A Nurse’s View From the Patient’s Side with Rachel Chianakas
Rachel Chianakas and Compassionate Care
Rachel Chianakas lost her ability to work as a bedside nurse after a knee injury with a subsequent failed surgery. Following her first surgery, she was made to feel “crazy” and “embarrassed” when she was told that she was fine and was healing normally. With her symptoms continuing, she was losing hope until a complete stranger told her she should seek a second opinion. She did just that and found that her symptoms were real. She finally felt validated.
Through her experience, she has become a fierce patient advocate and now works with low-income patients and assists them in navigating the immensely confusing healthcare system. Rachel is very grateful to the donor of a ligament graft placed in her knee and is able to function because of that selfless act of a stranger. Because of that, she encourages others to become donors and honors those that have donated organs and tissues so that others can continue to live.
Rachel is working to create a website where people can be educated on traversing the healthcare system and wants those that need help to reach out to her. She also would like to work with healthcare providers to educated them in delivering compassionate care to every patient they encounter and always be a patient advocate.
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About Rachel
Rachel Chianakas is a Registered Nurse living in Milwaukee Wisconsin. She obtained her degree from OSF Saint Francis Medical Center in Peoria, Illinois and began her career in the Emergency Department where she became passionate about providing both safe and quality care to each and every patient she cared for. Rachel has always taken pride in delivering safe care as a nurse and has helped foster change in her working environments to improve patient safety. After personally experiencing harm during a routine surgical procedure, Rachel’s passion and desire to advocate for patients grew exponentially as she learned firsthand the true impact a surgical error can make on one’s life. Rachel is here to give others a voice who have also been affected by patient harm and believes in the importance of being an advocate for yourself, transparency between healthcare workers and patients, the importance of second opinions, and effective communication amongst healthcare providers.
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Intro/Outro:
Welcome to Don't Eat Your Young: A Nursing Podcast, with your host, Beth Quaas. Before we get started, we have a few quick notes. Don't Eat Your Young is a listener-supported podcast. To learn more about becoming a member and the perks available to you for becoming a patron yourself, visit patreon.com/donteatyouryoung. You can learn more about the show, share your story to join Beth as a guest, or connect with our wonderful community, in our Facebook group. You can find all those links and more at donteatyouryoung.com. And now, on with the show.
Beth Quaas:
Welcome to Don't Eat Your Young. I'm your host, Beth Quaas. Today we have Rachel Chianakas on the show. She's a nurse that suffered a non-work injury that was truly life changing for her career. She's going to talk to us about her experience as a patient and how our treatment as providers can really change our patient's lives. Please welcome Rachel to the show.
Rachel Chianakas:
Hi, Beth. Thank you for having me. I'm excited to be here.
Beth Quaas:
Well, tell us a little bit about yourself.
Rachel Chianakas:
So I am 34 years old now. I am a nurse in Milwaukee, Wisconsin. I started my career in a level one trauma center and academic teaching facility and I worked in the ER. Did that first quite a few years and then moved on to the GI Lab, spent some time at urgent care during COVID, and then now I work as a case manager.
Beth Quaas:
Awesome. So somewhere in your career, when you were working, you suffered a non-work injury, and tell us where that took you.
Rachel Chianakas:
Yes. I was attending my sister's wedding back in August of 2020, and I had a traumatic injury where I was standing on a hill, I did have some heels on and my puppy's leash was in my hand, and the puppy lunched forward and I went with my puppy. I heard an audible pop and thought something serious had happened. I was able to get up and walk and I kind of pushed it off for a little while, but eventually I went to a doctor and had an X-ray and an MRI that showed that I tore my lateral meniscus on the left side.
Beth Quaas:
And so, you followed through with care with a surgeon that you thought you trusted.
Rachel Chianakas:
I did. Proceeded with surgery, which was recommended. The procedure that I had was in December of 2020, and just a few weeks before, there was a possibility that my ACL was also affected. He said he couldn't tell the by the MRI and he wouldn't know until he got in. So the procedure that I had was a left partial meniscectomy with a possible ACL reconstruction. And I had signed a consent to use my own tissue in order to do an ACL reconstruction. I woke up and they said the ACL was fine and I'd be back to work in two to three weeks. So only the meniscus had been... They removed part of it.
Beth Quaas:
And so, that, in the grand scheme of things, is more of a minor procedure and you thought you'd be up and running again in a couple weeks. And then what happened?
Rachel Chianakas:
Yes, very routine procedure. They are done. It's very common. Unfortunately, I did not get better and at my two week follow-up appointment, I was having a lot of difficulty with movement. I started to notice symptoms that became more apparent as weeks went on, but I had a purple foot that was cold to touch, extreme pain, and my doctor kind of brushed it off, and he diagnosed me with something called early complex regional pain syndrome, 14 days after the surgery, and then sent me to physical therapy at that time. So I went through physical therapy and did that for two times a week. My leg, I noticed had atrophy quite a bit. My quad was not firing. I kept bringing up these worries that I had to the physical therapist and my surgeon, but I kept getting told nothing was wrong. Everything was fine. I felt crazy and that I just didn't have a pain tolerance, so I kept pushing through.
Beth Quaas:
Because we usually trust what we're told when we see providers that with their education and experience, that what they're telling us is true, but that did not happen in your case. And so, how long did you go through physical therapy before you made a change?
Rachel Chianakas:
I went twice a week for approximately six weeks. It was rough, especially at the end. At that point, I was starting to really notice these symptoms and have significant pain. So physical therapy was really hard. I had my last follow-up appointment with the surgeon on January 26th of 2021, and at that point I was diagnosed with sciatica. To be honest, I was a little bit embarrassed with that diagnosis. I've seen sciatica a lot. It didn't seem right because my pain was only in my knee and it did radiate down my lower leg, but it was not in my upper leg, I did not have back pain, and the onset was after the surgery. So I felt embarrassed and, again, crazy.
Beth Quaas:
And isn't that sad that you're made to feel that way when you continued to tell them of your symptoms and it seems like you weren't taken seriously?
Rachel Chianakas:
Yes. And especially being a healthcare worker, you feel like you trust. And to me, what I experienced eventually, was a betrayal of one of my own. That's what it felt like.
Beth Quaas:
That's a powerful statement for sure. We feel like healthcare is... We feel like we're a family. We all understand the same things and being a patient as a nurse is very hard anyway. It's a little easier for us to navigate the system, which I can't imagine not understanding the system and trying to navigate, but you knew too much, which is good and bad.
Rachel Chianakas:
I did. So my last appointment with that doctor was on the 26th and I was encouraged by a complete stranger, who happened to be my next door neighbor at the time, to get a second opinion. She was an ultrasound tech and she noticed the symptoms I was having, and really pushed me to get that second opinion. I made the call, which truthfully, I don't know why I did. I was pretty defeated. And the second opinion surgeon saw me on January 28th, which was two days after my last appointment with the first surgeon, and they did a complete physical exam, which I then noticed I had this moment where I was like, "Oh my gosh, nobody did a complete physical exam after the surgery on me." And as a nurse, I felt... I was mad at myself a little bit for that, for not noticing.
Beth Quaas:
Nor did they do any scans or tests, correct? After your initial surgery and you started complaining of the symptoms, they didn't really do much of a follow up.
Rachel Chianakas:
Right. After that last appointment... Or not after, but while I was there, the doctor looked me in the eye, and I will never forget this moment, and he said, "We could do an MRI, but it's just going to come back abnormal because we just did surgery on your meniscus." So that was my last plea for him to do something, and that was eight weeks after the surgery, and he wasn't going to do it. He said it was wasn't necessary, and I was to follow up with him in four weeks.
Beth Quaas:
And obviously that didn't happen.
Rachel Chianakas:
No. So come to find out after my second opinion and that complete physical exam, they knew right away something was wrong and they ordered an MRI immediately. And I was still shocked. I remember telling them, "I don't know if I'm having just anxiety or if it's intuition." And I was in tears at that time, but then I found out that my patellar tendon was nearly severed. The lateral meniscus was torn again, and it was never really completely fixed. And my ACL, there was a good chance that it did need to be repaired. Again, that surgeon said he would know for sure when he went in, but he prepped me and said it was likely that the ACL would be reconstructed as well. So on May 23rd of 2021, I went in for a patellar tendon repair, a second left lateral partial meniscectomy and an ACL reconstruction. And because my patellar tendon was nearly severed, it wasn't usable.
Rachel Chianakas:
And the patellar tendon is the gold standard for ACL reconstructions, so it was decided that I would use donor tissue. So I was on that age cusp where he thought it was just a better idea, due to all the trauma that I had and because of my age, to go the donor route. I just want to talk about the donor tissue for a second, but...
Beth Quaas:
Please do.
Rachel Chianakas:
I never realized the impact of something like that, even as a nurse. And when I woke up that morning, or after the surgery, and found out that they used somebody else's patellar tendon to give me a second chance to walk and to live my life, that was the first time I think I felt peace for just a second. And all I had was gratitude for this person and their family. It was just one of those gifts that I am so grateful for.
Beth Quaas:
I completely agree. And in working in anesthesia and in the OR, I've done those cases where we do organ retrievals, and it is a very somber time, very respectful. But the gratitude that we give each one of those patients amazes me every time. Those patients deserve gratitude. The families that make those decisions, I can't imagine what they go through. But I'm a donor and I appreciate you bringing it up, because I think we need more donors and the lives that can be impacted are immeasurable.
Rachel Chianakas:
I agree. And I am one as well. And it's not just organs, it's tissue. That's what I realized as well that day. So it's amazing, and I'm so grateful that that patient and family gave me this gift.
Beth Quaas:
I thank you for bringing that up. So with that gift you were given, you have made some progress in your healing.
Rachel Chianakas:
Yes. I've gone through physical therapy for a second time and I am able to walk, do normal things. The only thing that I will never be able to do is bedside nursing again, or strenuous activity, due to the damage that I sustained during that first surgery. And it's a weird feeling just to know that at 33 years old, which is what I was at the time, I can't see certain things. And my career did change drastically. It was taken from me. I don't know if I was ready at that time for my career to be taken. Now, looking back, I'm okay. I have had doors open that never would've been open, had this not happen to me. It was obviously something that a person would never choose, but I feel that I am able to use my story in order to help others. I didn't realize how many people were harmed during procedures or care, because I, as a nurse, was always really worried that I would do that. And I never thought about it, so I hope that I can bring attention to people that have been affected by safety events and harm, medical malpractice, negligence, or whose care was delayed, such as mine.
Beth Quaas:
Because we talked before... Yep, you got a second surgery and you healed to a certain extent, but you were never made to feel that you were right. Your feelings were never validated, your symptoms were never validated, and I think that's something that truly is missing in your story.
Rachel Chianakas:
Right. Going through what I did, I will say that I went through a grief cycle. The first emotion that I experienced when I got those second MRI results was anger and it lasted a long time, I think right up until I woke up and had that donor tissue. And I attempted several things to make me feel better or to resolve that anger, to get that validation. One of those things was trying to see if I could be the validated with the court system. All I wanted, truthfully, was validation and to be reimbursed from the financial aspect, that I found what I lost. I don't care about anything else than that, is just significant financial loss that I've gone through. And I can't tell you how hard it was to be rejected so many times by lawyers. I couldn't get more than three sentences out of my mouth before they apologized and said, "Sorry, we can can't do anything." And after several attempts, I just quickly realized that this isn't helping me. So this did validate me and it gave me the validation that I'm supposed to advocate on the behalf of others in order to get the validation that I need.
Beth Quaas:
And you're doing that now, because out of all the terrible things that you went through to get here, you have found your purpose in nursing and now you're truly advocating for patients. Tell us a little bit about what you're doing now.
Rachel Chianakas:
Yes. I am really passionate about patient safety more than ever and I have created a mission statement in which I am hoping to create compassionate care through meaningful interactions. And I want to teach healthcare workers about that mission statement. And what I mean by that is, when you show compassion to others, you show that you're listening, you look them in the eye, you're truthful, you're transparent. Even if something has gone wrong, the patient is going to trust you more. You're going to have a better relationship, a better outcome. And I think some of that today has been lost at the bedside a little bit. And I really want that compassion to come back, or just people to remember that people go through difficult things and compassion is the best thing that you can give sometimes to others.
Beth Quaas:
Errors happen. We're all human. We can't deny that. But evidence shows the way you treat your patient once an error happens, if you show compassion, if you listen, if you are truthful, the chances of litigation occurring is less. And it may not help that patient get back to where they were, but like for you, validation, recognition of what you were saying, I think, would've made the world of difference.
Rachel Chianakas:
I have gone over that scenario in my head. If the first surgeon had done imaging, if he had listened to me, if he looked me in the eye, showed that he cared. He validated the symptoms that were obvious, that I was having, to the naked eye, including the atrophy and the lack of the quad firing, that cold, purple foot. Those are all things you just can't ignore. And had he done imaging, been truthful with me and just told me what had happened, I truly believe I would have had a different experience emotionally and not harbor all this anger and the emotional toll that it took on me. I would've been angry. I would've. I think that's a natural response.
Beth Quaas:
Yes.
Rachel Chianakas:
But I would've been able to forgive and realize that he is a human, just like we were talking about. And I probably still would've gone with a different surgeon, but yes, I wouldn't have even attempted to find a lawyer and that would've saved me a lot of time, efforts, and emotional trauma that I experienced from the rejection.
Beth Quaas:
Just the words that you use, embarrassed, you felt crazy, guilt. Those are not normal responses if someone had treated you differently.
Rachel Chianakas:
Right.
Beth Quaas:
But I can understand how you went through all of that. So now you are doing case management. And for those that don't work in case management, tell us a little bit about what you do every day.
Rachel Chianakas:
So my job is a little bit different. I am not working in a hospital. I am getting the opportunity to actually help people. And for the first time, I truly feel like I'm helping people. That was missing at the bedside for me and this is a path I never thought I'd go down ever. And I love it. So I get to help people. People who do not have a primary care doctor, who do not have transportation to their appointments. I follow up with people after hospitalizations and ER visits, and see how they're doing, if they need any resources. And I can tell you, I've never been thanked as many times as I have in this job than I had at the bedside. So, even something as simple as finding a primary care doctor for someone and seeing that they go to the doctor, is such a good feeling, very gratifying.
Beth Quaas:
I can't imagine. It must be quite rewarding to take care of people in that way. And like we talked about before, it is so difficult to find your way through the healthcare system. To have someone like you to help people, is probably sometimes their only way to get in and get through, and get care.
Rachel Chianakas:
And I'm so lucky that I get to be that person to help them. And I kind of always avoided... This is funny, but I always avoided jobs where I'd have to form a deep relationship with people because I am so compassionate and an emotional person. So when I took this job, I didn't know how I would react to it, but it's been great. And I love having that relationship with people. And I'm really lucky that I get to help people in this way, and reach people, and that they feel comfortable talking to me and opening up. So it's been great.
Beth Quaas:
I think that's a great fit for you with your experience in helping people get through that. So you now are trying to... You're working towards forming a business to help others. Talk a little bit about that.
Rachel Chianakas:
I am. As mentioned, I want to be an advocate on the behalf of patients who have gone through similar things. I also want to educate healthcare workers on how they can positively impact others through that mission statement or mind creating compassionate care through meaningful interactions. I have the goal, one day, to be a speaker. I'd love to work with medical students and share my experience. I'd love to work with new nurses coming into the field, just give them a different perspective and have that fresh in their mind when they go in. You can find me at my website. It's my name, rachelchianakas.com. So my last name is spelled, C-H-I-A-N-A-K-A-S. And I will also be providing a blog and hopefully sharing other stories too.
Beth Quaas:
I think that is a great way to educate people. I think telling stories is what people remember. They get the feeling, they remember the feeling. So I think you are going to do great things with the way you're going about this and sharing your story, and hopefully down the road, sharing other stories as well. So I give you nothing but hope that that is going to grow and people are going to find you. And all of Rachel's contact information will be in the show notes as well. So, Rachel, if you had tips to give nurses that are out working today, what would you tell them?
Rachel Chianakas:
Be compassionate to others. It's difficult sometimes, but you just never know. It could be that one person, that one person that you decide, that you just don't have any more compassion for the day. Find it in you to get that compassion for that person, because it just might be that one that really needs it. I'd like to encourage others to get second opinions. It's okay, completely normal. Listen to your gut, go with your instincts, you know your body best. And the worst thing that can happen is that somebody else tells you that you are perfectly fine, which is good news. And I'd also like to encourage nurses to really work on handoff report and communication, because I think a lot of errors are also happening in that realm as well. And looking back on my situation, and knowing what I know, I had an arthroscopic surgery, which was put on a large TV screen, and I have done procedural nursing with the same similar concept.
Rachel Chianakas:
And even if I don't exactly know what I'm looking at, I know what is happening, whether it's going well or bad, or difficult, it's going smooth, all those things. I would love people to just stand up and say something. If you see something that you feel is wrong, or if your intuition, or if you're not sure, just ask. That's all you can do. Advocate for the patient, because in my situation I was sedated and I was vulnerable. I couldn't speak and I couldn't advocate on my behalf, and I needed somebody at that time. So that's what I hope others get from this.
Beth Quaas:
I appreciate that. I'm so thankful that you're here and you shared your story. It took a lot for you to come, but I know you're coming from a place of wanting to help others. And so, I really thank you for coming on.
Rachel Chianakas:
Thank you for having me. I am so grateful for this opportunity.
Beth Quaas:
Yes. So our take-home message today, of course, is everything that we talked about, but become a donor as well.
Rachel Chianakas:
Yes, it really not only can save lives, but help others in times of need, like mine, give me a second chance.
Beth Quaas:
Thank you so much, Rachel.
Rachel Chianakas:
You're welcome. Thank you.
Speaker 4:
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Intro/Outro:
Don't Eat Your Young was produced in partnership with TruStory FM. Engineering by Andy Nelson. Music by The Lighthearts. Find the show, show notes and transcripts at donteatyouryoung.com. If your podcast app allows ratings and reviews, please consider doing that for our show. But the best thing you could do to support the show is to share it with a friend or colleague. Thank you for listening.
Speaker 4:
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