By Margaret A. Persaud, MSN, RN
During a brief return to bedside nursing in summer 2014 after two years away from direct patient care, I had the opportunity to care for an obstetrical/postpartum patient in need of help. This experience reminds me that, as healthcare professionals, I not only need my knowledge and experience at the bedside, but also the strength of and spiritual connection with God.
I was a maternal/child and gynecological nurse for more than 10 years and a med/surg nurse for a few years. But all of my experience in OB/maternal/child nursing did not prepare me to deliver the best care possible in this particular case. My patient was a one-day, post-vaginal delivery, first pregnancy and birth, who suffered more than a fourth-degree laceration. Her perineum was severely edematous, red, dark blue in color.
In nursing, we are sometimes faced with the unexpected and variances that deviate from our plans of care. What do we do? What helps us to creatively think and deliver the safe and effective care we are expected to give?
We depend on our knowledge and experience, each other and the critical thinking we learn in nursing school and over the years through our daily observations, tasks and interventions. Personally, I also need that spiritual component that supports me with what I do for patients and everyone around me.
On this day, I did all I could to make this patient comfortable. But she was in a lot of pain and discomfort related to her full bladder and perineal status. “Think quickly, nurse!” I thought to myself.
I knew she would be unable to void because of all the swelling and trauma of the delivery that affected her bladder tone. I had to relieve some of the pain. I needed to insert an indwelling foley catheter to straight drainage. Utilizing my nursing process, I was prepared to do this.
I gathered all supplies and the patient and family members were informed of my actions, and so was the physician. With the help of the charge nurse, I was able to insert that foley on one try.
Truthfully, I went in with uncertainty because the urinary meatus was deviated, and I was not sure of the location. The extreme swelling, as well as the fluid and blood accumulation at the perineum area, obscured everything, despite the spreading of the labia.
Initially, as I was inserting the catheter, I paused for a few seconds to pray and experience that feeling of faith that all will be well. I felt that sense of peace and gratitude knowing God is working through me to take care of the most vulnerable population — the sick, the elderly, the children.
Our goal is to deliver safe and effective nursing care, and in the end we get a sense of joy and peace that we have done our best, and our patients feel less pain or discomfort. They feel safe and secure that they are being taken care of, and their needs have been met.
After the patient was discharged the next day, the physician asked me, “Margaret, how did you insert that foley?” I said, “Not only with my experience, but I did it with God’s grace.”
Margaret A. Persaud, MSN, RN, is retention coordinator at Washington Adventist University, in Takoma Park, Md.
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