Brooke is an outstanding charge nurse on SSU. She is extremely efficient and is always helpful to all staff and patients. I have recently witnessed her compassion, resilience, and persistence to provide excellent care to a patient who was extremely difficult, verbally abusive and occasionally very irrational. She went above and beyond her call of duty and also went outside of her comfort level to handle an extremely unhappy and disgruntled individual. A fellow nurse requested if she could help her with a med pass since this nurse was dealing with other issues on the unit. She went to this patient's room to pass his 0900 meds. She was immediately yelled at, for coming into the room and giving meds too early according to this patient's home schedule. She stayed calm and asked the patient what she can do to help him better. The patient states that he had asked when he first came to schedule his am meds at 1200 as at home. She reassured that she can re-schedule this for him.
The patient also became more upset when his primary nurse came to the room. He immediately kicked her out of the room before she can even do an assessment and other care. She patiently stayed with the patient. Security was also called and the primary doctor also came in to talk to him. The patient was verbally abusive to his doctor. He voiced paranoia over the ED docs and other health care professionals from previous experiences. He was also using profanity as he spoke to staff. Even though she was not assigned to this patient as a charge nurse, she eventually took over his care. She allowed the patient to just talk and talk about his dislikes and lack of trust in the health care system and listened to him for a long period of time. She continued to explain the importance of treating the patient's infection even though the patient was not very receptive at this point. The patient also verbalized that he will leave AMA. She again explained the seriousness of his arm infection and that his labs indicate a possible infection in the bloodstream pending test results. She was able to help the doctor convince the patient to have some labs re-check as she explained the importance of getting this done. The patient continued to be paranoid of other staff members so Brooke was the only one going into the room while security and other staff members stood ready outside of the room for a possible escalation of behavior. She spent so much time using doc halo to keep the physician informed and to get the orders that she needed for the patient. She allowed the patient to eventually sleep while his antibiotic was infusing. She tip-toed in the room to check on him frequently while allowing him to rest.
Later that day patient's wife came in. She was at first snippy with the nurse while asking some health questions. She again patiently explained the gravity of the patient's infection to his arm and that risks if left untreated. She gave the patient and wife 2 options.
1. The patient has the right to leave the hospital if he feels that he has to. He chose to come in to seek help but he also has to option to not accept help or
2. Allow doctors and other healthcare professionals to care for him and treat his health issues.
Brooke spent time answering questions from the patient and wife for 2 hours or so. Eventually, the doctor came back to the room to discharge the patient. She again took the time to educate the patient about managing his diabetes better at home and what to do if arm infection worsens. She proceeded to call around for a primary physician to accept this patient even for a 1x time appointment. She never gave up on this patient even though he was the most difficult to handle. She herself was not feeling well that day but continued to do her work with such grace and sensitivity to the needs of her patient. Her personal ailment and feelings were put aside as she chose to prioritize the patient's needs over her own. I gained more respect and admiration for her, as she maintained her composure the entire time juggling her difficult role as a nurse to a very challenging patient and her charge nurse duties.
Brooke's peers and I were extremely impressed as none of us felt we could have handled this situation better than her. The patient eventually calmed down that afternoon after seeing that she did not give up on him. He even thanked her for her great care and asked for a hug before he was discharged. Nurses do take on difficult roles on a daily basis and it is quite impressive to see someone like Brooke put her clinical skills, knowledge, experience and a big heart to use, in order to make a difference in people's lives. I am sure that this patient will remember her in a positive way for what she has done for him. I am extremely proud and privileged to work closely with such an amazing and caring nurse like her.