We’re All Adults Here

images-40I was taking care of a younger (read: in his 50’s) patient last week. He developed flash pulmonary edema following severe mitral valve regurgitation requiring him to be intubated, treated, extubated, transferred to our hospital for mitral valve repair. He was intubated for surgery and then post-operatively we had a hard time getting him off of the ventilator (he was on 100% FiO2 and 10 of PEEP just to keep his SpO2 in the mid-80s).

I was his nurse on the day of surgery as well as post-op day #1, so the first day he was still under anesthesia, but when I walked into this room on my 2nd day with him, he was wide awake and able to communicate with me more than I had been able to communicate with any other patient prior to him in my career.

We went through several different settings on the ventilator and he was able to tell us which one was the most comfortable, he was able to turn himself in bed with very minimal assistance (he was a robotic surgery, so no worry about sternal precautions), and we even sat him up on the side of the bed with the ventilator and swan-ganz still hooked up.

He was writing notes asking me how much drainage was coming out of his chest tube when I marked it, and asking me what his oxygen saturation was, knowing that’s how we were determining how we were weaning down the ventilator. I was thoroughly impressed with his awareness of what was going on and his interest in his care and progress- our usual 85-year-old patients generally don’t have either of those qualities.

My pet peeve of the day came watching other staff members walk into the room and talk to the patient like he wasn’t mentally intact or like he wasn’t there. Some people would talk down to him saying things like “hey there sweetie; looks like that tube is still in your mouth, huh?” in a loud and/or overly-high-pitched voice.

Or, they would come into the room and start talking about the time that they went out with so-and-so from another department and they got so drunk that he didn’t remember how they got home (inappropriate whether the patient was awake or not, I know), but frustrating for me as his nurse as it makes the whole care team look incompetent.

All of our patients deserve our utmost respect and quality care and I truly feel that talking to patients using terms such as “sweetie”, “honey”, “sugar”, or any other demeaning terms is completely inappropriate. Our patients should leave the hospital feeling as though they were cared for by great, professional nurses. If we, as nurses, want respect from the community as more than waitresses or holders of the pain medicine, we need to act like it.