By “Compassionate care…isn’t just about taking away another person’s pain or suffering; it’s about entering another person’s experience so as to share their burden in solidarity with them; hence enabling them to retain their independence and dignity (Kret 2011).”
As a nurse, every day I come to work with the hope of providing compassionate care to my patients. Providing support in a time of healing and establishing emotional connections with people are the reasons I entered the healthcare field in the first place. Once I was out of nursing school, I quickly discovered that the fast-paced hospital environment was not always conducive to making these special moments a regular experience. I never expected one of these experiences to be with a patient that had never been in my care nor did I expect his wife to be a big part of such special encounter.
I was lead during a particularly busy evening shift. All of the nurses were maxed at five patients and many were working on their second admission. I was trying to cover the call lights to allow the nurses uninterrupted time with their admissions. I noticed a green flash all the way down the hall. Room 51 needed some assistance.
I entered room 51 to discover a gentleman sitting in his bed, looking rather uncomfortable. His wife sat at the end of his bed, looking equally uncomfortable. I introduced myself and asked the patient, who we will call “John,” what I could do to help. His wife immediately answered. She told me that her husband was there for a heart attack and that he had been through a significant number of cardiac events and procedures in recent years. She told me he was having some back pain and, given his extensive cardiac history, she worried his pain would stress his body and, ultimately, his heart.
I turned to John and asked about his pain level and how he would describe it. He told me it was, “really nothing, just some lower back pain” and that “I really don’t mean to bother you with it.” His wife jumped up, concerned, stating, “John always plays everything down. He never wants to cause anyone any trouble.” She went on to explain that John was one of the older Petaluma farmers who believed in being stoic and not asking for anything. I told them that my one and only job was to make sure he was comfortable. I looked into his medications on the computer in the room. “He has 1mg of morphine available. “John, can I go get that for you?” I said. “Oh, John, I think that would be perfect,” his wife responded. “Sure, I’ll try that,” John replied. “I will grab you a warm blanket to put on your back to ease some of that tension too,” I said before leaving the room.
As I walked down the hall, I kept thinking about how John’s wife was contributing to the tense environment in the room. “Family emotional climate (FEC) and biobehavioral reactivity influence one another and can ameliorate or exacerbate physiological processes, including disease activity and severity (Wood, 1993; Wood et al., 2008).” I knew I had more than one distressed patient in room 51.
I quickly returned with the warm blanket and 1mg of morphine in hand. “Let’s get that pain under control,” I said. I gave him the morphine and repositioned him using the warm blanket on his back. John reported immediate pain relief; however, his facial expression still held the same grimace of discomfort. This time, I followed his gaze and noticed his wife, still appeared visibly distressed as well. Even though I could hear the hustle and bustle of activity outside, I decided to stay in the room to talk with his wife for an extra 5 -10 minutes.
We talked about Petaluma, their house, the farm they raised, their children, and eventually, she began talking about his heart. She explained the journey they had been through and the countless times she had thought she would lose him. She revealed how emotionally exhausted she was and how she wasn’t sure she had the strength to handle the house, the ranch, and all of the medical ups and downs all on her own. Though I gave some suggestions on how to manage some of her fears, I mostly just listened. After she finished, she said, “Oh, thank you so much for allowing me to have that release. I feel relief and, oddly enough, I feel stronger for having let all of that out.”
I told her that she allowed me to do what I love by being able to help both of them. As I walked out, I noticed the atmosphere in the room was entirely different. The anxiety had dissipated. John looked at me and a smile briefly flashed across his face as he gave a small nod to his wife, who was looking down. He winked and said, “Thank you for all your help.” His wife looked up, also thanked me, and insisted I come visit them at their ranch. As I walked back into the busy hallway, I knew that, although the morphine provided John with some pain management, the real relief for him came from the emotional support I had given to his wife of forty-seven years. This is compassionate care.
Hospice care rarely gets the attention it deserves among medical professionals. Many seniors and chronically ill patients do not get the care they need from a loved one or the local community. Millions of aging baby boomers will need high-quality hospice care in the years to come. Like the gentlemen mentioned above, some of these patients don’t like to be cared for. They are used to taking care of themselves. That’s why providers should adjust their communication skills to make sure they are getting through to the patient. Compassionate care is about coming together and forming emotional bonds that last a lifetime.
The Compassionate Care Act, recently introduced in the Senate, would change federal laws to create a national framework for providing long-term hospice care to the country’s elderly population. It’s time for every provider to practice compassionate care.
Author: Brittany Aanestad, RN BSN. I work on a med/surg, telemetry and pediatrics unit at Petaluma Valley Hospital in California. I have worked at PVH since graduating from nursing school in 2010 from CSU Chico. I live in Petaluma with my husband, one-year-old daughter, and two dogs: a 9-year-old Great Dane and a 14-year-old Golden Retriever. Although this story was not an experience from nursing school, I feel many nurses can relate to these moments in everyday healthcare that imprint our hearts and influence our nursing styles.
