submitted by Gloria Herms contributing writer
As Pat Benner (1989) suggests that “Nursing is a caring practice guided by the moral art and ethics of care and responsibility that unfold in relationships between nurses and patients “, St. Elizabeth Healthcare has adopted a pledge to pursue improved care team-patient communication and overall patient experience in the program ‘Commit to Sit’. Since its’ inception, the results have proven to be effective in the patients’ perception of an authentic, caring and listening care team. I am a firm believer in the face to face, on their level, communication practice; as it is an obvious trust- invoking tool that enhances the patient/caregiver bond.
My recent experience with the ‘commit to sit’ initiative was one with an elderly woman I will call Eve. She was basically still in the hospital at this point for lack of a safe discharge. She was under an APS (adult protective service) investigation, and had been deemed unable to care for herself, or make sound decisions. There were never any family or other visitors, and she spent most of the day staring ahead; not appearing to be engaged in the current situation. Eve was underweight, and malnourished. She had to be coaxed to eat, was incontinent and could not walk. She also seemed to lack the ability to cooperate for her lack of understanding of what was going on. This made Eve one of those patients that weren’t exactly on the most wanted list of nurse assignments. (I’m sorry to admit). She was a difficult patient and took up a lot of time.
On one particular day, I was in Eve’s room, and noticed the Partner in Care form tacked up on the white board. It stated under her hobbies and interests that she liked music and dancing. I thought that seemed odd, just taking one look at her; forming an opinion of someone in a state of sickness, disarray and confusion. Her appearance of long grey hair that was unkempt, vacant eyes and hollow cheeks was just a picture of the shell of her spirit that was long gone lost. At this moment, I decided to commit to sit. I sat eye level with her and asked her about what music she liked. She slowly turned toward me, and her eyes began to liven. She mentioned several musicians of times past; some I recognized some I did not. She began to talk to me. She told me how she used to go to dances and sing karaoke. She said she loved to dance too. She spoke of her family and friends, how they would get together and enjoy music and dancing. She smiled as she spoke of these things.
I then asked of her family. She became sad. She told me of the sons she had lost to drug addiction. She spoke of broken marriages, abuse, overdoses, separations and many other painful memories of her obviously hard life; a life that reflected consistent lack, hardship and struggle. What I seen in Eve was an over comer. She was able to remember good times despite the blows of life.
After our talk, her demeanor changed a bit. She was calmer, and could engage better in her care. She was able to feed herself, and get out of bed to the chair with assistance. I could see a little light in her eyes, instead of the vacant look from before. I know that she still has dementia and lacks the ability to remember.
She would not be a part of a follow up survey that would have an impact on overall patient experience scores, but I am very glad that I took the time to commit to sit with Eve that day. I value the days I had to care for her. When she was discharged, she weakly raised her hand to wave goodbye to the staff in the hall as she was being transported out to a long term care facility.
I know that taking the time to sit with patients in this manner does not always easily fit into a nurses’ day. I do strive to do this as best as I can, because I do believe in it. Although, the goal is to improve the patient experience, I find it improves my experience as well!