Nurse sees value of human touch when she becomes patient
By Nancy Groat, R.N., B.S.N. (Feburary 2001- The Final Word (A monthly column on issues facing nurses)
Nancy Groat 2/23/1947 - 6/2005 She will be greatly missed.
By Nancy Groat, R.N., B.S.N. (Feburary 2001- The Final Word (A monthly column on issues facing nurses)
Nancy Groat 2/23/1947 - 6/2005 She will be greatly missed.
I was the problem patient no nurse wanted to be assigned to.
"I didn't check on her during the night, because I figured if she was unhappy she'd call the teaching nurse." These are
the words I overheard during walking rounds the next morning. Hearing this really scared me.
Let me describe how this came about.
I have a rare disorder, intestinal lymphangectasia, which makes it difficult for the intestines to absorb fat and protein.
Because I was Born with the disorder, I have been hospitalized many times for diagnosis, obstructions and infections.
I was able to maintain my life by eating large quantities of low-fat food until I turned 40. At this time, my system no longer
absorbed enough nutrients to sustain me. I was scheduled to have a Hickman Central Line implanted to begin home
TPN (total parenteral nutrition) and thus, the occasion for this admission.
The admission began on a very promising note. The nurse who admitted me used a good technique in interviewing me,
and said that because her mother has a chronic illness, she could empathize with my situation. So far, so good I
thought. I had been admitted the day prior to surgery for hydration and evaluation.
The very fact that I was admitted a day early (usually line placement is an outpatient surgery) was the first incident that
brought attention to me. The nurse who would be teaching me home TPN procedures gave me her card and said to call
her if I had any questions.
Finally, the day came for my Hickman Line placement. I had anticipated this day for years, a new lease on life. I didn't
sign the operating permit prior to surgery because I didn't know where the line would be placed, nor did I know what kind
of anesthesia I would receive.
These were things the surgeon wanted to decide when I was in the operating room. This is the second incident that
drew attention to me. Following a five hour delay, my Hickman Line was implanted.
All went well until 8:30 p.m., when my fever spiked to 102.3 degrees f. The policy for an infection work-up is 102.5
degrees f. This is the third time attention had been drawn to me, and I became a problem patient.
I knew my body well and knew that a fever more than 100 degrees was trouble for me. I asked my nurse about doing an
infection work-up. She explained the policy, and I countered with knowledge of my body. Because of my nursing
background, I understood many of the reasons that no action was taken, so I called the teaching nurse with my concern.
If it was an expected outcome of the surgery, I would be satisfied.
She then called the unit. I got an infection work-up and was started on antibiotics. My fever went down 36 hours later. I
wish I could say that was the end of my story.
I expected some resistance and probably displeasure from my nurse. I had questioned her decision not to take action.
What I had not expected was the total animosity I experienced from the entire staff, up to the supervisor.
It seemed nobody wanted to care for me, nor did anyone stop to ask me what was wrong. If only a nurse had sat down
to ask how I was doing, of had been able to help me identify the intense fear I felt about being able to do home TPN, I
don't think the episode would remain with me so vividly.
When I over heard the night nurse's report, I withdrew into my protective shell. I had several crying spells (in private)
and my surgeon ordered a tranquilizer. To make this admission complete, the nurse, who admitted me and had made
such a good initial impression, discharged me, saying "Well, you are finally going home."
Today, almost eight years later, I am doing well on home TPN. I retired from nursing, but have found other outlets for
my nursing skills. I am a regional coordinator for the Oley Foundation, a national support group for people on TPN and
tube feedings.
I have learned that the medical system, while providing wonderful, life-giving technology still needs the human tough that
nurses are in a unique position to provide.
Nancy Groat, R.N., B.S.N., lives in Grand Haven. She is a graduate og the Blodgett Hospital School of Nursing and
received her bachelor's degree from Michigan State University. She has worked as an oncology nurse in hospitals in
Massachusetts and Michigan. She also worked in staff developement, infection control and quality assurance.
"I didn't check on her during the night, because I figured if she was unhappy she'd call the teaching nurse." These are
the words I overheard during walking rounds the next morning. Hearing this really scared me.
Let me describe how this came about.
I have a rare disorder, intestinal lymphangectasia, which makes it difficult for the intestines to absorb fat and protein.
Because I was Born with the disorder, I have been hospitalized many times for diagnosis, obstructions and infections.
I was able to maintain my life by eating large quantities of low-fat food until I turned 40. At this time, my system no longer
absorbed enough nutrients to sustain me. I was scheduled to have a Hickman Central Line implanted to begin home
TPN (total parenteral nutrition) and thus, the occasion for this admission.
The admission began on a very promising note. The nurse who admitted me used a good technique in interviewing me,
and said that because her mother has a chronic illness, she could empathize with my situation. So far, so good I
thought. I had been admitted the day prior to surgery for hydration and evaluation.
The very fact that I was admitted a day early (usually line placement is an outpatient surgery) was the first incident that
brought attention to me. The nurse who would be teaching me home TPN procedures gave me her card and said to call
her if I had any questions.
Finally, the day came for my Hickman Line placement. I had anticipated this day for years, a new lease on life. I didn't
sign the operating permit prior to surgery because I didn't know where the line would be placed, nor did I know what kind
of anesthesia I would receive.
These were things the surgeon wanted to decide when I was in the operating room. This is the second incident that
drew attention to me. Following a five hour delay, my Hickman Line was implanted.
All went well until 8:30 p.m., when my fever spiked to 102.3 degrees f. The policy for an infection work-up is 102.5
degrees f. This is the third time attention had been drawn to me, and I became a problem patient.
I knew my body well and knew that a fever more than 100 degrees was trouble for me. I asked my nurse about doing an
infection work-up. She explained the policy, and I countered with knowledge of my body. Because of my nursing
background, I understood many of the reasons that no action was taken, so I called the teaching nurse with my concern.
If it was an expected outcome of the surgery, I would be satisfied.
She then called the unit. I got an infection work-up and was started on antibiotics. My fever went down 36 hours later. I
wish I could say that was the end of my story.
I expected some resistance and probably displeasure from my nurse. I had questioned her decision not to take action.
What I had not expected was the total animosity I experienced from the entire staff, up to the supervisor.
It seemed nobody wanted to care for me, nor did anyone stop to ask me what was wrong. If only a nurse had sat down
to ask how I was doing, of had been able to help me identify the intense fear I felt about being able to do home TPN, I
don't think the episode would remain with me so vividly.
When I over heard the night nurse's report, I withdrew into my protective shell. I had several crying spells (in private)
and my surgeon ordered a tranquilizer. To make this admission complete, the nurse, who admitted me and had made
such a good initial impression, discharged me, saying "Well, you are finally going home."
Today, almost eight years later, I am doing well on home TPN. I retired from nursing, but have found other outlets for
my nursing skills. I am a regional coordinator for the Oley Foundation, a national support group for people on TPN and
tube feedings.
I have learned that the medical system, while providing wonderful, life-giving technology still needs the human tough that
nurses are in a unique position to provide.
Nancy Groat, R.N., B.S.N., lives in Grand Haven. She is a graduate og the Blodgett Hospital School of Nursing and
received her bachelor's degree from Michigan State University. She has worked as an oncology nurse in hospitals in
Massachusetts and Michigan. She also worked in staff developement, infection control and quality assurance.
Little Leakers
Nancy
