Ashley Rybnkar-Acosta
March 2025
Ashley
Rybnkar-Acosta
,
RN, BSN
Surgical Services
Redlands Community Hospital
Redlands
,
CA
United States
Her comforting words gave me the chills. Ashley cared about this patient's heart too. Not just the ejection fraction or the rhythm, but all of the spiritual and emotional aspects.
Ashley is an amazing nurse with great skills and knowledge. Her most impressive qualities go far beyond that. She is very empathetic and treats all patients with compassion and kindness. Recently, we were assigned to do surgery on a very sick patient. The patient was end-stage, on a ventilator, multiple drips, DNR, in the ICU with multiple system failures. I was caught up in the medical problems, trying to learn as much as possible about this patient before surgery. I reviewed the chart, talked to the intensivist, surgeon, ICU RN, and respiratory therapist. The patient had an ejection fraction of 20% and atrial fibrillation with a heart rate in the range of 120 to 130. I remember thinking, what will I use if the heart rate goes up to 160 or even higher? Esmolol doesn't work well for that. Neosynephrine might bring the rate down, but increasing peripheral vascular resistance in an end-stage heart failure patient is not a good idea. Oh yes, I will load her with Amiodarone. That would be a good idea. As these thoughts were going through my mind, we were starting the process of transfer. The patient was on a 5 lead EKG and our transport monitor had 3 leads. Two of the leads had to come off to clear up the surgical field. As I pulled two of the leads off the patient, I noticed that she grimaced. How could that be? I thought she was too sick, too sedated to notice anything like that. Thank God Ashley came to the rescue. Ashley said to the patient, "We are SO sorry, sweetheart. We didn't mean for that to cause you discomfort. We are going to be with you the whole time and get you through this surgery safely. Before you know it, you will be back up here with your family." Her comforting words gave me the chills. Ashley cared about this patient's heart too. Not just the ejection fraction or the rhythm, but all of the spiritual and emotional aspects. I saw the patient in a different light. Our patients deserve our highest compassion and kindness. Thank you so much, Ashley, for this powerful reminder.