March 2024
Ruby
Hines
,
DNP, RN
Endoscopy
Health Carousel
Cincinnati
,
OH
United States

 

 

 

She specifically named you and wanted to say thank you for the wonderful customer service and for essentially saving her mother's life.
Hey Ruby! I just got off the phone with this patient's daughter, and she wanted me to let you know how grateful and pleased she was with her mother's care. She specifically named you and wanted to say thank you for the wonderful customer service and for essentially saving her mother's life. I thought you would like to hear this awesome compliment!

***

Ms. P is a 63-year-old African American female who was brought to the hospital by her daughters to have a PEG (feeding tube placement in her stomach for feeding related to failure to thrive). The patient weighed only 75 pounds, had a previous stroke, and was aphasic (unable to speak and used paper and pad to communicate with her daughters and the staff). The patient was bed-bound and very deconditioned.

The patient started to cry and complain of pain at her surgery site, and I immediately sent a message to the doctor for pain medication. It was explained to the daughter that I needed to monitor her for an additional 30 minutes after pain medicine for her safety. After 30 minutes, the patient was moved to the lower portion of the unit to make room for other patients coming to the recovery area (the patient was waiting for a bed assignment post-procedure, which was preplanned, but no beds available in-house at the end of the recovery phase).

The daughter peeked outside the curtain to motion me over and stated that her mom was nauseated. I quickly retrieved an emesis bag and took in a cool washcloth afterward for her forehead. The patient showed her daughter that she was throwing up blood. I assessed the character of the blood she vomited to discern if it was from a blood vessel or artery. The patient has a dark, bloody emesis, which suggests a slow bleed of some sort. Another GI doctor was in the unit seeing my present patient and was asked to evaluate this patient (both physicians are in the same group). I sent a message to the patient's GI physician (who was in the clinic at that time) to explain the situation and to let her know that one of her partners was at the bedside at the moment assessing her patient. The patient's GI doctor stated she would be over to assess and possibly take the patient back to the GI suite to perform an endoscopy to check for the bleeding source.

The patient's blood pressure dropped to 70's/50's and her heartrate went up to 140s, at that point we called a rapid response to get extra hands and medical professionals from different areas (MD, Resp, nursing supervisor, bed placement, emergency room, ect...). The patient's daughter was ushered out of the unit and placed in the nearby waiting room, and I promised I would update her along with the physician after she evaluated her mom and give her the next steps post-evaluation.

The patient was taken to the emergency room, started on a vasoactive drip for blood pressure (Levophed), and transferred to the ICU for monitoring. The patient's daughter was kept in the loop for everything that we did and also escorted to the emergency room to be with her.

The following day, the GI physician thanked me for caring for her patient and for letting her know what was going on with the patient. She also let me know that the patient was taken back to the endoscopy suite for evaluation later that evening, and the patient had a nicked vessel at the PEG tube site that was slowly bleeding. I thanked her for letting me know the patient's outcome post-RRT. I, in turn, thanked all the nurses on the unit involved in assisting in the care of the patient to get her to a higher level of care and a good outcome. The patient has since been discharged and is home with her daughter.