Stacy Lopez

Nursing Situation

During my time at Jackson South Community Hospital I had the pleasure of being part of
the team that would care for a variety of different patients. Our rotation allowed us to experience
nursing in different hospital units. The weekend that was that had the biggest impact on me as a
nursing student and also a lesson for my life was the second weekend in the Critical Care Unit.
Before clinical rotation I always joke around with fellow classmates about how we hope the
weekend will be fun and exciting and always in hope of something cool to happen. The
Critical Care Unit gave me just that, not in a whimsical sense but in the sense that I would learn a
lot about taking care of patients who were seriously critical ill and families in their most
vulnerable state.
When I first arrived at the unit I was assigned to my nurse proctor. I received report with
my proctor on one patient. She had been in the ICU for a few days now, remained stable and was
going to be tested to see if she could tolerate being off the ventilator. I had done total care with
previous nurses in other hospitals so for me giving baths in bed and changing linens was nothing
new. In the middle of the day we received a new patient, she came from the emergency
department. The charge nurse from the ED gave us a brief report and history on the patient. The
patient was brought in from her home because of shortness of breath. When she arrived to the
ED she was unresponsive and intubated. The patients granddaughter was her power of attorney
but she lived in Key West. The patient had a DNR order and was suppose to be in hospice care.
When the patients health began to deteriorate the family become concerned and anxious and
called 911 and thats how she ended up in the ED at JSCH. We contacted the patients

granddaughter and she said she was on her way to the hospital but given the distance she would
be a little while. The granddaughter made it very clear that she not longer wanted her
grandmother to have a DNR order, she wanted everything to be done to her grandmother in an
attempt to keep her alive expect chest compressions.
After my nurse and I finished the admission assessment and we documented everything
for the patients admission, my nurse said she was going to go to lunch. She was going to be in
the nurses lounge but I could stay and watch the patients, if I had an emergency I could call on
the charge nurse or find her in the lounge. I was reading the patients charts when I saw to girls
come in down the hall and head into the room of my newly admitted patient. One of the girls had
a serious face and the other one broke down in tears and walked out the room. I approached both
of them and introduced myself as the student nurse assigned to this patient, I learned that they
were the patients granddaughters; the one with the more serious attitude was the patients proxy.
I told them the nurse was taking her lunch break and she would return quickly. The emotional
granddaughter began to ask me is she alive? Do you think that shell be ok? I was caught off
guard with her questioning and emotions. I told her she was stable and that I could give her more
information once her nurse came back. I went to look for my nurse proctor and made her aware
of the situation, about 10 minutes later my proctor and I walked into the room to give the
patients proxy more information about the patient.
The patient was stable and about an hour later more family members began to arrive. Not
to be judgmental, but the patients family was of a lower educational level and it was difficult to
explain to them that the patient was stable, that her health was deteriorating and she needed to be
monitored. The emotional granddaughter would come out into the hallway and continue to ask
me why is she so cold? Is she dead? How come youre not able to get her temperature does that

mean shes dying? All of those questions were valid from her point of view but they caused me
stress. I felt like I didnt know what kinds of answer to give because I did not want to give false
reassurance but I also did not want to blow off the patients family. The patients daughter at
times would hold the patients hand and say dont leave me mommy, stay with us and she
would turn to me and say that she was not ready to let her go. The emotional granddaughter kept
saying that she should have everything done to try and save her. The patients medical history
stated that the patient had cirrhosis of the liver, the emotional granddaughter would cry and say,
lets find her a liver and get a transplant. My nurse proctor explained to them that given the
patients age and medical history that was not a possibility. This situation continued throughout
my shift as the patients son and daughter arrived with their significant others. The patients
family was not ready to let go of the patient and it was an emotional tough day for all of us
around her.
I could hear the family discussing the patients health. They were all against the decisions
that the one granddaughter was making. The patients daughter, mother of the proxy
granddaughter kept saying I would never do this to you. Youre an evil human being and the
daughter would answer back I would never trust you to make decisions about me, at one point
I had to intervene and tell them to calm down and focus on making the patients, their
grandmother and mother, comfortable. The patient could not be sedated so she could hear
everything they were discussing and saying, and her anxiety was evident in the measure of her
pulse and respirations. I had to teach the family what the monitors indicated and how by looking
at the patient and the monitors they could see that the patient was not dead.
At the end of my shift I was emotionally exhausted. I came home that night and my
emotions got the best of me. I began to cry and think about what I would do in that situation. Its

easy for me to say that if I were them I would want to see my grandmother or mother be
comfortable in their final moments and let them go when their time came. However, I am not in
their situation and I do not understand the intensity of losing a loved one. Nursing is more then
taking care of the physical being of a person. It is also about taking care of the emotions of the
family but never forgetting to advocate for my patient, despite what the family my think. I
reviewed what DNR and power of attorney was and what circumstances it was used in. I believe
it is important to educate yourself and your loved ones on those concepts, so in case this type of
situation arises the patients voice is always heard. Despite the emotional roller coasters I learned
a lot that day and I learned a lot about myself. I was able to carry through quality healthcare to
the patient and emotional support to the family.