Christa was assigned a young patient who was very sick and unstable. Around change of shift in the morning, it was found on an x-ray that the patient’s intraaortic balloon pump (IABP) was malpositioned. An hour later a cardiologist came through and repositioned it and several x-rays were done. Around 9:30 am, Christa responded to an alarm in her patient’s room coming from the IABP. She assessed the patient and the machine and while standing beside the patient she heard an unknown noise coming from the IABP tubing. Blood began backing up and it quickly became apparent to Christa that the balloon had ruptured in the patient’s aorta. She calmly and quickly stopped the IABP and called for help. While vigilantly monitoring the patient, she smoothly delegated tasks to other RNs so she could stay with the patient. While waiting for the cardiologist to show up, Christa kept the patient calm and even got him to laugh at her jokes in the midst of a life-threatening emergency. She stayed with the patient while the machine was removed and kept him as calm as she could while assisting the doctor. Once she ensured he was ok after the removal, she addressed the patient’s main concern and contacted his wife for him to let her know what happened. Her quick actions, attention to detail and her patient saved the patient’s life.
Later that day, when the patient reported increased pain in his shoulder/side where they removed the IABP, she didn’t waste any time. Despite the patient’s blood pressure and vitals being ok, she paged the doctor and got the patient ready for a CT scan to assess if bleeding was occurring. The patient had a contrast/iodine allergy which complicated the orders, but a CT with contrast was an absolute must for this patient. Christa spoke with multiple doctors and tried to come up with a solution to get the patient the CT scan. She hit roadblock after roadblock. She called, paged, and spoke with multiple physicians who all fought against her getting the patient a CT scan. The cardiologist argued with her that the patient was stable at that time and they didn’t need the CT scan yet. The ICU doctor argued that it wasn’t his place and it was up to the cardiologists. This is where Christa really exhibited what it takes to be a DAISY Nurse. She didn’t give up. She didn’t take no. After talking to 3 doctors, she finally got the orders to appropriately pre-medicate the patient for his allergy and get a STAT CT to assess for bleeding. She did not stop until she got what her patient needed. She was a true advocate and did not simply accept what the doctors told her.
It turned out that the patient did, in fact, have a bleed in his chest as she suspected. She spent the rest of her shift trying to elicit a plan from vascular surgery while administering blood to the patient, keeping the patient’s pain under control, and updating the wife continually. By 7 pm, she had paged, talked to, called, and discussed her patient with no less than 11 doctors, For the second time in one day, if it were not for Christa’s persistence, willingness to advocate for her patient, and attention to the smallest change with her patient, the patient would not be alive.
Every day she provides extraordinary care to her patients, but in this instance, she was literally the only thing between life and death with her patient. She saved his life not once, but twice.