Transpersonal caring relationships in Nursing

I walked into room 15 to introduce myself to my new migraine patient and I found her rocking back and forth on the stretcher.  Both of her hands were firmly pressed into her forehead and covering her eyes.  The chart says my patient is 17 years old but her tiny frame all curled in a ball made her look 10 as she rocked in pain.  An older woman sat in a chair in the corner of the room and looked at me with pleading eyes. 

I quietly closed the door and moved to the stretcher.  I sat the chart down on an empty chair and softly introduced myself to my patient and her mother. 

“Hello (name), I am Bobbi and I will be your nurse today…I promise I will get you feeling better soon.”

“Please help me,” my patient answered without moving her hands from her head.  I asked her to rate her pain on a scale of 1-10 with 10 being the worst pain.  She whispers “9”.  I asked her an acceptable level of pain and she whispers “not a 9.”

Her mother informs me that my patient has a 4 year history of migraines since suffering a major trauma…she mouths what the trauma was to me with a look of great distress.  I nod to her that I understand and move to my patient.  I tell her that I will start an IV and hang some fluid to get started while we wait for the doctor to come in.  I turned the light off as I left the room.

I put her chart in the doctor’s rack and went to gather supplies.  My patient was fourth in the rack to be seen~ hence about an hour.  I had one other patient at this time so I went to check on them and then returned to my little teen’s room. 

I entered her room and softly told her, “I need to turn the light on while I start your IV but I will turn it off as soon as I’m done.” I covered her with warm blankets and put my supplies on the bed. 

She continued to rock back and forth without answering.  I quickly started her IV and hung the saline wide open for a 500cc bolus.  I got two washcloths out of the closet and ran them under cold water.  I placed the cloths on her forehead and the back of her neck.  Tears leaked from her eyes.  I went to ask the doc for some orders for pain meds… the doc said, “I have to examine her first.” 

I went back into her room and asked her permission to give her a hand massage.  I explained to her that it would help relax her and ease her pain. I asked her if she was allergic to the scent of peppermint and if she minded me using the essential oil while I massaged her hands… She agreed.  Her mom remained sitting in the corner watching my every move. 

I slowly and deliberately massaged each of her hands for 10 minutes with the peppermint oil.  After the first few minutes she visibly relaxed and tension began to release from her body.  After the first hand was finished I moved to the other side of the bed to massage her other hand~  she was completely still and her face was relaxed…her mother patted my shoulder as I sat down in front of her and whispered “thank you so much” into my left ear.  I finished the massage of her second hand and just sat quietly for a moment observing my patient.  She opened her eyes and smiled at me.

“I didn’t believe that was going to help but I feel so much better!”  She then rated her pain a 5 on the pain scale.  I smiled, refreshed her cold cloths and told her, “I will let the doctor know what we have done and he will be in soon.”  I left the room and went to doc…I informed him of my nursing intervention…he looked up and said, “Cool.” 

The end result of this encounter~ a happy patient~ hugs from each lady in room 15~ and a satisfied nurse~ a patient who only required a bolus of fluid, hand massage and an injection of 30mg of toradol before going home a very happy girl.  For me ~ another example of the power of nursing presence, alternative therapies and transpersonal caring relationships!