September 2014
Ely
Rodriguez
,
RN
Medical Surgical
Homestead Hospital
Homestead
,
FL
United States

 

 

 

A 26-year-old female, who had a baby a month ago, was admitted to the unit. She was not breastfeeding the baby, and came to the hospital with complaints of pain in the right lower extremity. Patient was admitted with a diagnosis of left peroneal deep venous thrombosis and right superficial vein thrombosis. She was started on Lovenox q.12 hours. The patient's significant other and newborn spent most of the time at the bedside with the patient while she was admitted. Ely took care of not just the patient's need but also made sure the newborn had enough formula while at the hospital. When orders were written for discharge the following day, teaching was attempted by Ely to show patient how to self-administer Lovenox. Patient refused to self-administer Lovenox and refused to have significant other learn as she would not allow him to inject her ("without a license" ). Ely notified case management who attempted to arrange home health care (HHC). Unfortunately, when this was mentioned to the patient she advised the nurse that the address she gave was a relative and that she actually lived in a shelter. Case management advised Ely that HHC cannot be arranged for shelters. Nurse took it upon herself to call the attending to explain the situation and to see if the physician would be willing to change the medication to a PO medication that would be covered by Medicaid (Xarelto). The physician agreed to change the medication. The nurse kept the patient informed of what was going on to make sure she would be acceptable to the changes. All in all due to the prompt intervention of the nurse in contacting the physician to explain the situation, the patient was discharged to the shelter in a timely manner. The patient left with her family feeling comfortable with her discharged instructions.