Emma was in triage on this night which was an extremely busy shift. She encountered a 2-year-old female patient with her mom who came in for bloody stools. The patient's mom showed Emma an image of the stool she was referring to. Emma brought the image to me and asked if she could put in a verbal order for an ileocolic USS, to which I replied yes. The USS was positive for intussusception.
I want to point out some unusual things in this case: the patient was 2 years old, outside the normal age range for this particular disease, she never complained of abdominal pain, she did not have any vomiting, she did not have abdominal tenderness on exam, she did not look sick, and it was a very busy shift. Emma could have easily allowed the patient to wait her turn which could have resulted in more morbid consequences. The patient eventually had an air enema reduction and was admitted for observation on the floor.
I want to commend Emma for her thinking outside the box. I also want to add that Emma is one of the nurses that consistently asks relevant questions about patients' management plans, even if it is to understand the rationale behind this. She consistently advocates for her patients.