Deescalating tough situations with empathy in the MICU
What sort of questions do you ask yourself when you come across an agitated individual?
Do you ask if they’re comfortable? Do you wonder if there’s something happening making them anxious? Will adjusting their care deescalate their situation? Paying attention to someone’s humanity and responding with empathy can often lead to the best possible outcomes.
“I try to approach every patient with an open mind and an open heart,” says Laura Manuel. “When thinking about their reactions, I imagine what it might be like to wake up in the hospital with all these tubes and wires and people rushing around. It’s disorienting.”
As a new nurse in the Medical Intensive Care Unit (MICU), Manuel, BSN, RN, CCRN, was recently recognized by her colleagues after she showed an exceptional level of empathy for an agitated patient.
“I remember walking in and seeing this patient trying to climb out of bed and pull out their feeding tube,” she says. “I called the provider in and pointed out what I saw. I think I asked, ‘Can we dial back some things to see if that helps?’”
And it did.
Her compassion and dedication to dignified care earned her a DAISY Award.
Prioritizing safety for patients and staff
Manuel recalls walking in on the agitated patient and noticing that they were restrained.
“After we determined it was okay to remove the feeding tube, I started wondering about the restraints,” Manuel says. “Removing the restraints calmed the patient down a little bit but they were still in an altered state of mind and were pretty agitated the rest of the day. So, I chose to stay with them all day.”
Medical restraints are used in hospitals across the country when a patient is a danger to himself or others, which can include when a patient is delirious. For Manuel, it’s a unique balancing act to look at what’s best for a patient and creating a safe environment for providers. Manuel says they were comfortable removing the restraints because either herself or a sitter would be in the room with the patient the entire time.
“I wanted to make sure they had consistent care and routine. I think that creates an environment where patients feel comfortable and aren’t acting on their anxieties of being in the hospital,” Manuel says.
Delivering routine, compassionate care
Manuel praises her pod mates and the entire MICU team who supported her dedication to the patient. They allowed her to take breaks for herself in between compassionate moments with the patient.
“I remember we gave this patient a bath and washed their hair. I think sometimes the feeling of a warm cloth on your back or arms or even just a human touch can calm somebody,” she says. “I thought that maybe they hadn’t had much self-care in a while because they had been so agitated.”
Creating a space that’s comfortable and calming falls in line with Manuel’s belief about dignified care, saying she and her fellow nurses continually look for ways to provide a sense of normalcy for patients.
“To me, dignified care is maintaining a patient’s autonomy and a sense of routine,” she says. “I just think about what I would want if I were a patient."
