So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: “Question is: are there more things in nursing, Horatio, than science can explain? Can we touch patients and zap them with calmness or take away their pain? Can we, by our mindset during our provision of care, substantially affect our patients’ outcomes? Can any of this be taught? Can we do it on purpose? I don’t know. That situation has captured my attention, though, because the flip side must also be true—if I despise my patient, she can probably tell that too, regardless of how tightly I’m controlling my behavior.”
Little backstory: A few weeks ago I had a laparoscopic cholecystectomy. Basically, a very nice surgeon made a few incisions into my abdomen, inserted a camera and some wrenches or something, and took my gall bladder out. I had never had surgery before. Never been intubated. I have been on “the bed side” quite a few times, but never for surgery.
A week elapsed between the time we decided to do surgery and the time the surgery actually happened. It was a really hard week for me as I was very anxious about the whole thing. I’m not even sure what exactly it was that I was nervous about. I trusted my surgeon completely, I had full confidence in the hospital I was having surgery at, and I know it’s a procedure that is done thousands and thousands of times a year with a very low complication rate.
Still … well, I guess I have never been completely unconscious in a room full of people who were looking at my insides. I have never relied on a machine to breathe for me. I had never been under general anesthesia before. Basically, I was going to be vulnerable and exposed. One of the biggest things that caused me angst, though, was that I would wake up still intubated. The anesthesiologist assured me I wouldn’t remember being intubated at all. That was helpful. I believed him.
Anyway, I was supposed to tie this in with the passage at the top, wasn’t I? The point is that I was very nervous and the morning of the surgery found me in the pre-op area holding back nervous tears, sometimes unsuccessfully. I had the footies on, had the gown on, admission assessment was done, IV inserted and then we were just hanging out waiting for the surgeon.
One of the nurses who would be with me in the OR came to wait with me and she was genuinely so sweet and caring. Her general demeanor really put me at ease. We really were just waiting for the surgeon to show up; it was about 10 minutes past when I was supposed to go in. I was in the middle of mentally deducting stars from my future Yelp review of him when he finally showed up. We had a little chat, and then he left to go scrub.
In the meantime, a second OR nurse showed up in my little pre-op area. When the surgeon left, and it was time to go, I started crying a little again. The first nurse was at my side and was very sweet and reassuring. The second nurse was behind me, to help push the gurney to the OR. When she realized I was upset, she put her hands on my head.
I am not a touchy-feely person. When my patients are distressed, I’ll put my hand on their hand or arm and that’s about it. Before this experience, if you had asked me what would reassure me if I was upset, touch would actually be way down on the list, and touching my head? No way. But for whatever reason, her hands on either side of my head was exactly what I needed right then and I was immediately calmed by it.
Why? Why would someone find solace in something they would normally consider to be annoying?
By the time we got into the OR, I was ready for some pharmaceutical assistance. I moved over to the table, and as the nurse was strapping my arm to the board, the anesthesiologist appeared next to me. I told him I could really go for a nice intravenous cocktail anytime and he said he already injected some Versed. The last thing I remember saying is, “Well, I don’t fee…” Heh.
I woke up in the recovery room and felt nausea and pain. All I had to say was “hurts” and “sick” and I was out again. The next thing I remember was being asked to scoot over to my bed on the surgical floor. I said yes when they asked if I wanted some morphine for pain, and dang! That stuff really burns.
I went home later that day and my recovery was very uneventful. I was really amused to see that my incisions were covered in skin glue. No dressings at all. Just 4 incisions with a coating of glue over them.
Anyway, I had barely even remembered what the OR nurse did until I read Megen’s post. I think she’s on to something.
“Gina” is an intensive care nurse who blogs at code blog – tales of a nurse.
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