1. Beachy, Londa RN

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Taking care of patients on your own for the first time can be daunting. Working as a new nurse in a critical care unit (CCU), caring for patients who are balanced on the bubble between life and death can be downright terrifying. But with each hour that passes, your confidence begins to grow.


Until something goes wrong, of course. Maybe your patient goes into atrial fibrillation with a rapid ventricular response. Maybe a more experienced nurse steps in and points out something obvious that you missed, simply because you are still learning.


Having been a nurse for just 7 months, I face issues like these each time I start my shift. Many of my colleagues have been nurses for 20 or 30 years, and dealing with issues ranging from time management to cardiac arrest is second nature to them.


In the midst of all the knowledge and expertise of my colleagues, I sometimes wonder: What can I do for a patient that will make a difference?


Sound the alarm

These were the thoughts running through my head one chilly October evening as I arrived for my shift. I breathed a sigh of relief after getting my assignments: two patients who were currently stable. One patient, Mr. H, had undergone minimally invasive thoracic surgery for a lung tumor and was expected to be discharged within a few days.


The nurse who gave me shift report warned me that Mr. H was easily irritated and did not follow instructions to ring his call light for help before trying to get out of bed. His bed-exit and chair-exit alarms had been ringing all day.


Mr. H was sitting up in a chair when I went in to meet him. He seemed pleasant. We made small talk while I completed his physical assessment. After making sure his chair-exit alarm was connected, I told him I would be back in a little bit, and to push his call light if he needed anything.


Just as I sat down to document, I heard Mr. H's chair-exit alarm going off. I hurried into his room and found him tottering toward the bathroom. After giving him a gentle reprimand for not using his call light, I helped him to the bathroom and then back to bed.


I asked Mr. H why he did not use the call light to get help. "I don't need any help to walk," he said, "and I didn't want to bother you."


I sat down and he started to talk. A very independent person, Mr. H had worked all his life and was used to not only doing things for himself, but also taking care of others. And now, being in a strange environment and having to depend on other people was making him feel, as he put it, "like a caged animal." I reassured him that everything we were doing was only for his safety. I asked him again to please use his call light when he needed to get up.


Stop and listen

After fluffing Mr. H's pillows and making sure he was comfortable, I turned to walk out of his room. Suddenly, he grabbed my arm.


"You've done more for me than anybody else since I've been here," he said.


I was completely caught off guard. What had I done? I had not given him any medications or changed any dressings or bathed him. I certainly had not performed any lifesaving feats. All I had done was listen to him and fluff his pillows.


And then I realized that taking care of patients does not always mean having the most skill or the most knowledge. Whether you have been a nurse for 20 years or 2 months, sometimes the best thing you can do for your patient is to stop and listen. And don't forget to fluff the pillows.