Lifelong Learning Programme

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Personal Experience

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We have only one heart

Maria Kohoutková
Language: English
Country: Slovakia
Typology: health care professionals
Mrs. Luba lives alone in a small village house. She has been a widow for the past 8 years. She is 78 years old. She can organize her day well, she has good contacts with her sons and their families. They visit each other. After she fall down about 8 months ago she lost her confidence in moving alone so the nurse comes twice a week to help her with showering. She also checks if the overall situation has not changed. The family helps Luba with shopping, cleaning the house and also the garden work. Lately is Luba more breathless, even a small effort exhausts her. Her legs swell. Luba’s health state has changed so she went to her doctor. He evaluated her symptoms as worsen of the function of the heart and send her to cardiology ambulance. In the ambulance the doctor examined her and told her that for more accurate diagnosis and treatment it is needed to do cardiac catheterization. He explained to her how it is done and made an appointment with her in 3 weeks. He also told her that it is possible she will need heart surgery and replacement of heart valve, so Luba has 3 weeks to get over the fact that she has to undergo the intervention which may prove that she has to have heart surgery. When a nurse comes for the regular visit Luba asks her for support. While the nurse helps Luba to shower, moisturize and dress, Luba starts to talk about her feelings. She is afraid and considers the intervention as hazardous, mainly at her age and images of the heart surgery frighten her even more. She realizes that nervousness will not help her. She is curious how it would have been if she had not gone to the surgery. She realizes that it is not possible to live without heart and that this kind of heart disease can be fatal. She talks much about her whole life, she starts to evaluate her life and she starts to get over the fact that her health state can worsen and she can die. The nurse openly and truly answers all her questions about those interventions in the way that comforts her and brings her resolution and physical strength. During those 3 weeks Luba has twice a week opportunity to gain the resolution and psychical strength to manage the intervention and get ready for adoption of information whether she will need valve surgery or not. The nurse helps her in verbalization of all burdensome feelings and thoughts and comforts her when possible and supports her faith in good result. Luba feels readier to manage the catheterization or possible valve surgery with each meeting. She realizes everything the life already gave her and shares her acquiescence with the nurse. She is thankful for her family and for the desire to live. They farewell after three weeks and both hope they will see each other when Luba gets back from the hospital. OBJECTIVES: Create a space for expressing feelings, worries, uncertainty. Make real the idea of medical practice and promote Luba’s confidence in the success of her treatment. Provide psychological preparation for the severe intervention and possible surgery. MEANS AND STRATEGY: Active listening, expression of interest and respect, clarifying and motivation interviews, encouragement of finding own strategy for coping with the difficult situation, strengthening links with family and drawing energy from this relationship. Since Luba managed two births, she has an experience with handling difficult, painful and even threatening situations. She remembers how she dealt with it then, thus she has personal resources in her own past, the nurse activates them. CONCLUSIONS: Luba found in herself, with the professional help of the nurse, enough strength to handle the difficult surgery and continue to live with gusto.

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