Akilah Abdullah: Empathy First

Being a patient advocate does not always require empathy, but it can be an agent. Throughout nursing school in every class I heard, “Listen to your patient whenever they tell you they are having pain!” Even if the patient looked like they were fine and could hold an entire conversation, within reason, you always believe the patient.

Over the summer, I worked as a patient care technician at a local hospital in Greenville. The unit that I usually worked on was a thirty bed floor. Patients were discharged home after two to three days on the floor. This was possible because the patient was typically stabilized and of lower acuity than other units. 

There were some nights where I was not on my usual floor, and had to float. Floating to another unit is just being temporarily reassigned for the shift to help. Tonight was another night I floated to another unit within the hospital system. This was my first time being a technician on this particular unit. For the many nurses and technicians, this was their second or third night shift in a row. The previous nights had run smoothly and efficiently, so the pattern was expected to be carried out.

Walking onto the unit, I passed rooms of people sitting in the bed with chest tubes protruding unnaturally from their chests. There were also people who had drainage bags hanging from large surgical sites that filled up with drainage. The procedures on this particular floor were invasive and aggressive. Given that this unit was of higher acuity than normal, I did not expect to have the same patient population to care for. These patients were in a critical care situation and had been there for days to weeks. I was slightly surprised that a new patient had just been admitted onto the floor minutes before I had arrived. 

I received a bedside report from the patient care technician who cared for the set of patients I was to care for that night. I then waited for the commotion in the new admit’s room to die down to receive information about the patient. After the patient was admitted, the nurse completed her initial questions, administered the initial pain medication, and exited the room. She sat down at the nurses station and documented about the patient. I approached the nurse and waited for the report.

The patient we collaborated with had come out of a sickle cell crisis a few days prior. With sickle cell disease, the patient experienced severe pain due to the blood cells being “moon” shaped and causing clots within blood vessels. Due to severe pain and multiple exacerbations, the patient had built a tolerance to certain pain medications.

After allowing the patient time to rest, I entered their room. Immediately upon entry the patient expressed being in severe pain. They believed that the medication had not worked effectively. They mentioned the pain to the nurse awhile prior, but had not received or heard anything else. The pain medication was scheduled and only to be given at certain times and intervals by the nurse. Handling this situation in a timely and professional manner was of utmost importance. Failing to listen to a patient while they are in pain can cause a cascade of other complications. I talked to the nurse about the complaint of the patient and waited for action.

The time seemed to creep along, so I talked with the patient and offered therapeutic communication. We talked about the few activities that they liked to do as I held the patient’s hand. The patient squeezed so tight that my hands lost their color and feeling. This indicated to me that the patient was in severe pain.

I found the nurse, and inquired about what was being done from the time we last spoke. I presented the evidence of the patient’s recent vital signs. The patient’s heart rate and respiratory rate were significantly increased from the four hours prior.

I had empathy for the patient throughout the situation. Feeling unheard in any medical setting may feel discouraging, especially in relation to pain. I had too felt unheard by providers before. I understood the patient’s pain about being unheard. Through communication between the patient and I, they were able to understand the situation better. It was no longer a situation of not being heard but of waiting for what was ordered.

Akilah is a senior nursing major graduating in May 2022. Her breakaway was spent at Prisma Health as a patient care technician on numerous units. After graduation, she plans on moving to North Carolina and working on a NICU unit.