an impact on the family, this patient and the family deeply had an impact on her.
The Medical Intensive Care Unit at SRC population has high acuity and often times, our patients have multiple complex medical issues at once. Due to the high acuity of our unit, we have over 150 deaths per year and through her work with the MICU end-of-life committee, of which she is the co-chair, Catherine has either directly or indirectly provided some form of comfort for every one of these deaths. As a nurse, she saw an opportunity to help provide more support and kindness to families during a very difficult and grief filled time. As part of the end of life committee, Catherine helped to develop a bereavement project. When a patient is dying or dies, she helped to develop a process where the nurses of the MICU provide patients and families ceramic hearts and prayer shawls to help provide comfort to them during a grief-stricken time. She also helps to promote a peaceful environment by arranging for LED lit candles to be placed in these same patients' rooms. Her goal is to make a hospital room feel less like a hospital, and more like home when a patient is actively dying in our care. It has helped provide a bit of solace during an otherwise dark time. The ceramic hearts and shawls both serve as tangible items that families can then take home with them after their loved one has died. Patient's families have expressed their gratitude for being able to choose their loved one's favorite colored shawl, and appreciate taking the items home as remembrance items. In order to help fund the bereavement project, Catherine participated in applying for an Auxiliary Grant. Here is a short excerpt from her grant application:
"Our hearts project provides ceramic hearts to families of dying patients and has been very well received. When a patient is dying, and often times has become non-responsive, we ask permission from the family to put a heart on the patient's chest. The heart remains here until the patient passes. The family is encouraged to take the heart home with them as a remembrance item. There are some family members who cannot be at the bedside as their loved one passes, making the heart a tangible, and meaningful memento. We often receive requests for more than one heart and gladly fulfill these requests. We feel that this project has and will continue to provide great comfort to our patients and their families who are faced with terminal outcomes. Our staff takes great pride and comfort in seeing a family depart one final time from our unit with shawls tucked under their arm and hearts in their pocket."
This project alone has made a significant difference in the life of our patient's families. It also provides the nursing staff to have a way to help the families emotionally during their time of need. Her thoughtfulness in finding a way to help families in their darkest times is a true example of who she is as a nurse and a person. Catherine is an inspiration to her coworkers and a genuinely caring person.
This doesn't even include the multitude of patients Catherine has personally interacted with and made an impact upon. Recently, Catherine took care of a 50-year-old man who was critically ill, requiring 1:1 nursing care. He had a wife who never left his bedside. Catherine developed a wonderful rapport with the patient's wife, always involving her in the plan of care and translated medical jargon into terms that the family could easily understand. She spent four days taking care of this gentleman and keeping the family well-informed of any subtle changes in his condition. With extensive ICU care, he did eventually recover and was discharged home with his wife. One month later, he called the unit to speak to Catherine. He wanted to personally thank her for saving his life. He expressed his extreme gratitude for her outstanding nursing care and for supporting his family during his acute illness. She provided his family with strength and hope to emotionally endure his ICU stay. Her compassionate care made a lasting impression on them and it will never be forgotten.