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Miracle Man:Care of cardiac arrest patient educational, uplifting

Monday January 14, 2013
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Every once in a while you meet a patient who changes your practice. If you are lucky, you meet a patient who changes your life. Ben was that patient for our unit. Caring for him renewed our commitment to our patients and each other.

Ben was found by coworkers in cardiac arrest in late November 2010. He was airlifted to St. Elizabeth’s Medical Center just outside Boston, where a Code STEMI was called. After being stabilized, he was transferred to Seton 6 West.

When we first met Ben, who then was 49, he was in a near-vegetative state. He occasionally seemed to respond to his name, but was unable to interact with us in a meaningful way. He required complete nursing care for all ADLs. He had a moderate degree of agitation and was difficult to comfort.

With all of the challenges he faced at this time, one thing was clear: Ben was making eye contact with his wife, Mary. It wasn’t consistent, but it was meaningful. Mary drove two hours a day to visit. She was able to take time off from her job and was the key to Ben’s recovery.

From Christmas through the beginning of February, Ben made steady progress. It was an emotional and triumphant moment when he first started walking again. Soon he was able to eat by mouth, and his diet advanced from pureed foods to solids. His interactions with his family and us were significant. It was an amazing time, seeing this man make such strides. We began to know Ben as the man he was before his MI.

Then, in February, his progress inexplicably screeched to a halt. Ben never developed any medical complications, but something happened emotionally. He became increasingly agitated, angry and afraid. We thought it was a type of post-traumatic stress disorder. Ben fought us when we tried to help him wash, eat and ambulate. Mary was discouraged and we were frustrated, and trying to figure it out was our main topic of conversation.

The medical staff did not share our concerns. Our request for a psychiatry consult was denied. Finally, on a particularly rough Sunday with Ben, we adamantly insisted on a psych consult. Ben started Seroquel, and within a few weeks there was a significant change in his behavior.

By the middle of March, Ben was participating in his care again. He was walking, feeding himself and becoming more independent with ADLs. Ben liked to sit in a chair in front of the nurse’s station and "supervise" the unit. One day I was dragging linen bags to the laundry chute. Standing behind me with a wheelchair, Ben called my name. He put the laundry bags on the chair and brought them to the chute with me.

After Mary returned to work, part of our care included taking pictures of Ben and texting them to her so she could keep up with his day. Ben became a part of our 6 West family and was a presence throughout the hospital. He visited the gift shop and cafeteria. When the weather improved, we accompanied him on walks outside.

On May 6, 2011, Ben was able to go home. His wife, daughter, granddaughter and brother joined us for a celebration in our break room (where Ben frequently had taken "breaks" with us). We said goodbye to a patient and family we never will forget.

The following August, Ben and Mary returned for a visit. Mary thanked us for not giving up on Ben, because they were not ready to let him go. We thank them, because they taught us about advocacy, inspiration, love and hope in a new and dynamic way. •


Lisa Mancuso, RN, BSN, PCCN, CCRN, LNC, is a staff nurse on the Seton 6 West/Progressive Care Unit at St. Elizabeth’s Medical Center in Brighton, Mass., and owner of Mancuso Medical Legal Consulting (www.mancusomedlegal.com). The names of the patient and his wife were changed for this article. Write to editor@nurse.com or post a comment below.