Julia Kokes
March 2013
Julia
Kokes
,
BSN, RN-BC
Cardiovascular Unit
Penrose St Francis Health Services
Colorado Springs
,
CO
United States

 

 

 

Julia demonstrated compassionate care, clinical skill, exemplary service and a commitment to excellence. I would like to share a story about what this nurse did and why this nurse is so special.

As of Tuesday, April 9, 2013, a patient had spent 29 days on the unit. Nursing staff was very compassionate towards her and her sister who had been with the patient almost every day. A few days previous, the doctors told the patient and sister that nothing else could be done and they recommended hospice. Hospice agreed and offered a room but the patient refused to move. Her illness had taken her quality of life, her hope and all control. The patient was known for mood swings and on this day she was sullen and adamant that she did not want to go. Unfortunately her options were limited. She could either go to hospice or go home without care. She was discharged but refused to leave her room. Her sister was so filled with stress and fatigue after this month long ordeal that she said "I am on my last legs."

Julie came into the patient's room and tried to reason with her and encourage her that it was in her best interest to go to hospice. Still the patient refused. Julie comforted the sister and said "I'll call administration to see if there are any other options." Julia returned knowing the patient must leave that evening. It was one hour before shift change and Julia could have left this work and decision to the night crew. However, after a very long day, Julia made a decision. Julia went into the patient's room and said "we want to do what is best for you. We need to make a plan for you to go to the sixth floor. When would you like to do that?" Julia was very empathetic to the patient offering her dignity and respect and compassion to have influence over this decision. "Even when you are there, you can still decide what you want to do next." The patient became belligerent and said "Go away. I hate you." Absorbing her anger and frustration, Julie said "It's ok to hate me, but I need to find you a place to sleep tonight. It's only a change of rooms."

The sister was exasperated. Julia made the bold, compassionate and difficult decision to transfer the patient to a transport bed and move her to hospice. The sister said "I can't watch this" and went down the hall with a friend. Julia, along with Melanie gently and carefully wheeled the patient to the elevator and to hospice. The patient was calm and quiet the entire time. Having made the transfer, the sister said "That was a miracle. I am so relieved."

Julia's loving compassion for the patient and her sister combined with a bold decisiveness defused a very tense situation that had been building for days. Everyone breathed a sigh of relief. I believe she made a very difficult choice under stressful conditions and did the right thing and did it well. She should be commended and recognized for her excellent care.