November 2023
Ruby L
Zamora
,
RN
Surgical ICU
Audie Murphy VA Hospital
San Antonio
,
TX
United States
Ms. Zamora recognized and understood the magnitude of the decision not only for the patient but also for the brother and she remained at the bedside to hold his hand to provide additional support for the patient.
Nurses throughout our healthcare system are positioned in various ways that impact our special patient population and create opportunities to foster professional nurse-patient relationships. Mr. P, SICU Nurse Manager, nominated Ms. Ruby Zamora for her ability to develop a trusting relationship with a patient who underwent a craniotomy to relieve symptoms caused by cancer.
After the craniotomy, the patient remained in SICU for a total of 17 days. During this time, the patient began to decline and had named his good friend as his Medical Power of Attorney. Unfortunately, his friend had reservations about making decisions that could involve limiting life-sustaining treatments. Through daily communication with the patient, MPOA, and another friend of the patient, Ms. Zamora learned of a brother who lived in Germany. In efforts to alleviate uneasy feelings felt by the MPOA regarding palliative measures, Ms. Zamora recommended that the care team needed to attempt communication with the patient’s brother (his last living relative).
Ms. Zamora did some research on how to make an overseas call and worked with her leadership to gain approval. She discussed this with the patient which sparked excitement in a time when uncertainty was present. The patient now had a way to include his brother in his plan of care. The call was successful, and an interdisciplinary meeting was conducted which allowed the patient to express his wishes not to remain on any machines (due to his poor prognosis) as he was currently on a ventilator and still had decision-making capacity. This was a very difficult and emotional conversation for the patient.
Ms. Zamora recognized and understood the magnitude of the decision not only for the patient but also for the brother and she remained at the bedside to hold his hand to provide additional support for the patient. Unfortunately, the call was cut off, however, Ms. Zamora, reached out through Facebook Messenger to allow the brother to a proper closing on the conversation and asked if he would want to speak with his brother after they extubated him. To which he agreed and this allotted the patient and brother to spend some time together through video Messenger before the patient passed the following morning.
Mr. P recognized Ms. Zamora displays all the I CARE values and has demonstrated compassion for her patient as well as his brother. Her dedication and commitment to compassionate service make her our next DAISY Award Honoree.
After the craniotomy, the patient remained in SICU for a total of 17 days. During this time, the patient began to decline and had named his good friend as his Medical Power of Attorney. Unfortunately, his friend had reservations about making decisions that could involve limiting life-sustaining treatments. Through daily communication with the patient, MPOA, and another friend of the patient, Ms. Zamora learned of a brother who lived in Germany. In efforts to alleviate uneasy feelings felt by the MPOA regarding palliative measures, Ms. Zamora recommended that the care team needed to attempt communication with the patient’s brother (his last living relative).
Ms. Zamora did some research on how to make an overseas call and worked with her leadership to gain approval. She discussed this with the patient which sparked excitement in a time when uncertainty was present. The patient now had a way to include his brother in his plan of care. The call was successful, and an interdisciplinary meeting was conducted which allowed the patient to express his wishes not to remain on any machines (due to his poor prognosis) as he was currently on a ventilator and still had decision-making capacity. This was a very difficult and emotional conversation for the patient.
Ms. Zamora recognized and understood the magnitude of the decision not only for the patient but also for the brother and she remained at the bedside to hold his hand to provide additional support for the patient. Unfortunately, the call was cut off, however, Ms. Zamora, reached out through Facebook Messenger to allow the brother to a proper closing on the conversation and asked if he would want to speak with his brother after they extubated him. To which he agreed and this allotted the patient and brother to spend some time together through video Messenger before the patient passed the following morning.
Mr. P recognized Ms. Zamora displays all the I CARE values and has demonstrated compassion for her patient as well as his brother. Her dedication and commitment to compassionate service make her our next DAISY Award Honoree.