Archive October 2018 XIX, No. 10

My Turn: Blessed to Let Go Together

My patient and I leave our grief over losing a loved one on PACU Bay 6

Angela Ross

Angela Ross, RN, BSN, CEN

BIO

NIGHT SHIFT
Atrium Health-Mercy in Charlotte, N.C.
PATIENT-CENTERED CARE It's easy to lose sight that patients are people, says Angela Ross, RN, BSN, CEN.

Ooooh! I can’t believe it’s over. Am I done? Why can’t I feel my leg? Where is my husband? It hurts! Somebody, please! My fifth patient of the day just rolled into PACU Bay 6. I glance at the clock and realize it’s only 10 a.m. Another busy Monday. I lean forward to introduce myself as her nurse and she’s crying ... already she’s crying. Thinking to myself about how heavy this patient will be and how high her needs are within the first 20 seconds of exposure. How in the world am I going to get through this?

Her name was Susan. She was at Atrium Health-Mercy in July for a knee replacement. She’s 48 years old. After a brief introduction, during which I tell all my patients that my name is Angela and I’m here to help, she continues to cry. I quickly finish getting a report from the anesthesia team and OR nurse, grab a full set of vital signs (she’s a little tachycardic, but that’s understandable given the crying) and begin to cover Susan with toasty warm blankets.

I know a quick report isn’t ideal, but my patient needs me. Lots of data out there tell me this approach was not best, but I push ahead anyway. I know multiple studies published show a full, uninterrupted handoff is critical. As I tell her I’m going to get you comfortable, here are some warm blankets, and tuck her in carefully and compassionately, she begins to cry harder.

At this point, I have no idea if she’s in pain or just experiencing post-anesthesia emotion. It’s not uncommon and is known in the profession as pathological crying. Research remains mixed on the topic as there haven’t been conclusive studies to determine why this phenomenon occurs. We don’t know much about why this occurs, but all PACU nurses know it happens quite commonly, especially in the pediatric population.

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