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I want to write a different kind of clinical thread tonight, because board studying sucks and I want to talk about something I think I’m pretty good at - making people feel nice. A thread.
Ask anyone who’s had an extended hospital/ICU stay and they’ll tell you it’s dehumanizing, traumatizing, and often impersonal. But we can help through thoughtful action.
So let’s go: humanizing gestures for new clinicians, from a former ICU nurse. In no particular order:
So let’s go: humanizing gestures for new clinicians, from a former ICU nurse. In no particular order:
1. Is it your pt’s bday? Being stuck in the hospital on your bday SUCKS. Order them some Tiff’s Treats or Popeye’s or something as a bday surprise. Bully your peers into Venmo (they try to get you to buy Scentsy, right?) or just pay for it yourself if you can.
2. Talk to your patients. Yes, the sedated ones. Yes, during postmortem care too. Actions reflect intent, which in turn informs your inner thoughts. Once you stop treating people like people, you stop thinking of them like people. It means a lot to families, too.
3. Bath time is sacred. This is not some last-minute quick-wipe to get delayed until the end of shift… unless it can’t be helped. Baths are one of the most rewarding and humanizing parts of the job for both nurse and pt if done with respect and care. (Cont.)
Hot towel facial. Hot face shave for the fellas. Fingernails. Hard back scrub - they’ve been laying on it all day! Hair brushing. Give a bath you can be *proud* of when you hand off to the next shift. Give the kind of bath family members brag about. Every time.
4. Always be thinking about what your pt might need that isn’t in the room. Things you can order or ask for. Would they benefit from a specialty bed? Warm packs for cold hands/feet? Is their nasal cannula humidified? It can be hard to notice things that *aren’t* there.
5. When dealing with perimortem/palliative situations, see if you can order a “comfort tray” from dietary - a tray of sandwiches, drinks, etc - for family members who are stuck in a holding pattern, waiting for the other shoe to drop and perhaps not considering their own needs.
6. On the perimortem note: your ICU monitor has a palliative care mode. Learn to use it. The last thing any family needs is to see a mess of numbers that represent the person they’re losing, and to fixate on a slowly declining SpO2 or HR - even if you have the alarms silenced.
7. If you have a moment where you’re not covered up in stuff to do, take a moment to sit with your patients and just chat. Doesn’t matter about what. Get on the level of the bed, hold hands if you’ve got that kind of relationship, and just watch TV or visit for 5-10 mins.
8. Get in the habit of asking verbal patients and their family members what their goals of care are, as well as their fears. Their goals may or may not align with ours and we need to know that. Knowing their fears allows you to avoid triggers and provide better care.
9. Go the extra mile when it matters. I once had a coworker who stayed 3 hours after shift change (night, weekend) to find a priest for an unaccompanied Catholic patient in extremis. Nobody said thoughtful care would be easy, but it’s just as worthwhile as learning the drugs.
10. Is the therapeutic milieu capable of Outside? Then go outside. I’ve taken some fairly complex situations for a stroll through the garden because it was the right thing to do. Don’t take unnecessary risks - no sunshine is worth injury or death - but work for it.
11. If you have a license (looking at you, RNs) then you have the freedom to bend the rules and help guide treatment, provided it’s ethical and prudent. Don’t be bound by “rules” and “policy.” Fight for your patients when it matters. We aren’t chart jockeys.
12. Be vulnerable when viable. Tell dumb jokes. Wanna know why I got my DAISY? Wasn’t for my skills at pt assessment or norepi titration. Nope, I danced to “Be Our Guest” in the hallway with a troubled preteen. I looked absurd, but that wasn’t what mattered.
A final disclaimer: I’ve been out of the game for 2 years. A lot of the is impossible under the COVID milieu, and I have nothing but respect for my peers who have shouldered the burden of care during this time. My thoughts above reflect the way things were, and may be again.
