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Compassion: A Critical Link in Extraordinary Care for Patients and Families

Sweeney, Cynthia Divens, MSN, RN, CNOR, NEA-BC

Journal of Nursing Administration: October 2018 - Volume 48 - Issue 10 - p 471–473
doi: 10.1097/NNA.0000000000000653
Departments: Spotlight on Daisy

Delivering clinical nursing expertise enveloped with compassion should be the expectation for care. Ensuring this level of excellence happens when a critically ill patient is transferred from one hospital to another is challenging yet imperative to the patient’s and family’s experience. The DAISY Foundation recognizes nurses who provide compassionate and extraordinary nursing care, as demonstrated in the stories of 2 nurses, from different organizations, who cared for the same patient and family and were honored with The DAISY Award.

Author Affiliation: Executive Director, The DAISY Foundation, Glen Ellen, California.

The author declares no conflicts of interest.

Correspondence: Ms Sweeney, 276 Providence Rd, Annapolis, MD 21409 (cynthiasweeney@daisyfoundation.org).

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Linking clinical care with compassion should be the expectation of patients and families. Two nurses in 2 different organizations created an unbroken chain of compassion for a patient and his family. As is often the case, there was a need to transfer care from one hospital to another to meet the patient’s critical physical needs. Through their extraordinary compassionate care, 2 nurses made a human connection to the patient and family that was significant and unforgettable, providing continuity of compassion that made a great difference. For their extraordinary care, these 2 nurses, Abby and Kathy, were nominated by the patient’s spouse for The DAISY Award. The DAISY Award recognizes nurses who deliver extraordinary and compassionate care.1 Nominations for the award tell the story of care and are written by those who experience or witness such compelling care. This story is especially poignant in that the patient’s spouse is a nurse and a recognized leader in improving healthcare outcomes. This is the story of the critical link that compassion played in the provision of care for the nurses, for the patient and the family.

Transferring patient care is disruptive to a patient and his/her family, even in the best of circumstances. Transferring critical care between hospitals for a patient in crisis requires all involved to focus on the clinical priorities and the comprehensive handoff of that care for best patient outcomes. The art of the handoff is a critical element to patient outcomes.2,3 In this transfer of care, it is important that the chain of custody includes not only the handoff of clinical needs, but also the psychosocial needs of the patient and the family, ideally linking compassionate practices between organizations.

Like most of us, Sue Hassmiller, RN, PhD, never expected a typical day to turn into one that would forever change her life. As the senior adviser for nursing at the Robert Wood Johnson Foundation, she has a global view of nursing’s role in the healthcare landscape. The importance of how nursing care is delivered was to become very personal to her. She and her husband, Bob, were planning on taking a break from their busy lives to slip away for a much-needed vacation. But before that would happen, she received a message from a hospital. Her beloved husband, Bob, was severely injured in a bicycling accident. That message changed those plans and so much more for her and their family as she shared:

“This was the greatest tragedy that I could have even imagined, but within the tragedy and my proclivity toward extreme bitterness and hurt early on, I made a promise to myself to identify some blessings along the way. Even now as my bitterness lingers, having blessings to focus on balances my spirit. I know no other way to survive. Two such blessings were Abby and Kathy. They gave to Bob and me what we needed most of all: compassion and understanding. Sure, they gave great clinical care, but to me great clinical care, as I learned firsthand, was merely my baseline of expectation. They took time to understand our circumstances, and they got to know both of us as human beings and not just a patient in the bed and a family member. They used touch, eye contact, and kind words. They renewed my faith that nurses could indeed provide the needed compassion and understanding that was so needed amidst all the dozens of tasks they must perform in a single shift. As a nurse, they made me proud; as a family member, they renewed my spirit” (personal communication, April 2018).

Abby Di Gaetano, RN, CRNA, was the nurse anesthetist who received Bob in the trauma care unit following his accident. At her disposal was an array of technology, as well as her own clinical expertise to support Bob’s care. But it was the delivery of her care—the clinical skills wrapped with compassion—that was recognized by the family in her DAISY Award nomination, written by Sue Hassmiller:

“Abby brought a much-needed human connection to this tragedy. First of all, my spiritual side will start showing now when I say that her presence in my life was meant to be. I believe that my husband, always thinking of my well-being 1st above his own, guided Abby to me. Abby said she felt a very strong tug to come to me and tell me how special Bob was and how he had affected her and what she thought of our relationship. She could have ignored those feelings donning the cloth of professionalism to keep her distance, but she chose to connect… one human to another. Bob knew I would listen to a nurse, and he knew especially that I would pay attention to a nurse who had the same name of my beloved granddaughter. She did and said things that were from her heart. This did not take away from her professionalism. I could tell how competent she was. Rather this decision to connect only added to her professionalism. One of the most beautiful things was when she said she told Bob to think of something very beautiful when she was starting the procedure to insert his breathing tube, and she knew in her heart that he was thinking of me. She turned the mechanics of a brutal procedure into one where I felt comforted. It was the warmth she conveyed, her touch, her desire to not hold back in her words of reassurance. If I had to sum up her specialness, I would say that beyond her obvious competence Abby followed her heart when she chose her words with me and how she reached out to me” (personal communication, April 2018).

To best meet Bob’s critical care needs, the decision was made to transfer him to another hospital. Again, a chain of custody and handoff for his critical needs was established between nurses in each organization. How fortunate for Bob and Sue that Kathy McLernan, RN, was one of the nurses who received them in the surgical intensive care unit. Kathy added another link in the chain of compassionate care, started by Abby. Kathy was as clinically skilled as her colleagues in the unit, but there was something about her that made her stand out as she cared for Bob, Sue, and their family. Perhaps it was the connection to them and her ability to meet unexpressed needs, commenting on family photos, playing CDs for Bob, or just knowing when to hold a hand or lend a shoulder of support. Here is how Sue described the care Kathy provided, being attuned to the sensitivity and the needs of Sue and their family in a most difficult time:

“Kathy helped me move my 6-ft 4-in, 240-lb husband so I could lie next to him after my family and I decided to let him go. She stayed well beyond her shift to help me turn off his machines. She helped me pass the most difficult milestone in my life so far. I trusted Kathy who cared for my husband and me so much, with my soul and my husband’s life. She helped me make the most painful decision I’ve ever had to make. She always knew what to say to me. In the end, she would not leave her shift until my husband and God made their decision about when to go, and she could leave me in peace. My pain is deep and profound, but I know it was the right decision for him. That, to me, means my husband experienced a culture of health, even at the end of his life. Kathy knew the value of making a human connection. Her care, her experience, her hugs were what mattered most at that time.”4

Delivering clinical nursing expertise enveloped with compassion is what every patient and family should expect. Recognizing compassion as a critical component in healthcare underscores its importance. Honoring extraordinary and compassionate care is the purpose of The DAISY Award. DAISY nominations such as these give voice to what patients and families truly value. They tell us in no uncertain terms that compassion is an imperative link in the chain of care for patients and their families. Shouldn’t every patient expect a DAISY Nurse to provide their care? To learn more about The DAISY Foundation and The DAISY Award, please visit www.DAISYFoundation.org.

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References

1. The DAISY Foundation. What is The DAISY Award? https://www.daisyfoundation.org/daisy-award. Updated 2017. Accessed July 2, 2018.
2. Riesenberg LA, Leitzsch J, Cunningham JM. Nursing handoffs: a systematic review of the literature. Am J Nurs. 2010;110(4):24–34.
3. Nether K. The art of handoff communication. https://www.jointcommission.org/quality_reliability__leadership/the_art_of_handoff_communication/. Published December 7, 2017. Updated 2018. Accessed April 18, 2018.
4. The DAISY Foundation. The DAISY Award honorees. https://www.daisyfoundation.org/daisy-award/honorees/kathy-mc-lernan. Updated 2018. Accessed April 18, 2018.
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