Vital Role of Clinician-Patient Communication: An SCCM Member’s Story

---

SCCM member Amy Tschirhart, MSN, APRN, CPNP-AC, shares how her own story of multiple ICU stays has influenced her practice as a pediatric ICU nurse practitioner.

Amy Tschirhart dancing in the rain with her son the day before her cholecystectomy.

 
The day before her cholecystectomy, Amy Tschirhart, MSN, APRN, CPNP-AC, laughed and danced in the rain with her six-month-old son. It was June 2011, and Amy, who was then 21 years old, had had abdominal pain for several months. She was ready to get back to her life as a new mother and wife. “It was so innocent; there was not a care in the world at that moment,” she recalled. “I had a sense of freedom because I thought that the following day I was going to start this path to not being miserable.”

Unfortunately, that path did not appear. Amy had wanted to work in pediatrics for as long as she could remember. Originally her goal was to be a cardiothoracic surgeon, then a nurse—it was how she felt she could best help other people. “In pediatrics, it’s not just one of the hardest times of that child’s life but their families’ lives as well,” said Amy, who today is a nurse practitioner in the pediatric ICU at Texas Children’s Hospital in Houston, Texas, USA. “Being a practitioner who can have an impact on families during their child’s time of illness has always been something I was drawn to.”
 
Amy was studying for the Medical College Admission Test when her abdominal pain began. Her gallbladder was removed, typically a routine procedure with a three-day recovery time. The surgery took 27 minutes, but the recovery continues 13 years later. During the procedure, the surgeon placed a clamp on her common bile duct rather than the cystic duct and neglected to remove it after the surgery. Amy quickly felt something was wrong. Her pain was worse. This was not the smooth recovery she had expected.
 
But her surgeon did not listen. “I kept telling the nurses, I’m in so much pain, I cannot urinate,” Amy said. “The nurses kept calling the surgeon and telling him I was in pain. He kept responding by saying that she shouldn’t be in this much pain, and the nurses said, well, she is.” After Amy was released home, her pain continuing to increase. “The next couple of days are a blur,” she said. “What I know is what people have told me because I was pretty sick. I was vomiting a lot. I had a very high fever. My belly looked like I was nine months pregnant again, it was so distended.”
 
Amy’s husband Jason, an emergency medical technician, could tell something was wrong. His calls to the surgeon did not receive the attention the couple felt was deserved. “The surgeon and his staff would tell Jason, ‘Oh, it’s just gas,’” Amy said. “Not once did anybody say to bring her in so we can take a look.”
 
It was not until Amy became unresponsive while with a friend that she got the attention she needed. Emergency medical services was called—her husband Jason was one of them—and transported her to the hospital. Multiple tests were performed before the clamp was found, but its damage had been done. Dozens of hospitalizations; multiple ICU stays; seven major surgeries, including the removal of part of her liver; and multiple hernias followed over the ensuring years.
 

Amy Tschirhart during one of her many hospitalizations.

Amy has no ill will toward her surgeon for his mistake; she knows accidents happen in medicine. But she is bothered because her pain and concerns were ignored, which resulted in the pivotal lesson that she now applies to her own work. “The overwhelming point I’m trying to get across is to listen to your patients, listen to their families,” said Amy, who now has four children. “Patients and their families are advocates for themselves and their children. If those of us in medicine would just slow down, take time to hear what they’re trying to convey, and build trust with our patients, we can further meet their needs..”
 
She understands the stresses that come with working in an ICU, particularly a pediatric ICU. Whenever a child is admitted, she feels the weight of not only trying to treat the child but also the pressure to ensure that she is hearing all of the family’s concerns, who are often right there with the child. “It’s probably one of the most difficult but rewarding jobs,” Amy said. “The ICU can be such a stressful environment, and it is some of the hardest work I’ve ever encountered, but it is worth it.”
 
In 2023, when Amy wanted to share her story and the importance of listening to patients when providing care, a mentor introduced her to the Society of Critical Care Medicine (SCCM). Now an SCCM member, Amy is excited to share her experience in the hope that no patient feels ignored like she did. “Listen to what your families are trying to say, hear their concerns, and at least take time to say, ‘These are why I don’t think that’s going on,’ or ‘I’m glad you brought that up,’” she said. “If I can help one patient because a physician thought about my story when they chose to slow down, be compassionate, and listen to what our patients are telling us, then I’ve done my job.”
 

---

Posted: 5/17/2024 | 0 comments