It is very rare in the CPACU that over the span of one shift a nurse could call a code on a patient, assist in opening his chest three times, and hands over report to the incoming nurse with a smile. That nurse is Dayane Richards and my colleagues can attest that she is extraordinary when it comes to patient care.
My shift followed hers recently in the CPACU. She was taking care of a gentleman with an LVAD (Left Ventricular Assist Device) in the CVICU. She reported to me that after wishing a happy birthday to Mr. H, she was getting ready to sit him in the chair when he decompensated, coded, and required his chest to be opened at the bedside. Dayane took the patient to the operating room for re-exploration and afterward received the patient in CPACU for the continuation of care. Upon return to the CPACU, this patient was still hemodynamically compromised and coded again. His chest was opened twice for resuscitation and left open due to his instability. After such grueling events on her shift, Dayane was able to maintain a remarkably collective composure. Her handoff bedside report regarding the patient was incredibly detailed and her interactions with the family and the cardiac surgery treatment team were impeccable. It so happened that during this bedside report that the patient woke up from anesthesia and was able to respond to commands. Dayane's response to the moment was a palpable excitement that could not be dismissed. She said to him: "Oh no, I was not going to let you do that to me on your birthday anniversary". She held the patient's hand for a moment to let him know that his brothers were updated and that as ordered the sedation would be turned on for comfort and rest overnight.
Dayane is a very caring, compassionate nurse who truly listens to her patient's and family's needs. She made an emotionally stressful situation painless by helping the patient's brothers feel at ease in making medical decisions. She is very thorough in communication and took time to ensure the brothers understood what was going on. After seeing the patient's chest was left open with a wound vacuum dressing after the last coding event, the brothers were devastated stating that the patient has a living will and would not want to be suffering like this. Conversations with the surgeon did not ease their feelings on this matter as they have had bad experiences in the past with doctors giving them false recovery hope for their ill mother who ended up suffering through death. They wanted to make a decision within 24 hours to stop treatment. Dayane took the time to explain to them the medical rationale behind keeping the patient's chest open for at least 48 hours before having it closed in the operating room. She also gathered the Heart Success team and social services to speak with the brothers regarding their concerns. She was able to safely lower the patient's sedation which created an opportunity for him to interact with his brothers.
I am happy to report that I followed this patient for 3 nights and when I extubated him he was so grateful for the care he received in the CVICU. Dayane's ability to explain the rationale behind the interventions he endured while maintaining a personal connection with the brothers created a calming effect on everyone involved. The family called the unit back on my shift to express their gratitude. They were very appreciative of Dayane's special attention and were especially appreciative of her putting them in contact with the Heart Success team. As I'm writing this letter, the patient is successfully recovering in Gagnon3. Dayane's attitude is very inspiring and correlates with the Atlantic Health System PRIDE values. Colleagues like her, providing extraordinary care continue to make us "Best Place to Work".