Heart of Care
Nurses' creative attentions go beyond physical care needs to establish a special bond with patients

By Melissa Lehan Mackin, RN
June 26, 2003

The shortage of nurses and its effect on staffing ratios, as well as increasingly higher acuity in inpatient settings, have influenced the evolution of the nurse-patient relationship. Providing holistic nursing care becomes more of a challenge as physical needs and matching technical skills are continually forced to the top of the need hierarchy. Nurses find themselves having to become more creative to develop ways to maintain a connection with their patients, as well as a quality nurse-patient relationship.

In the midst of these circumstances, my nursing peers had the occasion to demonstrate the kind of commitment and passion to provide an excellent example of the necessary vigilance to meet this type of challenge.

Our staff came to know Mr. and Mrs. L. during an extended hospital stay in which Mr. L. had extensive surgery for esophageal cancer and remained under our care for his subsequent recovery. Luck was not on Mr. L.'s side: After being told his cancer surgery was a success, he developed a rare bleeding complication with little documentation of prior occurrence or effective treatment.

For several weeks, Mr. and Mrs. L. rode a roller coaster of hopes and disappointments, and many times the staff and his physicians were along for the ride.

Several efforts to keep up his spirits by staff members provided usual and unusual activities. Mr. and Mrs. L. shared the holiday season with us and, for Christmas, we decorated his room. Although we couldn't give him the first wish on his list, we did give him laughs. We presented him with unique gifts, such as a staff-autographed urinal and silly ornaments that were the subject of conversation for days.

And although time was marked with what seemed like one setback after another, one staff member called in some favors and members of the university basketball team dropped by to visit Mr. L., who was one of their biggest fans. He proudly displayed the pictures taken of their visit and quickly pointed out these souvenirs to everyone who entered his room.

This was not the end to the efforts of the staff. Just when Mr. and Mrs. L. were hearing things about his illness like "We are researching any further options," a visit was arranged by members of the cheerleading squad.

As more days passed, Mr. L. made mention of not being aware of what winter was like this year because he was limited to being indoors. Another creative staff member made him a miniature snowman. Mr. L. watched the snowman slowly melt away, much like Mother Nature was doing in the actual outdoors.

There were also smaller interventions, such as providing shoulders to lean on and compiling information to keep Mr. and Mrs. L. educated in order to help them make some of the difficult decisions they found themselves faced with. Mr. and Mrs. L. often said that the things we had done showed that there was no doubt we cared and demonstrated genuine concern. They said our "upbeat attitude was contagious."

To provide a happy ending to our story, Mr. and Mrs. L. were able to leave us on Valentine's Day after receiving a singing valentine complete with long-stemmed roses, arranged by yet another staff member. We reminded them once again how they had become permanent fixtures in our hearts.

Our staff would agree that each of us gained so much from this experience. We were able to demonstrate that patients are not just lab values or problems to be solved. We plunged enthusiastically forward, continually inventing creative strategies and demonstrating sincere empathy as we cared for Mr. L.

Allowing staff to use their talents or skills beyond their technical abilities made this experience meaningful and allowed us to feel we had made a contribution to patient care beyond meeting physical care needs. We left our work feeling personally fulfilled, ready and willing to meet the care needs of the next patient.

Melissa Lehan Mackin, RN, graduated in 1995 from the University of Iowa and has worked at the Holden Comprehensive Cancer Center at the university since October 1998. She spent the last two years as an inpatient care coordinator for gynecological and thoracic oncology patients on a busy 21-bed acute surgical unit. Her position allows her to follow patients from admission to discharge and assist them to make the transition home, as well as provide various support needs throughout their hospital stay.

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