A Conversation with Sarah

This last week I spent three days with 7000 nurses. 7000 people who care for others. It was the ANCC conference in Baltimore. As you might expect the ratio of males to females is still skewed towards women – like 98%. So 6800 plus women were learning by day and partying by night. It was a lot of fun. The focus was Magnet Certification. Magnet is a quality/collaborative designation to a hospital of nurses and physicians working on a process that yields a better product. The product is, of course, a better patient outcome. It is also peace of mind for patients and relatives that the best care is being given. It is additionally an award that instills pride in the workplace. I learned all this in one conversation with a delightful Interventional Radiology nurse named Sarah.

I have struggled for five years with a question: What more could I have done for Annie to improve her outcome? I’ve heard it called “survivor guilt” and I have tried through therapy sessions (though very few) to reconcile the nagging feeling that I should have known more and taken more action. I should have known where to send Annie for the best care. I should have known which hospital provided the best stroke response. When to airlift and how. But the truth is it wasn’t even on the radar. How would one ever expect a perfectly healthy 48 year old woman to have a massive stroke. If either of us was going to have an incident it would have been me. After all, I was the risk taker and possibly the one with the bad habits. But the guilt still permeated my downtime. In the back of my mind I felt there was more I could have done. So my conversation with Sarah drifted to this subject and Sarah knew a lot about it.

In the last five years or so great strides have been made in Interventional Radiology. New tools, devices like shunts, doctor designed special tools, and probably most important a host of new techniques. Unfortunately the equipment and its use remain fairly narrow. In Texas, Houston and Dallas have stroke centers that are state of the art. As one moves further out the equipment tends to be there but the expertise thins. Interventional Radiology in Austin doesn’t match the larger cities. She also pointed out that the expertise in diagnosis has only really developed in the last five years. She also noted the outcomes, while varying widely, are also just beginning to be chronicled. I told her of Annie’s successes and she was in awe. The professionals that do the saving work rarely get to see the long-term result.

Her last words were “Stop beating yourself up”. I’ll try.