January 2024
Jola
Scheepsma
,
BSN, RN
Post Anesthesia Care Unit Binghamton General Hospital
United Health Services Hospitals
Binghamton
,
NY
United States
Jola was diligent and showed compassion by accurately assessing and notifying the proper providers and carrying out their orders.
Jola received a patient into the BGH PACU after a procedure. Upon arrival, the patient was pale, had low blood pressure, and stated that he "just didn't feel right." After lowering the head of the bed, she quickly notified the anesthesiologist that the patient was running a low blood pressure and didn't look well. Orders for IVF and labs were obtained and carried out. After some fluid and albumin the blood pressure still remained low, so some vasoactive agents were added to help increase his blood pressure. The proceduralist and anesthesiologist consulted the hospitalist, and it was decided to also consult general surgery. Blood products were obtained and administered via emergent release and administered in an attempt to increase his blood pressure. At first, the surgeon contacted wanted a CT scan to determine if there was a bleed and continue with blood products before they would take to the OR. The hospitalist deemed the patient too critical to go to CT for a scan. Observing that the patient's abdomen was becoming distended and firm, Jola advocated for her patient and asked for a second surgeon to be called to immediately take the patient to the OR for definitive treatment of what most likely was a bleed. The doctors determined that, indeed, the patient needed to go to the OR emergently and started an MTP. The patient was taken to the OR, where 2 liters of blood and clots were removed from the patient's abdomen, and an arterial bleed was found and clamped. After surgery, the patient required a higher level of care and was transferred from BGH ICU to Wilson ICU. Overnight in ICU, the patient became more stable and was weaned down to one pressor at a much lower dose than was needed before. Labs normalized and was taken to the Wilson OR the next day for a reexamination. While this does not seem like a great story, I feel this emphasizes the importance of something that isn't stressed enough, that nurses do for our patients daily, and that is advocacy. Jola was diligent and showed compassion by accurately assessing and notifying the proper providers and carrying out their orders. She stepped forward in a difficult situation to the hospitalist to make sure he contacted another surgeon to come and assess the patient as she knew the situation was dire and a timely intervention was needed. The BGH team showed the trust and respect that they had for each other and their clinical skills by being proactive and acting in the patient's best interest. It was their teamwork that led to this patient receiving the lifesaving surgery when he did. I am proud of them all, especially Jola, for being strong in her skills, determination, and advocacy for her patient and stepping in when she knew that something had to be done.