Susan is an extremely experienced nurse, who has worked in Endoscopy for 14 years and also has many previous years' experience. Susan is highly respected nurse by her peers, coworkers, and many staff that she has encountered through her years of service at Centra.
Recently, when Susan was in charge, she was in her routine role, of assessing and planning for the next day's schedule at VBH. While she was doing this, it was already known that on our schedule was an outpatient who was coming in for a procedure. The patient was a 22yo autistic young woman, who was going to require some extra needs, due to her behavioral disability, and the need for a urine straight cath, requested by urology while the patient would be under anesthesia. In her planning, Susan made her routine phone call and spoke with the patient's mother to assess any needs and offer any support and reminders that are involved with them coming in for the procedure. During this conversation, the patient's mother developed a bond with Susan. The level of the mother's concern and anxiety about her daughter coming in as an outpatient was identified by Susan. This level of uneasiness was brought down considerably by Susan's knowledge, and the manner in which Susan communicated to the mother, by Susan identifying the knowledge deficit. Susan offered the mother compassion and reassurance in regard to her daughter coming in for the procedures that her daughter had never had before. She reassured her that we were able to conform to her daughter's potential behavioral issues, by allowing her daughter to leave her normal clothes on. Also, obtaining the urine straight cath while under anesthesia was a big concern for the mother, so that it can be completed.
The next day was also the same day as the procedure. I was in charge that day, and Susan was working as staff. Susan immediately communicated to me, that after the conversation she had with the patient's mother yesterday, the mother felt much at ease, and asked if Susan was going to be there the day of the procedure. Susan reassured the mother that she would and requested that she be the circulator with the young woman that day since the mother felt a bond. Not only that, but Susan was also prepared, in that she reviewed and printed the protocol for a straight cath since it is not a skill that we practice regularly. The patient was brought to Surgery Center, which is normal, to get them ready for Endoscopy. Normally, the patient removes any clothing or belongings, puts on a patient gown, receives the patient band, and other bracelets applicable, has an IV started and reviews medical information with staff. Our autistic patient was exhibiting anxious, upset behavior, even with the comfort of her mother. The behavior was to the point that the Surgery Center Staff could not even place the identification band on the patient. The anesthesiologist that would be working with us that day, recommended that the mother give her daughter her prescribed Ativan, and we would wait to see if it would take any effect.
After more than an hour, the mother was able to place the band on her daughter, but the daughter's behavior continued to be an obstacle to proceeding to get her procedures done. The next plan from the anesthesiologist was to bring the patient over and attempt to give an IM injection to calm her down, to make it possible to start an IV and proceed. We had transport walk the patient and her mother to the Endoscopy procedure room since the patient would not even sit on the stretcher. Susan was in the room waiting for them. The patient continued with anxious behavior, crying, yelling, and at times hitting her mother. Susan was very patient, empathic, and calm. She allowed the mother to comfort her daughter and patiently offered support to both of them. Susan didn't rush the patient, with her behavior the way it was, but instead let the patient ease into becoming somewhat comfortable with her environment.
Eventually, the patient sat on the stretcher with her Mom. With much reassurance and compassion from Susan, the patient allowed Susan to start her IV in her hand, and from then on, all of the rest of the procedures went smoothly, and the patient was safely cared for. She competently obtained the straight cath to report to the urology service for a post-void residual. Also, the patient did not have to receive the IM injection of ketamine, which would have prolonged her recovery time.
I am want to recognize Susan for her expertise, critical thinking skills, compassion, empathy, and patience, offered to both patient and family. Susan is a wonderful example of the excellent care administered in our department. This is one example, but Susan exemplifies this behavior continuously for all patients and family members.