Recently, Kelsey activated RRT to the bedside of a patient with concerns regarding his extremely large, semi rigid abdomen. He had increasing pain and shortness of breath. Kelsey requested RRT assistance to help plead the patient's case further to the medical team, as she felt her concerns were not being addressed and validated. My immediate assessment, as a seasoned surgical nurse, was completely in line with her concerns. I knew upon sight of this patient's abdomen that we were moving towards a surgical emergency. I was able to discuss the plan of care with the providers at bedside, who agreed to consult surgery. Surgery's assessment did not agree with the nursing sense of urgency, which was frustrating, but we had to continue.

The following day, while rounding, Kelsey brought me back to the bedside with continued concern. I agreed with her and assisted in administering a Harris drip enema per the medical recommendations. I had to leave the bedside for an emergency, but upon my return that evening, it was very clear that Kelsey continued to strongly advocate for her patient throughout the course of the day, which was not met with open ears by the medical team. I arrived as a chest x-ray and KUB were being performed and brought the medical team back to the bedside to further assess. Kelsey and I gathered more evidence to support our concern, like an intra-abdominal pressure of 18 (near the level of impending organ failure of 20). Surgery returned to the bedside once more, and finally ordered the CT ABD/Pelvis we were hoping for. That CT showed a volvulus, which required immediate surgical intervention that evening, and ultimately STICU admission post operatively. Per the operative report, they had to resect ischemic bowel, but also, there were areas of "impending perforation." 

This impending perforation would have been definite perforation, and possible death, if it wasn't for Kelsey and her strong advocacy for this patient, which is why I believe she is deserving of the DAISY Award. She continually communicated with her providers, performed multiple time-consuming interventions, and brought RRT to the bedside multiple times to support her concerns. 

At the time of this nomination, this patient is now out of the STICU, alive and ambulating on SW5, all because Kelsey trusted her instincts and did not give up.