Joseph Foran
April 2017
Joseph
Foran
,
RN, BSN, BA
MICU
Yale-New Haven Hospital
New Haven
,
CT
United States

 

 

 

The MICU often cares for patients during the end-of-life, and it is the ultimate stress for patients and families. Care of patients during this time is both stressful and challenging to the nurse. Joe exemplifies how to compassionately support patients and families during this process. He has the ability to explain the patient's clinical situation and care options in a way that helps them to understand and compassionately supports them during end-of-life. They are able to make decisions that they can accept and begin to heal after the patient's death.
Recently Joe cared for a patient who had a lengthy hospital stay with many setbacks. Prior to hospitalization, the patient was in a good state of health. He suffered an unexpected major anoxic event and was in a persistent vegetative state without any signs of neurological recovery. The patient eventually received a tracheostomy and feeding tube and was transferred out of the MICU for continued care once he stabilized.
Throughout his initial MICU stay, the patient's family would not accept that he was unlikely to recover, and expected him to fully recover and come home. The family was primarily Spanish speaking, and very intense, making communication with them very challenging, especially when discussing the patient's lack of progress to neurological recovery. They were also very frustrated that the patient made no neurological progress. The patient was later readmitted to the MICU, quickly developed multisystem organ failure and was dying. Joe was able to make a connection with the family to help them understand that their loved one was dying, and was able to lead them through end-of-life decisions in a way that they were able to cope with his death and freed of any guilt from letting him go. He was able to earn their trust in a way that no one else could do throughout the patient's hospitalization. They were now able to accept his condition and make realistic decisions about his care.
Joe made a significant difference in the life of the patient by allowing him to die a peaceful death while helping his family cope with his impending death. He explained the patient's situation in a way that they could clearly comprehend his condition and options for his care. They now realized that he was unlikely to recover and be the person he was before hospitalization. Joe made the family feel that everyone involved in the patient's care had his best interest at heart. This was key in winning their trust. They were able to leave the hospital after his death without feeling any guilt or regret about their decisions, allowing them to begin the healing process.
Joe is very thorough delivering nursing care and is an excellent patient advocate. He is inquisitive, and actively finds answers and solutions to any questions or clinical problems that he encounters. He is a good communicator with patients and families and is able to connect with them and help them understand their disease process and its medical and nursing treatment. He is very patient and kind to patients and families. He will take the extra time and effort to help patients and families deal with difficult decisions in a way that they are able to understand and make informed decisions. He also interacts in a positive way with all members of the interdisciplinary team to achieve the best patient outcomes possible.