A patient arrived to our unit for a planned Irrigation and Debridement of an infected right below knee amputation site. This patient was refusing any type of anesthesia, due to her previous experience with anesthesia and appeared somewhat angry. Elizabeth Pyle worked with this patient and sought to find her back story, noting that she had been truck driver (which was unheard of in her day and age for a woman) and even had traveled cross country in her truck with a pet Ball Python. The patient was obviously distressed due to her disease process and limitations and the nurse recognized that behind the gruff exterior of this individual was a frightened woman who was losing control in her life. The two developed a relationship and understanding through this brief interaction.
When the procedural team arrived to take the patient back for the procedure they verbalized concern that the procedure was going to be done under local anesthesia, since the wound would be somewhat extensive and may be difficult for the patient. The patient stated to the team "I do not want anesthesia and if you try to give it to me I will knock your teeth out". Realizing the patient's background was one of toughness as a female truck driver, Elizabeth instantly advocated for the patient's wishes. She met with the procedural team and helped them understand the patient's background and reassured them that the patient indeed did not mean the statement literally and that she would be willing to go with the patient for the procedure since she had developed a rapport with her. This attendance during the procedure is definitely out of the norm for a pre-procedure nurse in this area, but Elizabeth jumped into volunteering to be with this patient during the case, which the procedural nurses openly welcomed.
The patient successfully was able to make it through the case with only local anesthesia with the pre-procedure nurse's help and she even commented, "I need to apologize to you nurses for what I said". Elizabeth recognized the fear in this patient and went the extra mile to assure her wishes and safe procedure course, representing outstanding patient care and compassion.