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Therese Richmond, PhD, CRNP, FAAN, GR’95

“Around 1980, I worked in a 14-bed trauma ICU in Washington DC as a primary nurse leading a team of 7 nurses who provided care to our primary patients 24 hours a day, 7 days a week. One primary patient was a 19-year old man who had survived a serious motor vehicle crash. He had a brain injury and was slowly emerging from a coma and had complex wounds over his entire body. He was in isolation and my team and I spent hours each shift in his isolation room without a break to manage his wounds over several months.

One day his parents sought me out to thank me for taking care of their son. They said they were so happy we were their son’s primary group since they had been told we were the best group in the entire ICU. I told them on behalf of the group how honored we were to have the privilege to care for their son and to work with them. At the end of the conversation, I asked who had told them we were the best primary group. I thought it was likely one of the intensivists, the surgeon, or therapists. The parents told me the housekeeper had told them.

I was initially surprised, but as I reflected on this, I was even more pleased. Our housekeeper did not know how knowledgeable or experienced we were. But she had a birds-eye view of our care—someone who we never thought of watching us. Indeed, she was a silent witness to how we carried on non-stop, one-way conversations with their son, how we played music we knew he liked, and how carefully and gently we handled him during the many hours we were alone with him providing complex wound care in isolation.

To this day, I keep this experience central to all I do. To me, the touchstone of excellence is how we manage our most vulnerable patients when we think no one is watching.”

Photo by Eric Sucar

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