Annemarie Nobile
November 2019
Annemarie
Nobile
,
RN
Medical Surgical Unit
The Ohio State University Wexner Medical Center, University Hospital
Columbus
,
OH
United States

 

 

 

Annemarie identified that there was an education need on our unit regarding the dying process. She organized and presented on this topic in July at the 9 East Rhodes quarterly peer to peer.
I have had the pleasure of working alongside Annemarie for several years now. She has worn many hats on our unit including floor nurse, charge nurse, ULC member, and magnet representative. She provides excellent care to her patients and is a wonderful resource on our unit especially to our newer nurses. 9 East Rhodes is a medical surgical unit, specializing in hepatology, pre-liver transplant. Many are very sick as they wait for the news that they will be able to receive a transplant, or that they are not a candidate. This brings me to the story of a lady whom I will call S.
S was diagnosed with non-alcohol related fatty liver cirrhosis several years ago. She had been on our unit for several weeks. Her hospital course was complicated by confusion, weakness which impaired her mobility, fluid overload, and failing kidneys. Her husband of 50 years never left her side. He fed her, helped turn her, held her hand and watched over her care. He was an assertive individual and a wonderful advocate for his wife. He appreciated honesty. S had gotten to the point that the cardiology team did not think she was a good candidate for a liver transplant. She was getting weaker and the husband was getting more frustrated as each day passed. Annemarie was S's nurse on one of these days. She sensed their frustration and, as an experienced hepatology nurse, she recognized that this patient was declining rapidly. If the transplant was not in her future, some big decisions needed to be made by S's husband.
Annemarie quickly reached out to the hepatology team and expressed her concerns about this situation. Annemarie sat down with the S's husband and daughter and tearfully gave her opinion about S's condition. She explained that in her experience, S was rapidly declining and entering the dying process. The family was tearful but so appreciative of Annemarie's honesty and empathy in such a difficult situation. Annemarie acted as an advocate for not only her patient this day but also for the family. She gave this family the gift of more time. I believe that if Annemarie had not spoken up, S would have coded and died in the hospital. Because she had a kind, empathetic nurse, S was sent home hospice and passed away at home with her family at her side.
Most staff would have probably left that day, went home and put this situation on the back burner. Not Annemarie. Annemarie identified that there was an education need on our unit regarding the dying process. She organized and presented on this topic in July at the 9 East Rhodes quarterly peer to peer. She arranged for a palliative physician to educate our staff regarding the dying process and palliative medicine. She also arranged for an OSUWMC chaplain to present on the spiritual aspect of dying, and a representative from LOOP (Lifeline of Ohio Organ Procurement) to discuss the organ donation process. Annemarie also presented on resilience and the importance of self-care for the staff. She knew, from this personal experience with her patient, how difficult this job can be at times.
The staff that attended this Peer to Peer session gave wonderful feedback about how informative it was. Many admitted that they shy away from having difficult conversations about death with patients and families. The general opinion was one of the feeling of "giving up on the patient." Where in actuality, it becomes a gift to the family. The gift of more time with their loved ones. Annemarie led the way in this change of thinking. It has empowered our staff to have those difficult conversations and to be honest about outcomes. She truly is an Extraordinary Nurse and makes a huge difference in the lives of her patients and also the 9 East Rhodes staff.