Post-op craniotomy patient arrived on 6 South at 5 PM this evening from PACU. He was talking, alert and oriented. At 8 PM, nurse Steven Page assessed him and he was talking clearly and had an intact Neuro exam. Steven had made up his mind at the beginning of the shift that he was going to assess this patient every 30 minutes for the night shift because he was a fresh post-op craniotomy patient. At 8:30 PM the patient was speaking clearly. Steven went in at 8:52 PM and the patient was opening his eyes, but he was not speaking coherently and not answering any questions. He was opening his eyes and mumbling yes or no only he was not following commands. All vital signs stable and blood glucose WNL. Charge nurse Tracy notified the neurosurgeon via cell phone and he said to take the patient down for a stat head CT. Judy Dektas, CRN walked onto the unit at this exact moment to check in on 6 South and see if we had any patients who were not doing well. She immediately came to this patient's room and an OR tech was on the unit to drop off a post-op patient and he came in with a stretcher and oxygen tank and we were able to move patient quickly onto the stretcher. Four of us, (Steven, Tracy, Joe, and Judy), got the patient down to CT within five minutes of first noticing declining Neuro exam.
This was an example of going above and beyond because one nurse could've taken him down with the transporter, but it was nice feeling supported that if the patient was to deteriorate in route, you would have staff there to support you and also for the patient to have this staff all looking after him to help him have the best outcome possible.
The radiology technician Joanne McClung was ready for us when we arrived to CT. She made sure the radiologist reading the CT called the neurosurgeon within minutes of the scan being performed. Judy secured us a room in SICU and the neurosurgeon was on the phone telling us he was on his way to take the patient back to the OR. We took the patient to SICU and the housekeeper Silvia was finishing up cleaning the room. When she saw us, she was so nice and said she would finish as quickly as she could. The nurses in SICU were excellent and were all working as a team. Christopher Trapp was the nurse who took over in SICU and he was ready for the patient. Steven was able to update the patient's wife when we were still in SICU and the neurosurgeon arrived at 9:25 PM and took the patient to the OR. This is 30 minutes after Steven first noticed declining Neuro exam. This is unbelievable teamwork.
The patient was taken to the OR and had a new collection of blood. This was a potentially life-threatening condition. If Steven had not decided on his own, (even though he had six patients), that this patient should be checked every 30 minutes, who knows what the outcome might have been.
Overall, I feel that if this teamwork had not been in place on this evening, I am not sure the outcome would have been as desirable. We helped this patient in a way that I would have been very happy to see if this had been my parent or loved one. I was so proud to work with these people. It was truly moving and I was not the only one to comment on how everything went so smoothly.