We are exploring comfort theory in class. Our assignment this week is to
post an exemplar story about comfort in our clinical setting. Here's my
attempt at this:
I don't have a specific story of comfort to write about. I will try to
gather the ideas that I believe have helped to provide comfort to
patients in my nursing care. The most difficult part of providing
comfort to a patient coming to the OR is that each of their experiences
and circumstances make their situation unique. I must tailor my brief
time with them while they are conscious to provide the best care (and
comfort) I can.
Perioperative nursing is quite different from bed-side nursing. We
have limited contact with conscious patients; rather our patients must
trust us to care for them when they have lost all ability to care for
themselves while under anesthesia or sedation. Patient advocacy is one
of our biggest responsibilities. Some patients are
well-prepared for surgery or are in such a state that surgery is
something to "just get done with it." Other patients are not ready for
the loss of control that they must experience just getting to the OR. We
take their clothes away, we pry into their private information,
question after question after question. Does anyone read the chart?
Interviewing
the patient preoperatively is one of the most important forms of
advocacy I do. I do an extremely brief head to toe assessment, gathering
information about my patient in a multitude of ways. Some of the ways
in which I comfort a patient during my interview are interesting to
consider:
I introduce myself so I am no longer a stranger,
I assure the patient that I will be caring for them during surgery,
I make sure the correct patient is getting the proper treatment,
I make sure to verify important information about the patient (i.e., allergies),
I also make sure to ask about particular concerns, just in case the patient forgot (i.e., allergy to iodine or latex)
I make sure that the patient has an adequate understanding of what surgery they are having,
I inform the patient about the environment of the OR (cold, bright lights, narrow table, noisy, etc.),
I assure that patient that if they need anything at anytime they only need to say so,
I
also inform the patient about what to expect in those first few minutes
in the OR (i.e., lots of people talking, attaching monitors, placing
SCDs, safety strap),
I then instruct the patient about what to expect
when they wake up (i.e., hair removal, tubes and drains, catheters,
funny looking skin from dyed soaps).
For the most part, patients
seem to be calm and ready for what's next by the time I am finished with
my interview. Some aren't, especially when I start seeing them get
nervous about what it will be like after surgery ("I'm going to have
tubes/a catheter?"). These patients are sometimes the most challenging. I
try to pay attention to their expressions and tailor my instruction to
what they can emotionally handle at that time. Some patients will state
"The less you tell me about what you're doing the better." These are a
rare exception, but it does cut my interview down significantly. Just as
rare is the patient that thanks me when I am done for telling them
everything.
The last question I have for my patient is, I think, one
of the most important. It can also convey comfort because it lets the
patient take control: Do you have any questions for me? If the patient
does, I can offer them answers that usually provide further comfort (or
find someone who can). If they do not have any questions, then I assure
them that at any time if they do think of a question, they are
encouraged to ask. I think giving the patient some sense of control of
their situation can provide them with a great deal of comfort.
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