October 2017 marked the one-year anniversary of a new life I didn’t choose. My beloved husband, Bob, died in the fall of 2016 after taking a hard fall off his bicycle and spending 10 days in the ICU. I made the painful decision to follow his wishes and remove him from life support.
Before his accident, Bob and I hiked, biked, danced and relished days spent with our two young grandchildren. I loved my work, which involved speaking about and promoting prevention and wellness. I always emphasized that following the vision of building a Culture of Health in the U.S. — to make it possible for everyone to have the opportunity to live their healthiest lives — nurses needed to teach others to eat well, exercise regularly and address the systemic inequities that prevent people from living healthy lives.
But after the accident, life changed for me. I could not erase the image of Bob surrounded by tubes and machines and the feeling of being so out of control.
It was impossible for me to speak authentically about building a Culture of Health when it seemed to exclude critically ill and terminal patients, and the nurses who cared for them and their families.
In my vision of a Culture of Health, people lived life to the fullest without experiencing too much pain and suffering. A Culture of Health was impossible for Bob and patients like him.
I vividly remember the kindness of a few nurses who hugged me, asked about our lives and looked at the family photos on Bob’s bedside table. They took time to know who we were when our lives were whole.
But too often the ICU seemed chaotic, and practitioners were too busy and preoccupied with the tasks at hand to provide the human touch I desperately needed. I am convinced that my husband received good clinical care, but I also needed practitioners to explain what was happening to Bob. I wanted them to look at me and address me when they came into the room to see him, and I wanted to feel consoled. I wanted them to look at Bob and understand that just hours and days ago he was full of life and caring for his family. Instead, at times I felt abandoned and on the defense.
As nurses, we need to do everything possible to foster well-being for patients and their families. We need to know what matters to patients and their families. We should invite families to join in rounds, so they can be involved in decision-making, ask questions and share information.
By engaging family members as partners in care, we can improve communication, decrease family stress and improve patient outcomes.
Above all, we need to create a culture of compassion, so health professionals can offer comfort. Health facilities should have adequate staffing levels and support nurses as they carry out their work. Nurses cannot give what they do not have. Most men and women become nurses because they want to help others who are sick, scared and hurting and their workplace should make it easier for them to offer compassion.
I don’t want to change the pursuit of hospitals to improve safety and quality through evidence-based care, nor the efficiency needed to drive toward this goal. But Florence Nightingale observed “apprehension, uncertainty, waiting, expectation [and] fear of surprise do more harm than any exertion.”
As a scientist and a nurse, she understood that although knowledge, skills and evidence were critical, no true healing occurs without empathy and compassion.
I know this to be true after witnessing Bob’s care. As I’ve grieved, I’ve sought reasons for why I lost my husband suddenly and tragically. I still don’t have answers, but drawing attention to how the care experience can be improved for patients and their families has given my life new purpose. I’ve realized, too, that a true Culture of Health prizes well-being and putting patients and their families at the center of their care experience.
Now when I speak about building a Culture of Health, I discuss how health professionals can engage patients and families as partners on the care team. It’s what patients and their families’ desire and it’s what nurses were born to do.
Courses related to ‘ICU nursing’
CE625: Evidence-Based Practice for ICU Sedation, Central Line Infections and Early Feeding
(1 contact hr)
Advances in technology give us easy access to a wealth of information to support evidence-based practice. By accessing these resources, nurses can provide patients with the best evidence-based interventions and treatments. This continuing education module reviews the evidence behind three practices: breathing trials for patients on mechanical ventilation, preventing CLABSIs and early feeding of critically ill patients.
CE476: KA Lurking Danger
(1 contact hr)
Central line-associated bloodstream infections affect an estimated 80,000 patients in ICUs each year and are associated with about 250,000 patients with bloodstream infections, including non-ICU cases each year. CLABSIs can cause serious infections and lengthen hospital stay, inflate medical cost, and increase the risk of mortality. Nurses play a significant role in reducing these troubling numbers. The nurse’s understanding of CLABSI and evidence-based bundle practice can improve patient outcomes significantly.
CE390-60: Life-Threatening Fungal Infections on the Rise
(1 contact hr)
The incidence of life-threatening invasive fungal infections such as Candida and Aspergillus has doubled during the past several decades because, in part, of an increasing population of immunosuppressed and critically ill patients. Cancer patients with chemotherapy-induced neutropenia (an abnormally low number of neutrophils); transplant recipients receiving immunosuppressive therapy, such as corticosteroids or cyclosporine; patients with HIV; and patients in ICUs are at an increased risk of acquiring fungal infections. The risk of infection has increased for critically ill patients with normal immune systems as well. Nurses and other healthcare professionals need to educate these vulnerable patients about the importance of infection-control protocols to reduce their risk of developing invasive fungal infections. Such patient education can save lives.