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  1. Alejandro, Josefina Inoturan DNP, RN

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I WAS VISITING the long-term-care facility where my nursing students were scheduled to begin their first clinical experience. Walking toward the nurses' station, I passed a woman with her festively decorated walker.

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"When are your students coming?" she asked.


Noticing that I hadn't recognized her, she readily introduced herself.


"Hi, I'm Ms. B, remember? How is Christie?"


"Oh, hello! My students will be here in two days," I replied, surprised that she remembered me. "Christie is doing fine and is in the next level of the nursing program."


Ms. B tried to keep pace with me, indicating that she wanted to chat some more about her experience with Christie, one of my former nursing students. I recalled that in Christie's first clinical rotation, Ms. B was her assigned patient. Christie had told me that she'd read Ms. B's medical records to learn about her hypertension and prescribed medications. She admitted that she was unsure of what she could do to help Ms. B. I said that getting to know her patient was the first step toward providing excellent care.


Ms. B remembers

As we approached Ms. B's room, she reminisced about the times she'd spent with Christie and how Christie had taken the time to talk with her. She treasured these conversations, especially when she was missing her niece, her closest relative.


Ms. B confided that she wanted to share some of her conversations with Christie with me. I listened with interest when Ms. B acknowledged that she'd revealed to Christie her preference for staying in her room, just lying in bed. She recounted Christie's willingness to listen as she talked about missing her former life as a prolific student who'd earned three degrees at a master's program level. Ms. B told Christie that with her aches and pains, she'd lost the energy to even read a book and lamented that all she did now was watch reruns of old movies on TV.


Ms. B's story

I now recalled Christie telling me about Ms. B's background. This 80-year-old patient had been living with her niece for several years. With her hypertension, constant complaints of pain, and other health issues, her niece felt Ms. B needed constant supervision. The decision was made to move Ms. B to the long-term-care facility 2 years ago.


Christie further informed me that, according to the clinical nurse, Ms. B and her healthcare team had drawn up a plan to get her more involved with her neighbors and increase her daily activities. However, Ms. B often didn't participate, saying she just felt "too tired."


Formulating a new plan

I reviewed Christie's nursing care plan for Ms. B during student conference. Using the NANDA nursing diagnosis of ineffective activity planning, Christie formulated a plan to motivate Ms. B to take a new interest in her surroundings and shared it with the rest of the healthcare team and her patient.1


Christie's enthusiasm must have been contagious. Ms. B fondly remembered that when unlicensed assistive personnel came to bring her to the physical therapy room for exercises, Christie would accompany her and stay nearby to cheer her on. Ms. B had so looked forward to her workouts with Christie as cheerleader! She even claimed her aches and pains were receding. As Christie's clinical rotation ended, she and the nursing student wished each other a bright future.


Patient as teacher

It wasn't until the first day of my new students' clinical rotation that I witnessed what that future meant for Ms. B. Once she was so despondent that she'd resisted leaving her room. Now she freely roamed the hallways with her brightly decorated walker, enthusiastically giving the next nursing student assigned to her a tour of the facility.


Christie's future as a nurse is equally bright. Even as a student, she embodied the spirit of nursing. Thanks to Christie's kindness, persistence, and creativity, Ms. B pays it forward, reaching out to teach the students assigned to her the art of compassionate caring.




1. NANDA Nursing Diagnosis List for 2015-2017. http://healthconditions.com/nanda-nursing-diagnosis-list-2015-2017. [Context Link]