... JV was assigned to a MICU/SICU overflow patient with known sepsis and subsequently, a cardiac arrest. JV made note of a rigid abdomen and found information leading to the conclusion that the patient had been constipated for weeks. A CT of the abdomen was performed and negative for necrosis, however, JV was not convinced. Being a well-respected, intelligent, seasoned nurse, she called the physician's attention to her assessment. JV was positive the odor in the patient's room was due to necrotic bowel. JV convinced the CCU resident not to delay. The resident then called surgery to assess the situation. The surgical resident was skeptical with the negative CT, but called an attending to evaluate the patient. At 0300, the patient was urgently rushed to the OR for a bowel resection and ostomy placement.
JV used patient advocacy skills and critical thinking in the urgent situation. JV recognized metabolic acidosis and worsening lactate levels. The deteriorating lab results, coupled with JV's ability to recognize necrosis of the bowel despite resistance from other professionals saved the patient overnight.
The patient returned to the CCU about 3 hours later, where the surgeon and residents commended JV on her clinical expertise and exemplary persistence. For these reasons and many more, we feel JV Cruz is deserving of the DAISY Award.