The Art of Nursing in a High-tech World
Today, patients with severe cardiomyopathy are able to live longer with the help of a ventricular assist device (VAD), either to await a heart transplant or to depend on the artificial pump permanently. But the complexity of the VAD can be overwhelming for the patients and absorbing for the staff. We may become so involved with the clinical aspects of the equipment that we lose sight of the patient attached. Boosting our patients’ spirits, perhaps by simply washing their hair at the sink, is just as important as checking the VAD’s function. It is essential that we keep our focus on the emotional aspects of patient care through encouragement, teaching and friendship.
To meet the patient’s total needs, it is important for the nursing staff to set goals. At first they may seem simple, like eating a nutritious meal or sitting at the side of the bed. But as major providers of emotional support and encouragement, we recognize the difficulty of each step and heap praise for every milestone. Within a few weeks, our patients often are walking around the hallways, making progress with every step.
Patients often stay in the Cardiac Surgery Step-down Unit (Tower 8AB) for months. In setting goals, it’s important to involve patients in the decision-making, to give them as much control as possible, to blend clinical care within their individual daily routines. Bringing a little normalcy into their lives can mean so much. For example, we arranged for one man to briefly visit with his dog; we took a 12-year-old girl to the top of the building to see the July 4 fireworks.
Customized education also enhances care. While some of our
critically ill patients stay at BWH to await a heart transplant, others are able to go home, either to await a transplant or to depend permanently on a VAD. As we help them adjust to life with a VAD — how to change the battery or what to do when an alarm goes off — we recognize that every family is different. They may live a long distance from BWH, have financial difficulties, or the chief caretaker may have other family members to care for, such as children. We need to be sensitive to all these factors.
We often are rewarded by visits from former patients. Their success stories are gratifying and a source of encouragement to similar patients. One VAD patient who had awaited transplant in our unit had coped by planning her only child’s wedding. She later brought her 5-week-old grandchild to visit us — a wonderful reminder of the intensely personal side of medicine.
J
anice Childs, RN, BSN
Staff Nurse, Cardiac Surgery Step-down Unit, Tower 8AB
(pictured above with a patient and his wife)