Recently, we have had a patient within AICU who had a very long stay. For the majority of their stay, the patient was awake and on a ventilator. They had a tracheostomy, and as a result, were not able to speak. They were only able to mouth words. Being able to lip-read these patients is both a skill and an art; it takes patience and persistence to understand the patient and for them not to get frustrated. This patient, due to their illness, could also not move at all. It was therefore vital that anyone who cared for the patient took the time to work with them to understand and meet their needs as well as act as their advocate.

Felicity cared for the patient on numerous occasions. She built up a relationship with them by consistently meeting their needs and wishes. She always went the extra mile by massaging them, washing them with toiletries that she supplied herself to replace hospital ones, and thinking outside of the box to see if there was anything additional that we could do for this patient.

As the patient’s condition developed, it became clear that they would not survive this illness. Felicity supported the patient and their family through multiple medical conversations, which included talking through the withdrawal of ventilation and the most appropriate timings for this. During a particularly difficult conversation around this, Felicity acted as the patient’s advocate and also bridged the gap between medical decision making and the patient wishes.
Felicity then worked with the patient to establish what their wants and wishes were for the last days of his life on AICU. She advocated for them to try to ensure these were completed. All of this can only have been possible with her excellent communication skills, advocacy, empathy, caring attitude, and patience.

It was planned that this patient’s treatment would be withdrawn after the weekend. Over the weekend, Felicity worked a night shift and was caring for the patient. She recognised that they were not their normal self and started a conversation about this. They trusted her enough to start a conversation about being ready to have treatment withdrawn sooner; they were ready. Rather than avoid a difficult conversation, by encouraging them to sleep on it, Felicity explored this with them and escalated their wishes to a Consultant. Felicity established that the patient had been worried about their family getting to the hospital to be with them. Felicity arranged a taxi to collect their family (and return in the morning). She supported conversations with the patient and their family. She spent time with the patient listening to their favorite radio station, massaging their feet and legs, whilst waiting for the family to arrive. During this time, the patient relaxed enough that they were able to have a laugh and joke at times. Felicity bought, from her own money, a cold Costa to allow them to have their final drink – in fact, this was the only drink they had been able to have in their whole Critical care stay (over 2 months). Felicity cared for the patient as their treatment was withdrawn; they died peacefully, at a time of their choosing, with their family alongside. We state that we only have one chance to get the end of life right. Felicity worked to make this patient’s death phenomenally right.

The difference that Felicity made to this patient’s mental well-being throughout their critical care stay cannot be underestimated, nor truly conveyed through words. Felicity went above and beyond in caring for the patient. She is an exemplary nurse who is only at the start of her Critical Care career.