1. Swanson, Jay R. BSN, RN, OCN


Patients aren't the only ones who need reassurance.


Article Content

I wasn't sure why Mary Sue was in long-term care, but I could tell she had dementia. She spent most of her time in a recliner near the nurse's station, asking anyone who walked by why she couldn't go back to bed.


"It isn't time yet, Mary Sue," the staff would reply. I asked one of the nurses why they didn't just take her back to bed. "When we do," she told me, "she asks to return to the chair. Out here we can keep an eye on her. She can look out the window. She smiles more often."


But I had yet to see a smile. This was my first rotation as a nursing student, and I tried to use techniques I'd read about to distract Mary Sue: towel folding, cards, books. But she remained on target, reaching out to me and repeating her request with a distraught look on her face.


When I arrived at work on the Tuesday before Thanksgiving, I braced myself for Mary Sue. This time, however, she had a huge smile on her face. I smiled in response and asked her what was making her so happy. She said that her family was coming to see her that evening. They were going to eat a big meal and sing songs. She was particularly excited about the singing.


Mary Sue was so excited that I found myself eager to meet her family. But they weren't due until 5 pm, and it was only 7 am. On every trip past Mary Sue's recliner, I had to tell her that yes, they were coming. It was hard to see the anxiety on her face when she thought her family had forgotten her, and I knew there had to be a better way to reassure her. I'd noticed that one of the occupational therapists used index cards to help patients remember important things, so I found one and wrote in big black letters: "Mary Sue, everything is OK. You have nothing to worry about. Your family is coming."


The next time she grew anxious about her family, I gently said, "Read your card, Mary Sue." She looked down, inspected the words closely, and her smile reappeared. Then she looked up at me, nodded, and leaned back in the reclining chair. This happened several times; I could tell it was working because she seemed less inclined to grab my scrub top as I walked by. The other staff noticed and began reminding her to read her card when- ever she asked about her family. After a while she began to read the card on her own, and each time she'd smile.


I never did meet Mary Sue's family or witness their Thanksgiving celebration. I was assigned to a different area for my last clinical rotation and didn't see her again. I like to imagine a room full of residents singing along with the family around an iconic Norman Rockwell table full of food.


In the five years since then, I've written reminders on cards for other patients-although it has never worked quite as well as it did with Mary Sue. And I've also used cards to remind myself to stay strong and focus on what really matters. Sometimes they're real cards with prayers or other daily affirmations that I can keep on my portfolio or put on my bulletin board. Sometimes they're the memory of advice from my parents or encouragement of a colleague. We can all think of a phrase or saying that we've displayed somewhere to tell us to slow down and remember the important things. And just as I reminded Mary Sue to reread her card, I realize that I may need to "read my card" more often.


The words written on my card change depending on what's happening in my job and in my life. Like Mary Sue, we all need reassurance, moment to moment and day to day. What will you write on your card?