Tuesday, October 16, 2012

holistic nursing and the surgical patient

A category 2 abdominal pain patient was brought into room 5 from the waiting room of my ER…She was an early 20 something who happened to be 17 weeks pregnant…she was complaining of diffuse belly pain, fever and nausea that had escalated over 48 hours.  I watched the tech wheel her by the nursing station to go into room 5.  She was petite in stature, and even smaller in appearance as she hunched forward guarding her stomach with her arms.  A very worried looking older woman accompanied her. 
I quickly exited out of my charting on the computer, grabbed her triage information and scanned it.  I went to the med room and collected an IV tray, saline, and a Doppler.  As I entered the room I quietly laid my equipment on the counter and walked to the stretcher.  Worried eyes looked at me from the face of this attractive young woman.  She sat on the stretcher in a semi-fowler position with her knees drawn up to her stomach.  She held the older woman’s hand and barely changed expression as a tear fell from her left eye. 
I outstretched my hand to her as I introduced myself to them both.  “My name is Bobbi and I will be your nurse tonight, I promise to take very good care of you and make you more comfortable as soon as possible.” 
“Thank you…and my name is ***** and this is my mother….I’m pregnant” she tearfully answered.
After she finished telling me about her abdominal pain I examined her, assessed her vital signs again and started an IV, drew blood and hung NS at 150/hr.  Using the Doppler I found her baby’s heart beat to be a bounding 176…this brought a fresh tirade of tears from both women as they visibly exhaled with relief that the baby was okay.  Her temp was 102, respiration's 22, heart rate 122 blood pressure 126/70, lungs were clear bilaterally with a room air sat 100%.  Her skin color was pale and very warm to touch.  She rated her pain 8/10.  She had positive bowel sounds all quads and was extremely tender to the slightest touch with positive rebound tenderness. 
As the next couple of hours went by with tests and the diagnosis of appendicitis ~ I carefully took care of this patient as we awaited her trip to the OR.  She was quiet but strong…she was childlike when the pain intensified and somewhat soothed by her mother’s reassurance.  I administered morphine often in small doses to alleviate her pain…I gave her cool cloths for her forehead, dimmed the lights and sat with her.  I offered her constant reassurance that her baby would be okay~ when my interventions for her and my other patients were completed,  I was able to give her a hand massage and Reiki as we waited. 
What I noticed, as did her mother, was that during the hand massage and during the Reiki treatment her pulse significantly lowered and her breathing slowed as her face relaxed.  The pain meds helped of course but the visible transformation of her facial and body features during the relaxation therapies was so obvious that her mother commented on it several times.  As I wheeled her to the OR she again asked me for reassurance of her baby’s safety…I gave this to her.  Before I left her in the care of the OR team she tearfully took my hand and thanked me for caring about her and her baby…she thanked me for the way I cared for her in the ER… “the touching therapy helped me so much…thank you…Can you come and take care of me when I’m in labor? She asked with a grin”…
Walking back down to the ER I felt so thankful that I was able to take care of this patient in her wholeness…body/mind/and spirit.  I have been blessed these last few years to have my nursing skills enhanced with the knowledge of holistic care and the learning of alternative therapies like hand massage and Reiki.  My BSN classes included a Reiki course to which I became a level 2 practitioner… I now have the awesome pleasure of teaching Nur. 101 and I’m able to pass on the teachings of holistic care with real life examples of what it looks like.  Being able to nurse someone holistically positively affects not only the patient but me as well… I have a very grateful heart.


  1. Bobbi, this is so wonderful! You are such an asset to the nursing profession, UMA, and the community! I hope when we have our next trip to the ER that we are lucky enough to have you!

  2. Amanda... thank you. It is my awesome pleasure to serve those that God puts in my path... and Im so happy to working with you at UMA!!! I hope if you EVER need a nurse in the ER that I am there~ I promise I will serve you well. :)

  3. Great Story! did you know you could become board certified in Holistic Nursing?
    American Holistic Nursing Association www.AHNA.org I am on the board and it is a wonderful organization where caring and presence are the norm.

    and for training http://birchtreecenter.com/certification.html

    there is a whole body of nursing knowledge incorporated in the holistic nursing practice standards. thanks for highlighting Holistic Nursing

    1. Thank you for the info you provided me with Holistic Nurse Marie~ and hopefully one day in the near future I can begin that process... Ive been practicing holistic nursing for some time but life has been so busy with the many things Ive got my hands in that this hasnt been a top priority... I do believe in its value and one day i will get there! Thank you for your obvious passion for holistic nursing!!