BWH Nurse Narrative:

Eleanor Bergin Ericson, BSN, RN

Editor’s Note: Eleanor Bergin Ericson, BSN, RN, is this year’s Mary S. Fay Essence of Nursing Award recipient. This narrative, which was part of her impressive nomination package, illustrates the importance of connecting with patients and their families and its lasting effect. For Bergin Ericson, this relationship evolved organically from what she considers daily and routine acts.

In January of 1992, I first met Andrea, who was a 39 year old being admitted with a history of Eisenmenger Syndrome. She was to undergo the first heart-lung transplant at Brigham and Women’s Hospital. There was a lot of unknowns on our part and the patient’s and family’s part in terms of what to expect related to her outcome. I had taken care of many patients undergoing surgery and had come to know the routines associated with each kind of surgery and was able to detail step by step what the patient was likely to experience and what they could expect over the course of the post-operative period through recovery. This was a situation where the medical team, patient and family were going to be taking each day at a time, learning from one another what the best course would be for each day.

During the first few weeks of caring for Andrea during the acute post-operative phase, I came to know the family and through them a better understanding of Andrea’s life. She was very close to her mother, father and two sisters. The family was a very loving and supportive family who had always encouraged (expected) that Andrea would live and enjoy life as much as those who did not have the physiological limitations she was living with. She had gone to college and traveled to Europe with her family. She had always taken a keen interest in dogs as a result of being around her father who was a veterinarian. She loved her own dog, Chloe. She was outgoing and positive, which was reflected in the numerous friends who came to be with her and offer their support.

The weeks of Andrea’s stay in the unit became months of a roller coaster ride with her periods of worsening and then improving and then worsening again. During this time, I and other members of the nursing team began to coalesce with the family, almost becoming an extension of the family for the periods of time that they could not be present at the bedside. We began to focus more on what we could do to provide normalcy (to model the family’s behavior) in this very protracted hospital stay. Routines and relationships began to form. The family often brought in food for themselves, Andrea and the nurses as a way of providing opportunities for socialization for Andrea. Given that Andrea was not a “day person,” and liked to set her own schedule about how and when she would carry out the routines of the day, she and I often spent the later evening hours doing activities she would do at home—watch a movie, wash her hair, having her friends visit late into the evening. When she was stable enough we would take wheel chair trips outside to break up the monotony of the day. She developed relationships with other members of the team caring for her. They, too, recognized her graciousness and bravery and went the extra mile, like the resident who not only went to CT scan with her but sat with her holding her hand during the testing. Any of the activities for celebrations on the unit were attended by the family and Andrea. When members of her team were off duty for a day or two, they would call in to find out how her day was going. At one point, Andrea was feeling very depressed and talking about how much she missed her dog, Chloe. We made a plan with the family (sanctioned by the Thoracic/Cardiac team) to have the dog brought in on the weekend to visit Andrea. This was no small project given that the dog was shepherd-size and we were trying to be as inconspicuous as possible. The visit made all the difference for Andrea who was able to reconnect with the dog she loved. After many months, Andrea was discharged home.

Following her discharge the family sent in a catered lunch for everyone who had become “their extended family.” Only a few weeks later Andrea was readmitted and died. Since her death her family has sent cards to the nursing staff on every holiday. The family sent me and other team members a copy of a children’s Christmas book that a friend of the family had written. The Christmas story was to memorialize Andrea’s birthday on Christmas and her bravery through the years until her death. I and others on her care team have attended anniversary masses for Andrea with the family. This has provided a means of reconnecting with them and to validate the importance of Andrea to all of us.

During the seven years since Andrea’s death, I have frequently reflected on my experience, and the experiences of the nursing team, in caring for Andrea and her family. That experience made me so much more aware that what I consider routine in my daily work is not routine for patients and families. Each time a card comes to us on a holiday, it reaffirms for me the importance of learning from patients and families. The simple things that can be done to make them feel we are invested in them as individuals and as a family. As a nurse I can become an extension of the family. When a family is separated by hospitalization, I can provide the sense of security, caring and emotional support that they would normally provide for each other.