Kathy called a patient who was having surgery the next day. During the nursing interview, over the phone, Kathy could hear that the patient was very short of breath and was coughing. I could hear her asking the patient if she was sick and the specifics of her cough. The patient said she wasn't sick or coughing up anything. She did have a history of COPD that required the use of oxygen at home. I could hear Kathy asking about her medications and Kathy sounded quite alarmed when the patient said she could not afford to take what she has been prescribed. Apparently, she was no longer using her Trelegy Ellipta inhaler, Furosemide (a diuretic), or Escitalopram as she "can't afford it". Her SOB was obviously concerning to Kathy, especially since she was sitting in the car with her daughter at the time and wasn't exerting herself. I heard Kathy ask her if she could go to the ER, she said no, but she would be better if she had the Trelegy Ellipta inhaler. I could hear Kathy go a little deeper into her history/ living situation. The patient said that although her son lived with her, he wasn't too helpful. Her elderly friend was bringing her to the hospital the next day.
Part of our interview process for patients who will be admitted to the hospital and kept overnight is the TOC Risk Needs Assessment. Within that set of questions is one that specifically addresses "Do you skip medications because you can't afford them"? This patient was expected to go home the same day so this is not a question we would routinely ask. Even though this patient was going home, Kathy emailed the patient's primary care physician and several other people to see if anything could be done. Someone from Pharmacy said the only thing that we could do would be to call the MD to see if the medication could be changed to a different inhaler.
Kathy has been a nurse for a long time and with her surgical and critical care history in nursing, she was well aware that not all inhalers treat all types of respiratory illnesses. She was so concerned about this patient that she went home that night and did some research from home. She found the company that makes Trelegy Ellipta, got their phone number and information sheet for people to contact if they cannot afford their medications. She printed this out at home, brought it to work the next day. Kathy waited for this patient to come in and gave it to the patient so she would have a resource and hopefully some financial help.
Kathy's diligence, caring, compassion, and professionalism, exhibit an exemplary example of everything a nurse should do for their patient. This behavior is a role model for new and seasoned nurses and reminds us we can always take a moment to go above and beyond for someone in need.