A Good Lesson to Re-Learn

For the past month I have been caring for a patient who is known as a “total care” patient.  In simple layman terms, this means that the patient cannot do anything for him/herself.  The care for this patient includes turning every 2 hours, dressing changes, completing trach care/suctioning, maintaining the patency of the PEG tube, cleaning any incontinent spells, and of course treating this patient as the person that he/she still is. 
The situation that led to the patient being this way is very sad and heart breaking, not to mention the fact this patient has been in the hospital setting for an entire year. 
When I first started caring for this patient, it was a bit overwhelming to think of all the things I had to accomplish during the night to give the adequate care for the patient, but as the nights built up with experience of providing care, it has become easier and easier to give all the care within the 12 hours. 
In fact this patient may be one of the easiest patients that I have ever cared for.
In nursing school we are taught about the importance of communication with the patient…however when you care for a patient that you think is incapable of communicating it is easy to forget to treat this patient as much of a human as possible…that was before…
One night while I was caring for this patient, the heart rate increased to 138 and kept increasing to 145.  I was a little concerned but not overly since the patient usually runs tachycardiac.  As I was in the room, doing dressing changes and pushing some pain meds through the PEG tube, another nurse came into the room.  (Now when you take care of a patient repeatedly, it is a little hard not to become attached and to form somewhat of a bond with them).  She teasingly told me to take good care of her favorite patient.  She went to the other side of the bed and started to talk to the patient.  As the patient heard her voice, the heart rate began to decrease and the arms and legs began to move a little.  This was amazing because we were all under the belief that any movements were based on reflex and there was no intentional movements left in the patient.  She then began to ask simple questions such as “Are you in pain, Do you want the Light Left On, Are you comfortable?”  She then asked the patient to blink once for yes and twice for no…and of course there was response and the patient was making preferences known!!!
While I always make it a point to talk to the patient while I am providing care, to be honest, I never really paid attention to see if the patient was trying to respond to the attention and care.  I plan on making a more conscious effort in having a two way communication with this patient and not just see the non-responsiveness as all that is going on with the patient.  It was a good lesson to re-learn.