When working as a Registered Nurse at the beginning of each shift as I updated the patient’s board I would think about the patient’s admitting diagnosis, history and current orders. For every patient, each day there is a standard goal. The goal that I chose was “Stay Safe and Comfortable”. No, this isn’t a NANDA goal within nursing, but it was one thing I can promise my patients while they are under my care as their nurse. Other things may be out of my control, but I will always take every measure to keep my patient safe to include free of falls and aspiration. These two care measures take additional time throughout the day but ensures safety for my patient which I am responsible for. Not only do I have ownership of responsibility towards my patient, but also the family. Upon discharge, I end my care with each patient with a farewell card which includes “Stay safe and comfortable – Take Care”.
A patient had been under my care who benefited from an implanted brain stimulator which was related to Parkinson’s disease. Upon admission the patient was alert to self but had the ability to communicate with simple words and nods of the head. The spouse presented the remote to the implanted brain stimulator and advised she turned the brain stimulator off at bedtime to conserve the battery. The patient was placed on remote telemetry which appeared to cause interference with the brain stimulator, resulting in a faulty reading. Therefore, the spouse proceeded to turn the implanted brain stimulator off.
Returning the following day, I was again assigned to this same patient. Upon change of shift report the patient appeared less alert and lethargic, unresponsive to any interaction. Further, the patient presented with tea colored urine which was also a red flag. After notification with my team leader and charge nurse, a rapid response was called to further assess the patients’ presentation. The rapid response team which grew to five nurses as time passed was given report regarding the changes in presentation and the issues surrounding the implanted brain stimulator. It was interesting to note there was uncertainty regarding the interaction between other electrical devices such as the remote telemetry and the implanted brain stimulator. I have since completed research taking note that this issue is still being investigated through evidence-based practice; to include pacemakers. The end result, the brain stimulator was turned back on by the spouse and additional labs were drawn to assess the patient’s current condition as this patient also carried the diagnosis of chronic renal failure.
Personally, I grew concern regarding the spouses’ ability to turn the implanted brain stimulator off and on. This in a sense, was dictating when the patient had the ability to interact and voice their personal preferences. Throughout this time, as the patient’s nurse I simply was an advocate for the patient when there was a lack of ability to do so themselves; something which is practiced every day while practicing as a Registered Nurse. This in fact is why I have chosen to become a nurse. It is my desire to not leave anyone alone while they are ill or incapacitated to do so themselves. Additionally, I am at the bedside to assist the families during a fragile time and keep their loved one safe and comfortable when they are not able to be there.
In addition to this patient experience, I treat all patients each morning as a brand-new beginning, regardless of a previous shift experience, I assure them that I will review the doctors’ orders and continue their care, helping them to move forward in their recovery in a positive manner.
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