My patient was a 54 year old, physically active, self employed tree trimmer, who had a massive heart attack. After a stay in ICU he is stabilized and is going home for 1 week with a “lifevest” defibrillator, while he awaits his surgery for stent placement and permanent defibrillator surgery.
He has a very complex situation. He is young and just had a massive heart attack. He is a smoker and now has to quit. He was physically active and has a loss of ability to perform normal activities due to SOB. He has the loss of income as he is unable to perform his job and depression over ho new diagnosis. The traditional patient education approach would have been to present the materiel and information and expect that the patient would comply. We would …show more content…
I used the Collaborative Care and Self Management Educational models. The conversation went like this:
Nurse: Tell me what concerns do you have about wearing the lifevest?
Patient: Wearing this life vest isn’t for me. I give it 2 days before it comes off. It is just another reminder of how worthless I am now. Real close to game over!
Nurse: Tell me more about why you feel this …show more content…
Nurse: I understand wearing your life vest reminds you of your heart condition, however, it is only for a week until your surgery and can keep you safe until then so you can get back out there to help your friends.
Nurse: Tell me how important is it for you to get through this next week, so you are ready for your surgery?
Patient: Very important.
Nurse: Tell me, what would a goal be for you over this next week.
Patient: To wear the life vest and not start smoking, so I can have my surgery. With any luck, I may be better than before my heart attack.
Nurse: That is a great goal. We will arrange for you to receive your life vest before you go home. I will call you your first day to see how you are doing. Here is my number and Dr. Edward’s contact if you have any questions after you get home. How does that sound?
Patient: Good
Nurse: Describe in your own words what your goal is and what your plan is this week
Patient: To wear the life vest to keep me safe until my surgery and not smoke. I will call if I have any problems.
Nurse: Are there any barriers/reasons you won’t wear the
He has a very complex situation. He is young and just had a massive heart attack. He is a smoker and now has to quit. He was physically active and has a loss of ability to perform normal activities due to SOB. He has the loss of income as he is unable to perform his job and depression over ho new diagnosis. The traditional patient education approach would have been to present the materiel and information and expect that the patient would comply. We would …show more content…
I used the Collaborative Care and Self Management Educational models. The conversation went like this:
Nurse: Tell me what concerns do you have about wearing the lifevest?
Patient: Wearing this life vest isn’t for me. I give it 2 days before it comes off. It is just another reminder of how worthless I am now. Real close to game over!
Nurse: Tell me more about why you feel this …show more content…
Nurse: I understand wearing your life vest reminds you of your heart condition, however, it is only for a week until your surgery and can keep you safe until then so you can get back out there to help your friends.
Nurse: Tell me how important is it for you to get through this next week, so you are ready for your surgery?
Patient: Very important.
Nurse: Tell me, what would a goal be for you over this next week.
Patient: To wear the life vest and not start smoking, so I can have my surgery. With any luck, I may be better than before my heart attack.
Nurse: That is a great goal. We will arrange for you to receive your life vest before you go home. I will call you your first day to see how you are doing. Here is my number and Dr. Edward’s contact if you have any questions after you get home. How does that sound?
Patient: Good
Nurse: Describe in your own words what your goal is and what your plan is this week
Patient: To wear the life vest to keep me safe until my surgery and not smoke. I will call if I have any problems.
Nurse: Are there any barriers/reasons you won’t wear the