It was January 2022, and my medical unit was overwhelmed with patients who had COVID-19.
After receiving report on my patients, I gathered supplies, prepared medications, and began my morning routine. I tried to cluster my care as I moved from one patient to the next to limit my exposure.
I entered the room of a patient, JM, and noticed he was sitting on the side of the bed. He was attempting to relax, but I could see the fear in his eyes. He was dyspneic after just changing his position in bed. I introduced myself, explained his medications, and answered his questions once he got comfortable. Although he took his medications, I could tell he was hesitant. However, I could not tell if his hesitation was toward the medication or just being in the hospital.
I obtained JM's vital signs and performed a head-to-toe physical assessment, including auscultation of his heart and lung sounds. I also provided education on incentive spirometry and the importance of hydration. He seemed to appreciate my advice, but I could tell he still felt uneasy. I continued about my day but frequently checked in on him. He spent much of the morning resting and reading the Bible on his bedside table.
Throughout the day, JM and I developed a rapport, which encouraged him to slowly open up and talk about his wife and children. When I delivered his dinner tray, I asked him how he was feeling, and he replied as he had all day: "I'm okay. Thank you for asking." I looked at him and asked, "Are you really okay? You seem worried. Is there something I can do to make you feel more comfortable?"
JM then explained that he had not spent much time in a physician's office, let alone a hospital. His last hospital experiences were heartbreaking. In 2009 and 2013, he lost his parents; each was admitted to the hospital and never came home.
It was then I realized that he automatically associated hospitals with death.1 He was afraid he would not make it back home to his wife and children. During this point in the COVID-19 pandemic, patients could not have visitors, and he was afraid he would never get to see them or hug them again.
I reflected on how I could make JM's hospital stay more positive. Words of affirmation came to mind immediately. I decided to take the time to highlight his progress as part of my care.2 Each time I saw him use the incentive spirometer, I cheered him on. I noticed he was not as dyspneic with mild exertion and pointed that out to him. I could tell it was helping, and his fear was slowly fading.
We continued to connect over the few days-each day better than the last. I weaned his supplemental oxygen down to 2 L/minute, and he even felt well enough to shower on his last day at the hospital. His fear gradually shifted into positivity, and he became excited to return home to his family.
On our last day together, JM explained that during his first few nights in the hospital, he had begun to question his faith and God's existence. He began to think, "Why me?" and was angry at God for placing him in this frightening situation. But he then realized that God had a plan for him and placed me to care for him. He explained that I was the listening ear he needed when he was worried or had questions, and the encouragement that kept him optimistic.
Establishing a relationship with a patient and making them feel safe during some of the scariest moments of their lives is one of the reasons I became a nurse. I want to be there for people during hard times, and I also want to celebrate their improvements. JM made me realize it will always be worth the extra time to establish a trusting relationship with patients
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