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Brynne Kessler, RN, BSN, CMSRN

T4-ENT, UC Davis Medical Center

Sacramento, California

"S" came to Tower 4 after an anoxic brain injury for a respiratory arrest. She was a beautiful 19 year old who had so much going for her until one day at church when an asthma attack changed her life. Now her lifeless body lay on a Kin Air bed, dependant on her nurses and family to make every move for her. She couldn't move her body on her own - in fact the only movement she made was the involuntary movements triggered by pain or some other sympathetic response. She no longer breathed through her nose, a tracheotomy was placed to aid with her breathing. She was no longer able to eat, a tube was placed in her abdomen to feed her.

Brynne was one of the Primary Nurses who took care of "S", a "total care" patient that everything had to be done for. To make the patient's care less overwhelming, Brynne created a list to aid in her care:

"Please turn me every 2-3 hours. I really like to lie way over on both sides and straight on my back too. I have episodes of severe agitation where I cry, sweat, stiffen my muscles, write about and my heart rate goes up. Pain medication really helps me. Please do lots of mouth care. I sleep with my mouth open. I don't like it and I might bite the swab, but it's good for me. I have a really big family. They are learning to care for me one at a time. Please be patient."

With this list, "S"s care wasn't as overwhelming as it once was. The nurses knew exactly what to do and when to do it. Teaching the family had gotten easier as well. With the family being an active participant in her care, and when she was stable she was able to be moved to a sub-acute facility. Her family thanked the nursing staff for all of their help. Their involvement in "S"'s care allowed them to accept her disposition. If it weren't for Brynne's hard work coordinating her plan of care, "S"'s discharge wouldn't have been as smooth as it was.







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