“I’ve worked as a nurse in neurointensive care for over a decade. Most patients in the neuro-intensive care unit are comatose, which makes the link between the nurse, the families and the rest of the medical team, delicate and vital. These patients often suffer catastrophic neurological injury, which sometimes translates to poor outcomes. It is for this reason that nurses have a place, an unique role in caring not just for patients but also their families. Faced with varying stories and narratives from families, nurses are often challenged as they try to balance both the physiologic and psychosocial needs of the patient as well as the psychosocial needs of families. For example, what does one say to a husband when his young wife, 33 years old, is admitted in the ICU following a hemorrhage in the brain. One certainly knows that that is just the beginning of her hospital course, that even if the aneurysm is treated, no one knows if she can walk or talk again. Or, to a couple who have been married for over forty years and now, the wife presents with a devastating stroke? Or how often are we asked “She’s sleeping, she’s not in coma, right?” We all know the old cliché that sometimes patients often get worse before they get better. Families experience a wide spectrum of emotional feelings.

 

In the summer of 2001, I became yet another statistic in joining patients who’ve had suffered a brain hemorrhage. My world came to a devastating halt when I myself had a subarachnoid hemorrhage from a ruptured aneurysm. Having the worst headache of your life feels similar to being hit by a shovel. I can still feel that sudden warmth and bang that knocked me unconscious that day. I had an aneurysm burst and this time I was being cared for by my colleagues. Having spent many days in the ICU as a patient, I experienced being in coma, then waking up confused, and not being able to speak properly. My aneurysm also took the vision in my left eye temporarily. It was all too familiar and frightening. I felt cheated! I’ve been asked many times if it is difficult for me to continue to work in a place where it is a constant reminder of that horrible summer. Working in the neuroscience ICU is a very special place. I was cared for by a dedicated team of physicians, surgeons, nurses, therapists, social workers all of which made my recovery possible. As a survivor and a nurse, the experience has certainly made me a better person. It has strengthened me both personally and professionally. Most especially I have become a more compassionate and empathetic nurse.

 

I remember a patient who had a brain hemorrhage who spent weeks in our ICU. His family stayed with him almost every day. There were days that it was difficult to see both patient and his wife. She was going back and forth taking care of their kids and coming to the hospital. He instead was getting sicker by the day. We were concerned that she could’ve gotten sick as well. We held many conferences with her including the medical team, social worker and the priest. She didn’t seem to be receptive at first, she was angry. It wasn’t until he was discharged and spent months in rehabilitation that they decided to stop by one day in the ICU. She had tears in her eyes; the only thing she said was thank you.

 

It is easy for nurses to insulate themselves in the multitude of tasks that need to be performed. Yet, it is imperative to lend a sympathetic ear, to spend time and explain the current state of the patient or, as may be required, refer them to their appropriate physician/surgeon. Incorporating a multi disciplinary approach with social workers and pastoral services will help the families as well. In a hurried high tech environment one still has to be able to relate to the humanistic aspect of their needs. Families understand that nurses, among the hospital staff, are the ones who spend the most time with their loved ones. So they often look to nurses for answers. Answers that we may not have, or only time possess. Or there may even be no answer. Yet, it is part of the patient’s family struggle, and in putting ourselves in their shoes, maybe the best answer to their question is to just listen and be empathetic. Our caring action is one of our best interventions.”