Partnering with patients to process difficult experiences

2018 Patricia Mackey Patient- and Family-Centred Care Educational Award

Rina-Marie Austrie-Fletcher is the recipient of North York General Foundation's 2018 Patricia Mackey Patient- and Family-Centred Care Educational Award for the work she has done to introduce journals in the Critical Care Unit (CrCU) as a tool to support patients and families.

With the help of Patient and Family Advisors, the Critical Care Unit team is continuously evaluating the patient and family experience. When Rina-Marie, the CrCU's Clinical Coordinator, learned that there was interest on the unit for helping patients and families through journaling, she began to work with her colleague Meagan Daley, Social Worker and Co-chair of the unit's Patient- and Family-Centred Care Committee, to research the idea and establish a pilot project.

3 woman, 2 in scrubs, pose for a picture

Social Worker Meagan Daley, Clinical Coordinator Rina-Marie Austrie-Fletcher and Clinical Nurse Educator Connie Leroux introduced journals to support patients and families in the Critical Care Unit.

Studies show the experience of being in an intensive care unit can be traumatic for patients and stressful for family members. Patients in the Critical Care Unit undergo a number of interventions and report that during this time they are unable to distinguish what is really happening to them, which can leave them with disturbing memories. 

“I've seen first-hand how hard it is for patients to come back to the unit after they have recovered because they experience a flood of negative memories,” said Rina-Marie. “We want to do our best to help them make sense with what they have been through and to know they were in caring hands while they were here.” 

Families of patients in the Critical Care Unit also report feeling overwhelmed because they don't know how to help their loved one while they are critically ill or how to process all of the information that comes with being in an intensive care unit. 

Journals help reduce stress for Critical Care Unit patients and families

Providing a journal for patients and families to write down their questions, important information and feelings has proven to reduce the stress of being in an intensive care unit. Families feel like they are participating more actively in their loved one’s care and can provide details that help patients fill in the gaps in their memory. 

“We decided to use journals that were created by the Josie King Foundation to introduce the idea to our patients and families,” says Rina-Marie. “Right now we are in the process of ensuring that we provide the journal to those patients who have a projected long CrCU stay — at least one week — with family presence, while implementing a feedback process so we can evaluate and improve on this idea.” 

Being in tune with what patients and families experience while they are at the hospital, identifying ways to better meet their needs, and implementing changes based on their feedback is the essence of patient- and family-centred care at NYGH.

a green journal

Providing a journal for patients and families to write down their questions, important information and feelings has proven to reduce the stress of being in an intensive care unit. The journal headings on this page are: Parking place, Medical team on duty, Daily goals, Medication, Surgery/Procedures/Tests, Diet, and Questions to ask. 

Patricia Mackey was one of North York General Hospital's inaugural Patient and Family Advisors and helped the hospital establish our initial goals and vision around providing truly patient- and family-centred care. The award, which bears Patricia's name, was established through the North York General Foundation by her family and friends as a tribute following her passing in February 2014 from breast cancer. Delivered through the hospital's Patient- and Family-Centred Care Office, the award continues her legacy of creating patient- and family-centred care at North York General.

"Receiving this award is an honour and I can't imagine working anywhere else,” said Rina-Marie. “Working in the Critical Care Unit allows me to practise truly holistic nursing, caring for the whole patient and supporting families and caregivers.

Share this article