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Reflections of a Notecard

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Reflections of a Notecard

A nursing student named Carrie was wondering why Mary Sue was in long-term care. Carrie could tell she had dementia but, Mary Sue spent most of her time in a recliner near the nurse's station, asking anyone who walked by why she couldn't go back to bed. "It isn't time yet, Mary Sue," the staff would reply. Carrie asked one of the nurses why they didn't just take her back to bed. The nurse replied "when we do, she asks to return to the recliner."

When Mary Sue is out here we can keep an eye on her. She can look out the window and she smiles more. Carrie had yet to see a smile. Techniques used to distract Mary Sue: towel folding, cards, books did not seem to work. Mary Sue would continue to reach out and repeat her request.

When Carrie arrived at work on the Tuesday before Thanksgiving, Mary Sue had a huge smile on her face. When Carrie asked what was making her happy, she said that her family was coming to see her that evening. Mary Sue was so excited that Carrie was eager to meet her family. But they weren't due until 5pm, and it was only 7am. On every trip past Mary Sue's recliner, Carrie had to remind her that her family was coming.

It was hard to see the anxiety on her face when she thought her family had forgotten her. Carrie thought there had to be a better way to reassure her. She noticed that one of the occupational therapists used index cards to help patients remember important things, so Carrie found one and wrote in big black letters: "Mary Sue, you have nothing to worry about. Your family is coming." The next time she grew anxious about her family, Carrie gently said, "Read your card Mary Sue." She would look down, inspect the words closely, and her smile reappeared. The other staff noticed and began reminding her to read her card whenever she asked about her family. After a while she began to read the card on her own, and each time she'd smile.

Carrie never did meet Mary Sue's family. She was assigned to a different floor for her last clinical rotation. Since then the staff have written reminders on cards for other patients, although it has never worked quite as well as it did with Mary Sue.

It would not be a bad idea for everyone to carry a notecard to be reminded to stay strong and focus on what really matters. When the next group of nursing students came in, they were encouraged to use this technique as well. Patients with dementia can be very anxious and need positive reinforcement at times. Caregivers need to remember to take some extra time with dementia patients.

This story reflects on how a new nursing student realizes that patients are not the only ones who need reassurance. Like Mary Sue, we all need reassurance, moment to moment and day to day. Like Carrie, we can all think of a phrase or saying that we have



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