By Myra King, DNP, APRN, ACNS-BC, CCRN-CSC
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I have been a nurse for 20 years, but last year the tables were turned when I found myself on the other side of the bed as a patient. That experience reminded me of the privilege – and responsibility – of being a caregiver. It also drove home a few key points that I have recommitted to as a nurse and encourage others to revisit as well.
Aug. 3, 2018, started off like any other day. I finished a great workout at the gym, then about 15 minutes later I developed abdominal pain. It got progressively worse throughout the day and was accompanied by projectile vomiting, so I ended up going to the emergency department. The healthcare team ordered lab work and a kidney, ureter and bladder X-ray. They diagnosed me with gastritis and discharged me home with medication.
As I was being rolled out of the ED, I got an overwhelming feeling that something wasn’t right. I really didn’t want to leave. So I asked the physician to consider keeping me for observation. At my insistence, she agreed. While under observation, I was still in a lot of pain that was not consistent with gastritis, so the physician ordered a CAT scan. It revealed that I had a complete bowel obstruction due to a uterine fibroid, and I was taken to the OR emergently.
Thankfully, the surgeon was able to perform the surgery laparoscopically. All of my bowel was still viable, and I did not require an ostomy. I stayed in the hospital for five days before discharge. My experience as nurse-turned-patient provided some powerful reminders of things we can often lose sight of as clinicians.
- Listen to your patients and their families. Patients know their bodies and should be partners in their care. I am grateful that the ED physician heard my pleas to remain for observation. If I had gone home and come back later, my story may have ended very differently. The healthcare providers saved my life – or at the very least, improved the quality of life I now have. If I had gone home, I could have suffered from an ischemic or perforated bowel.
- Manage patients’ pain swiftly. I was in excruciating pain when I came to the ED. My suffering was a potent reminder of how important it is that we take patients seriously when they are having pain and try to alleviate that pain quickly. As we strive to mitigate the misuse or abuse of pain medications, we must ensure that pain management plans are individualized, timely and clinically appropriate.
- Regularly assess the need for invasive equipment. I had a nasogastric (NG) tube, a Foley catheter and IVs. I felt very vulnerable, insecure and weak having this foreign equipment in me. In fact, when the NG tube was first placed, I instinctively pulled it out – the very thing we tell our patients not to do! The nurses had to give me Ativan to calm me down. I’ve probably put in hundreds of oral or NG tubes over the years, and I never realized how uncomfortable they actually are. I now have a renewed sense of empathy for patients who require invasive equipment. It is uncomfortable, and we need to do our due diligence to assess whether or not the equipment is needed and remove it as soon as clinically possible.
- Include patients and their families in bedside reports. Throughout my stay, I appreciated being part of bedside reports and rounds. It made me feel as though I had valuable information to contribute to the conversation. Including patients and their families during rounds and handoff communication makes the patient feel respected and valued. I know it’s not always easy because it may require more time, but it really is the right thing to do.
- Make patient education a priority. Because I was a nurse, my caregivers may have assumed I knew a lot of things. But when you’re the patient, you’re not always thinking as you would from a nursing standpoint. For example, I wish someone had stressed the importance of using the incentive spirometer to me. I’ve taught it to patients numerous times over the years, so of course I know it’s important to do. But in my mind, I thought I was young and healthy and didn’t need to be as consistent with completing this task. After all, I was ambulating quite frequently. Unfortunately, about two days after being discharged, I had to go back to the emergency room. I had atelectasis, which caused me to be extremely short of breathe. It was frightening as I literally could not take a deep breath. Thankfully the atelectasis resolved with time – and with use of the incentive spirometer – but I will never forget that experience. During my hospitalization, it was really helpful to me when the nurses explained things to me in simple terms – not in a demeaning way, but to reinforce what was important.
- Be accepting of family visitation. The fact that my family and fiancé were able to be with me 24 hours a day was so important. At the end of the day, having my fiancé there and sleeping by the bedside was my true source of comfort. Allowing families to be at the bedside can really improve the patient experience and provide a much needed sense of security.
- Pay attention to the details of nursing. I watched everybody that came in my room to see if they were performing hand hygiene. (They were!) I also appreciated the practice of patient identification. All my caregivers did an excellent job identifying me before they administered every medication, which made me feel safe. Hand hygiene, patient identification, scrubbing the hubs of IVs, clean dressing sites, bar code scanning – all of the “details” of nursing matter! Although they may sometimes seem small, these things matter greatly and can have a tremendous impact on patient outcomes.
- Put patient empathy at the forefront of all you do. Being a patient reminded me of the imperative of always showing empathy and compassion toward our patients and families. When we take a moment each day to see things from their perspectives, to imaginatively walk in their shoes, we glean insights that can enhance and improve the care we provide. I think this makes us better clinicians and human beings. I have resolved to put empathy at the forefront of all that I do for my patients, families and co-workers.
Looking back, I realize that life can change in a minute. I try to savor every moment and have a spirit of excellence in all that I do. Despite all I went through, six weeks after my surgery I had the pleasure of walking down the aisle to get married (without an ostomy). I was alive, healthy and thankful. I enjoyed a wonderful wedding, reception and honeymoon cruise!
My experience as a patient caused me to reflect on why I entered the profession of nursing. I became a nurse to promote wellness and to relieve suffering. I felt a calling to do so. As I suffered with a bowel obstruction, I was reminded that it’s a very powerful position to be in when you can relieve the suffering of another human being. With that comes a lot of responsibility. It’s something we can’t take lightly. We should be honored to have this ability and continue to hold it in high regard. I am profoundly grateful for the excellent care I received and for the potent reminders I received being a patient. They will forever inform my nursing practice.
Myra King is a Clinical Nurse Specialist in Critical Care at Cleveland Clinic main campus.