It is no secret that nurses don't like floating to other units. Many of us feel like we can't provide superior care in an unfamiliar area or to patients with unfamiliar diagnoses. Lisa Cross provided a level of care in the Heart Center that surpassed what we often see in nurses' home units, let alone while floating.
As a member of the Vascular Access Team, we encounter nurses all over the hospital. Lisa's advanced clinical knowledge and dedication to patient safety far surpasses the norm. I was stopped by Lisa when doing my daily dressing checks. She informed me that based on her patient's morning x-ray the tip of the PICC was malpositioned and that the line was therefore not central. She expressed concern that his TPN contained 30% dextrose and was, therefore, an unsafe osmolality to be infused through a non-central line. This patient was not stable enough for any intervention to the PICC line, so Lisa strung all new lines to rearrange his infusions so that any potentially caustic medication went through his femoral line and not his PIC line. She also made sure that an order was placed in the chart to inform staff that his PIC line was not to be used as a central line.
This may not sound very exciting, but very few nurses in this hospital would recognize central line malposition on x-ray or realize the potentially catastrophic effect of infusing a high-osmolality solution in a non-central location. In addition, it takes an enormous amount of work to re-string multiple infusions. It is not a task many nurses look forward to, and seldom would voluntarily do it two days early, especially for an ICU patient on multiple drips.
This patient was lucky that Lisa was the nurse that floated to him that day. Our hospital and our patients would greatly benefit from more nurses just like her. Her knowledge, dedication, and advocacy are assets that should be rewarded. Thanks for going above and beyond!
Note: This is Lisa's 2nd DAISY Award!