Ashley Bukay

Ashley Bukay

Ashley Bukay, BSN, RN

5East Cardiac Unit
Medical University of South Carolina
Charleston, South Carolina
United States

Ashley was caring for a patient on 5 East who was one of those special patients whom everyone loved. The patient had been on the unit for an extended period of time, and developed relationships with most of the unit staff. The patient originally was admitted for an Endovascular Aneurysm Repair, however unfortunately he developed multiple complications (unrelated to surgery) which prolonged his stay. As his days grew longer as an inpatient and he clinically deteriorated, the patient became increasingly frustrated and anxious with his lack of progress. The patient went from being fully mobile, and walking the unit to requiring max assistance. Imagine the devastation he must have been going through.

On the 23rd, the nurses called a MET due to his declining status, but he recovered enough to remain on the floor. On the 26th and 27th Ashley cared for the patient. That day, other staff members listened as Ashley expressed her concern for the patient. She felt he was in limbo, was falling through the cracks and needed an advocate. Over the course of her first morning with him, she was observed spending more than two hours talking with the patient and listening to his wishes and concerns. Initially she was able to work with the primary team to get additional pulmonary and cardiology consults. Each consult led to additional work up and new diagnoses requiring further treatment. The following day the patient expressed to Ashley that it was all just "too much" and he wanted to be a DNR/DNI.

Although it was Ashley's personal wish that he keep fighting, she listened to his wishes and his code status was changed. Mr. B. then got a thorough bath and they communicated more about the finality of his code status. When they were done with his bath, he grabbed her hand and sincerely thanked her for all of her patience and the wonderful care she had given him. Later that day the patient continued to detiorate and become more hypoxic, confused, and scared. As the on-call team assumed care of the patient and tried to move him to the ICU for further observation and treatment, the patient looked to Ashley as an advocate. He then coded and the MDs in the room were ready to jump in and aggressively treat him and Ashley stopped them all and expressed the patient's wishes. She was his biggest supporter putting her personal beliefs aside and following his wishes.

As a PCT working through nursing school, watching Ashley care for Mr. B. over the last two days was inspirational, an example of advocacy, and the type of nurse I aspire to be one day. This commitment to Mr. B. is just one example of Ashley's willingness to appropriately advocate of behalf of her patients. She exhibits the attributes of a DAISY nurse and is a testament to MUSC Excellence in her daily practice. She truly deserves to be awarded this honor.