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| FEATURE STORY | 06/01/2009 |
| Author: Kristine Brennan | |
| Around-the-Clock Compassion | |
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| For Robin Sutton, RN, her father’s illness was the catalyst for a nursing career that has spanned more than three decades. He developed metastatic prostate cancer and attempted to treat it with megavitamins, metal bracelets, and chiropractic adjustments for the pain that coursed through his hips and pelvis. By the time Sutton’s father was hospitalized, he was suffering. That’s when the family met a compassionate LPN named Carolyn, whose example proved inspiring. “I couldn’t wait to start nursing school, so I started right after I graduated from high school,” Sutton recalls. After earning her associate’s degree in 1977, she began her career at UAB Hospital, where she has practiced ever since. Sutton is a staff/charge nurse on the 20 bed surgical intensive care unit (SICU) at University of Alabama at Birmingham Hospitals (UABH), a 950-bed referral center serving the southeastern US. She likens each hospital building to “a city inside a city.” The hospital holds Magnet status, and Sutton served on the committee that oversaw the Magnet application process. In the SICU, nursing excellence is often the deciding factor in matters of life and death. “I personally like to take on the more complicated patients and conditions,” says Sutton. The SICU provides an abundance of challenges, admitting patients from many different ports of entry, everything from general surgical patients to transplant recipients and complex ob/gyn cases that require critical care. “It is exciting and stimulating, all the energy and exhilaration,” she observes. Just a few of Sutton’s day-to-day responsibilities include assisting with intubations, bronchoscopies, surgical prep—and the occasional emergency delivery or bedside operation. As a charge nurse, she primarily triages admissions and transfers while additionally acting as a nurse manager extender, performing staff evaluations and scheduling. She rotates other days to having primary responsibility for two SICU patients at a time while training orientees and nursing students. “I enjoy their enthusiasm; always trying to soak up all the learning opportunities like a sponge.” Sutton thrives in the dynamic environment of the SICU, and she attributes the good match to UABH’s Registered Nurse Intern Program. Her intern program consisted of one year of fully compensated orientation, during which she received ample exposure to different patient populations and diverse nursing practice philosophies before choosing her specialty. The program exists today as a five-month orientation with precepting. Sutton praises the Nurse Intern Program as “an excellent recruitment and retention tool.” “A new nurse might think, ‘I want to do cardiology because, well, I got 100s on all my cardiology tests,’” she continues, “but in reality, she might find that she enjoys those patients less than, say, critical care patients. A few days in any one place just gives you a snapshot: maybe the unit you were on was just having a good day, or you discover a different treatment philosophy on another floor that’s a better match. [The program] is also attractive to employers, who see—if you’ve spent two weeks in one unit, really hands-on, and then in another—that you can adapt quickly to change and bring diversity of experience.” Sutton shares her knack for adapting to new situations, as well as her caring touch, with people in need both in and outside of UABH. August 29, 2005, was her birthday; and it was also the day that Hurricane Katrina slammed into Louisiana and Mississippi. As a former critical care transport (CCT) flight nurse, Sutton swung into action, placing calls to see where she could put her considerable experience to work. She wound up at the “loud, chaotic, and roaring” Red Cross headquarters in Montgomery, Alabama. Even though being a nurse gave Sutton priority status, it was a long and chaotic road to a makeshift command center in storm-stricken Gulfport, Mississippi. Her first night away from home was spent in an elementary school with no potable water, and sleeping on school desks. Her final destination was Pascagoula, Mississippi, where she was part of a team charged with improvising a first aid clinic in an empty courtroom. Hurricane victims stood sweltering for hours in long lines to get disaster-relief checks. Sutton “ran the line,” by offering care and support. She cut rags and dipped them in ice water until her hands were blistered in an effort to help cool people off. She passed out spiritual literature given to her from her chaplain and Bibles, which were grabbed up quickly. A few cases still stand out in her memory: a dangerously overheated 12-year-old boy who was locked up in the car for protection; a full-term pregnant woman having contractions who did not want to lose her place in line; and a man whose wife needed a transfer for emergency brain surgery. The man, who told Sutton his name was “Sam,” wanted to get his wife admitted to a facility that could better meet her needs. “I assured him that we had the best surgeons at UAB and that we had a jet that could transport her with a full medical team,” she says. Sutton gave him the number to call and offered to help in any way. She later learned that Sam’s wife had successfully undergone her operation at UAB. “He came to thank me at work and my son and I took him out for dinner.” “It hurt to see all these people who had suddenly become homeless with no jobs or money. Their hopes and dreams had been shattered. They were hungry and suffering so many losses, including loved ones and pets,” she says of the experience. “So you keep going and doing everything you can with whatever you have for as long as you can.” Upon Sutton’s return home, even simple things like enjoying ice cream and hugging her dog took on new meaning. A handwritten “Creative Cooling Award” certificate bestowed on her by her Red Cross colleagues is a “dearly treasured memento” of the journey. Sutton’s Katrina relief work was proof that she could perform under grueling conditions. When she contemplated an international medical mission, however, there were definite limits to what she would do: “I did not want to ride any elephants to the jungles, camels in the desert, or little boats where there were anacondas and piranhas waiting for your boat to overturn.” In February of 2007 she decided to go to Ambato, Ecuador, with Medical Mission Ecuador (MME), an organization founded 16 years ago by Henry Vasconez, MD, chief of plastic surgery at the University of Kentucky. His brother, Luis, Vasconez, MD, is chief of plastic surgery at UAB. Sutton accompanied Dr. Luis Vasconez and, Jobe Fix, MD, on their annual mission trip to Ambato. The trip coaxed Sutton past her comfort zone in more ways than one. More importantly, she worked in an operating room for the first time, scrubbing in on 20 general surgical cases. One of the biggest challenges she faced was learning the names and functions of numerous surgical instruments on the fly in what she describes as “quick on-the-job training.” Joining her in this adventure was fellow UAB SICU nurse Cheri Plasters, RN, who circulated in the OR on 20 pediatric reconstructive surgeries for microsia and cleft palate. She recalls handing over medical waste to their Ecuadorian hosts, who combed through it to salvage sponges, Foleys, gloves (washed and hung to dry) and other discarded equipment for cleaning and reuse. “They were very resourceful and utilized everything they could to the max,” notes Sutton, who came to care deeply for her patients and their families. “You have an appreciation and respect for the governing agencies in the United States. To see the impact on people’s lives makes you not want to leave, so you can give more. Even though I could not speak Spanish, we could communicate with our eyes, laughter, smiles, hugs, touch, and the tears when we left,” she says. “This is a universal language we all understand. All patients are very grateful and many had walked miles barefoot to get there.” While she currently she is exploring other opportunities in medical missionary trips, Sutton strives to “lend an extra helping hand” wherever she can. On March 10, 2009, a 28-year-old Geneva County, Alabama, man went on a 24-mile shooting spree, killing 10 before turning the gun on himself. One of Sutton’s close friends had relatives who were affected by the tragedy, so she asked how she could help. Carrying illustrated Thomas Kincaid Bibles and other spiritual keepsakes; she made the four-hour drive from Birmingham to Samson, Alabama. She spent time with survivors there, just listening. “I talked with one man, for example, who lost his wife and 15-year-old son and his two in-laws,” she recalls. “That was his whole family. I didn’t do it for thanks,” she says, “but I always want to know, ‘Did it help?’ ‘Did I make a difference?’” Sutton later learned that her actions had indeed been a source of comfort. She got a follow-up call about a Geneva County sheriff’s deputy who had lost his wife and toddler daughter in the massacre and his 4-month-old was injured. The Bible and keepsake she’d left at his door had quickly become a cherished possession. Her giving spirit also finds expression closer to home: Sutton recently opened her house to a young woman who had aged-out of the Alabama Department of Human Resources foster care system with nowhere to live. As she lovingly encourages the 19-year-old on the road to independence, they both look forward to visiting DHR group homes to pass out care baskets filled with necessities and little extras to the girls who still reside there. Sutton’s young friend also hopes to return to the group homes and talk to the girls about how to survive in the system and plan for a brighter future. Similarly, Sutton goes the extra mile to provide spiritual and emotional care in the SICU back at UABMC. Her latest endeavor focuses on making the ICU waiting area as welcoming as possible for patients’ relatives and loved ones. “Our goal is to promote a healthier and healing environment in the SICU waiting area through spiritual, emotional and educational support and resources, along with conveniences and diversional activities,” she explains. “We have volunteers in the waiting room, and we’ve hired someone who spends time there with the families, and is able to give us information that helps us when we interact with them.” The presence of caring people, plus literature from the hospital chaplain, says Sutton, is designed to give people a “sense of relief and control” as they await word about their loved one’s condition. This comfort, in turn, helps her and her colleagues in practical terms, since she estimates that it takes 20-30 minutes to prepare a post-op patient for visitors. “Now, we can clean them up and initiate pain management without anxious families ringing the bell outside the door. We try to take care of their needs, too.” Sutton’s extraordinary blend of compassion and clinical skill has not gone unnoticed. She won the UAB’s Clinical Excellence in Nursing Award in 2002; a special recognition award from the Chief Nursing officer; “Dedicated to Clinical Excellence 2003” award followed, as did the SICU’s Team Spirit Award (2007), a UAB Continuing Clinical Excellence Award in Nursing (2008) and UAB Nurse’s Touch Excellence in Action for “Commitment.” Sutton was a co-author of the article “Our Unit: Team Competence,” which appeared in the April 2007 issue of the journal Critical Care Nurse. “My co-workers are the best co-workers anyone could ask for,” she enthuses. “When you are in a crisis, they are ready to go with helping hands to assist with any patient, nurse or physician. We have specialty teams in the hospital working together respecting each one’s expertise.” Even the best clinicians, however, cannot guarantee good outcomes. Suffering, death, and the strong emotions that accompany them can be draining, according to Sutton. “You have to find your protective balance in being able to be compassionate while performing your duties and providing comfort to your patient and family,” she explains, adding, “You must come to terms with your faith and understand the limitations of medicine. One day you may be grieving with a dying patient [and discussing] donating organs and the next day you may be celebrating new life with a transplant recipient or you may be taking care of a patient happy that all the cancer was removed and your other patient became inoperable due to cancer metastasis.” Short staffing makes emergent and emotionally wrenching situations still more stressful. “Nursing is a physical and emotional job for a properly staffed day,” she notes. “The nursing shortage is a great concern…potential nursing students are being turned away due to lack of nurse educators. As shortages continue in other areas supporting nursing, nursing carries the load for that shift and pick up for the staffing deficiency from other support services.” Sutton loves to do her part by supporting fellow nurses at the bedside in the SICU, where anything can happen. No matter what does happen, Sutton makes compassion a priority. “The patient is a human being with real feelings that is trusting you to take care of them,” she says, “and they look for us to protect them.” Robin Sutton, RN, earned her ADN from Samford University, Birmingham, Alabama, in 1977. She is a staff/charge nurse in the Surgical Intensive Care Unite (SICU) at University of Alabama at Birmingham Hospitals, Birmingham, Alabama. Sutton is a certified ACLS instructor. Kristine Brennan is a freelance writer on the editorial staff of NEWS-Line for Nurses. |
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