On or about week of August 24, we had a highly complex inpatient on our medical surgical unit; she had been debilitated since May, 2015 related to placement of a poorly functioning ileostomy. The patient lives locally but had surgery performed in Las Cruces. She experienced multiple readmissions due to emergent leakages and painful excoriation around the stoma site. On this particular admission, patient experienced copious amounts of caustic drainage that caused the device to pull loose easily and at times, related to frustration, the patient would simply remove the bag device and this created a pool of caustic drainage onto her skin, her clothing the bed linens etc.
The son became quite concerned about his mother and became frustrated at his perceived lack of knowledge and ability of the nursing staff to meet his mother's needs. There were two different shifts that nursing was challenged under very stressful conditions that culminated in the son making remarks about abuse and neglect.
I approached Kelli Dion, administrative nurse leader, on the building tension of the situation and especially the possibility that the hospital might be at risk for the abuse and neglect allegations. After several minutes of reviewing the circumstances as we knew them, she prepared to visit the patient and family member for an investigation into the matter.
After a short length of time, I decided to round on this patient room and check to see how things were going and planned to meet the son and provide as much support for the family as I could. What I discovered when I went to the unit was a heartwarming and touching lesson into the compassionate caring that nursing is all about.
I found that Kelli had not only investigated the dissatisfaction events that impacted the patient's and her son's perception of the care being provided, but totally shifted the focus from a potential risk for our hospital to a patient centered focus on providing the best care of the patient within the limitations that her anatomical challenges presented to our nursing staff.
Kelli had empathized with the patient situation she found that she had made an all-out effort to work with the house supervisor on as well as calling in a wound care RN from another department to look at the lack of needed supplies as well as closely examine the ostomy site and collaborate with the colleague to make an individualized plan of care to be as successful as possible under the circumstances.
Kelli had donned gowns and shoe covers and was physically caring for the patient herself. She went through different ostomy devices and did out of the box assessments of the challenge of the ostomy site. The site made it impossible to properly apply a device that would adhere to the skin surface more than just a few minutes. This nurse leader stayed at the patient bedside for more than 4 hours shifting devices, asking for different adhesive appliances, sending the son home to bring back home supplies. She called for different solutions to treat the burns and excoriated areas of skin that surrounded the device site. She reached out to different vendors for ideas on how to best address the patient's continued inability to heal therefore rest comfortably therefore leading to a sleep deprivation state that many patients fall into when finding themselves in such an unanticipated challenging recovery process.
Kelli found herself dealing with a patient that possibly had never even had the opportunity to do acceptance of having this procedure that placed a caustic part of her intestinal track pulled to the outside of her body to be covered a drainage device. She forgot for 4 to 5 hours the high stress demands of her role in administration risk management to just become the essence of the nurse in us that looks that patient in the face and connects through empathetic and compassionate care of the human being that she had pledge long ago to be an advocate for. Kelli continued to be vigilant in checking on the care being given, getting changes done that hopefully would improve her home care experience at discharge, worked shift to shift to ensure any nursing training needs were being met and continued to engage the son in the care. She became a beacon of remembering what our core being is about when we are called to care for others. It is that simple---remembering to care for others in an extraordinary dedication to a fellow human being who is suffering.