Patients First

Submitted by Brianne Gallagher, RN, BSN, CCRN

Tags: communication PACU patients

Patients First

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It was another busy day in the PACU when I received Mr. S from the operating room. He was here for a left cochlear implant. The CRNA informed me on report that he already had a right cochlear implant and that his wife had his box in the waiting room. She also told me he was almost completely deaf without his instrument.

Mr. S was resting comfortably on arrival to PACU with stable vital signs. Once he started to wake up, it was difficult to do a complete neurological assessment since I didn’t have a good way of communicating with him. I called the patient representative to bring his wife to the bedside.

Once Mrs. S was brought to the bedside, I could just see the look of relief in Mr. S’s eyes. She began using sign language and he quickly responded to her. I asked her to ask him a few basic questions for me just so I could ensure that he was alert and oriented. He was able to answer the questions appropriately and his behavior was appropriate to the situation. I was able to medicate him for pain and he was able to communicate that his pain was improving.


We have limited visitation in our PACU due to the small amount of space and how busy our flow of patients is. After about 10 minutes at the bedside, the patient representative came to escort the wife back to the waiting room. I made the decision that it was safer for the patient to be able to communicate with me after his surgery and asked the wife to stay at the bedside.

The patient was recovering well after anesthesia and was given ice chips since he complained of a dry mouth. He was also able to void about an hour after surgery. I assessed his pain level to make sure his pain was being controlled prior to discharge. He was responding well to the medications I had given him and declined any further narcotics. It was such a relief to have his wife at the bedside to help me communicate with him. I asked them if he felt ready for discharge and he was. Report was called to our discharge area, SPU, and the patient was assigned for transport.

Right before he left the recovery room, the patient asked his wife for a piece of paper to write something down. He thanked me for my care and wrote how much it meant to him that I allowed his wife to stay with him. He said when he first woke up he was a little frightened because he was unable to communicate with me. Once his wife was there, being able to communicate his needs to me quickly alleviated his fears and he was so thankful.

I wear hearing aids, so I could relate how scary it would be to not be able to hear what is going on and be able to talk to your nurse. Mr. and Mrs. S were very kind and had managed to work out a great system of communicating using sign language and lip reading. Caring for Mr. S has inspired me to consider learning sign language, both for myself and for my patients.