Professional Nursing Continuum Generic Narrative

Employee #: __________________________ Professional Nursing Continuum Generic Narrative
Narrative
This day is just like any other day and it is not that I have witnessed death for the first time. I work as a
nurse in the step-down intensive care unit (SICU) and thus have to witness several complicated cases
and painful deaths every day, but there are always few cases that keeps a considerable mark on your
brain. I experienced the same thing with one of my patient, who was suffering from chronic Obstructive
pulmonary disease (COPD).
She was 84 years old and has already lost her husband, whom she adored and without whom she
felt life was a lot less worth living- Two years before when her husband died of Cancer. It has to be
remembered that COPD is a chronic disease and for those living with COPD , every breath can be difficult
and as the disease progresses the patient gradually faces significant challenges in carrying out the life
processes, the communication abilities, spiritual and the psychological well-being, impairment that is
equivalent to the distress caused in deadly diseases like cancer.
The patient was being admitted to the hospital with severe a respiratory distress. She had a past
history of COPD exacerbations and had visited the hospital several times before. Although I got the
opportunity to spend a very little time with her, but she was very sweet and jovial in communicating in
each of the health care staffs and truly captured our heart, in spite of all the pain and sufferings.
At the time of admission the patient had a mild respiratory distress, but the family admitted that
they did not want to risk her lives and wants her to be kept under the supervision of experts. In spite of
tremendous efforts from the doctors, the condition of the patient deteriorated than getting better.
Finally after three days of prolonged struggle, the family decided to transfer her to the hospice care,
which aims to give a quality care on her final days. On the day when the concerned patient was being
admitted in SICU, my shift time has not yet started. The patient was under the non-invasive ventilation
and was receiving the BiPAP therapy. I was going through the handover and was checking the medical a
history and the chart of the patient, when I noticed that her family, sister, niece and patient's best
friend, had already arrived before at around 6 P.M and were spending some quality time with the
patient. The physician in charge decided that the patient has to be shifted from the BiPAP therapy to 2L
oxygen. Noticing her, I felt," In spite of all the love and bonding we still have to leave one day, no matter
who you are or how much you are being loved". I felt sad but I was used to all these kind of feelings as I
knew I would be seeing somewhat similar picture the next day. I concentrated on the discussion with
the RN regarding the change of the medications and the level of the oxygen concentrations.
Being a nurse, I assured patient's sister that we would take best care of her in lessening her
distress. The condition of the patient was deteriorating with time. The patient was continuously
experiencing increased cough and dyspnea. At the time of admission the patients was suffering from
severe respiratory trouble and chest heaviness. She was panicked, restless, tachypnic and was not even
able to talk due to the exacerbation.
At around 9 P.M she was switched from BiPAP therapy to 2L of oxygen and 2mg morphine and 1mg
ativan was given to the patient for comfort at an hourly interval. We were a bit perturbed if the