Kendra is the kind of nurse that inspires others through her amazing patient centered care. She sets the bar for patient advocacy. Recently Kendra cared for a patient with a large frontal brain tumor. The patient also had expressive aphasia and needed careful assessment and attention to meet her needs.
Kendra recognized the very unique needs of the patient and equally importantly the family needs. Because of the patient condition the family had difficulty managing the prognosis but also the challenges of making life altering decisions for care. The family had very limited resources both intellectually and financially. Kendra spent considerable time with the family navigating them through a very complex health care system. Kendra recognized the family needs for support by having many resources available to them such as a notary public to help them understand what they needed to complete the required documentation to establish power of attorney. When concerns were raised about the motives of the family and the patient finances and the conflicts presented she involved the Ethics director to work with the staff and the family to sort through the ethical challenges of the conflicts between financial and medical care for the family.
Above all Kendra prioritized the patient care. In conversation with the family it was very clear to her that the family was not able to fully grasp what was happening with their mother medically. She asked the neuro PA to meet and talk with the family for the fourth time to explain the patient condition and the expected outcomes. She wanted to be sure the family understood what was happening with the patient and what each test result meant. She insisted that the speech therapist evaluate the patient even though she had already been assessed. Kendra championed the care of the patient and was convinced that more could be done. "There had to be a chance that the patient could understand more, "I know she can understand more than we realize." Kendra observed the 45 minute speech evaluation and gained a true appreciation for skills of the therapist for care delivery and how to better partner with other disciplines for patient care. "We have to be a cohesive team to truly meet the patient's needs."
When cognitive deficits were evident Kendra swiftly shifted gears and refocused on the patient care to keep her safe and to promote successful outcomes that the family could understand. She realized that the family did not grasp the extent of the patient condition or how to cope with it. She found ways to communicate with the family that would not be obstructive by asking "What do you think your Mom would want?" etc. Kendra was sensitive to family's limitations as they struggled to make decisions for their Mother. She never judged the family but pursued their understanding of the situation.
With careful attentive assessments Kendra was able to detect that the patient's deficits were more impaired than could be ascertained through a simple neuro exam. Yes, she could answer appropriately most any questions or follow simple commands but was it because she truly understood or was it a simple reflexive response? What Kendra realized was that the cognitive deficits were far more severe than passed on from a basic neuro exam. This helped Kendra to think about appropriate expectations for the patient as well as discharge plans.
She was able to use this a teachable moment for everyone; patient, family and other staff. Kendra is a role model of true nurse excellence in care delivery. Kendra was also able to determine a break in care that created a barrier to discharge. "Was it possible that because of vacation schedule the patient fell through the cracks?" "Could the patient have gone to Rehab sooner?" "Could progress notes have been better at explaining the true patient condition?" "What can we do as health care professionals to be sure we promote a successful experience for every patient we care for?" These are just a few questions that plagued Kendra as she worked through her care delivery.
Kendra was able to not only be a bedside clinician but a true navigator and a champion for the patient and the family. She was impeccable in her assessments and her enthusiasm to provide the best and safest patient centered care.
Listening and observing Kendra throughout this patient's experience I realized how proud I am to be a nurse and to share Kendra's incredible practice. When Kendra first joined R6 as a nurse she was full of trepidation and concern that she was not ready to assume patient care after a few short weeks of orientation. It is clear that she has arrived and is an exemplary nurse. She is so deserving of this award!