March 2014
Laura
Dickerson
,
RN
Recovery Room
Saddleback Memorial Medical Center
Laguna Hills
,
CA
United States
Laura never sits still. Even when there are a few minutes of downtime she walks around the PACU looking for something to clean or some way to help out. On January 8 during one of those moments, Laura recognized a critical situation and called out, "Do y'all need help?" as she quickly made her way across room to what we call the "heart bed" in PACU. A patient had very recently been extubated after heart valve surgery and had started to bleed out. Laura saw the chest tube chamber start to rapidly fill with blood. She stayed on the chest tubes and immediately began calling out directions to the team to open fluids, run to the blood bank, and titrate the vasoactive drips in just the right way to support the blood pressure.
At the same time Laura had the wherewithal to pull nurses in with less experience to change the chest tube chambers as they filled up with blood and teach the importance of milking the chest tubes so they would not clot off and create Tamponade. The team recounts how Laura took control of that intense scenario also while talking to the patient and reassuring her the whole time. She coordinated the resuscitation as the patient was reintubated and returned to the OR within 30 minutes. Dr. S, Chief of Anesthesia, was part of the team that day and says, "Laura showed incredible expertise and prioritization. She was just fabulous. She did a wonderful job." Our team credits Laura with saving this patient's life by acting quickly and providing exemplary care. The patient was discharged 5 days after surgery. The Cardiovascular Nurse Coordinator spoke with her on the phone 2 weeks post op and she is doing well at home.
In the same week, Laura had another great save! She was taking care of a patient after a dialysis catheter was inserted in the patient's chest in the OR. Prior to discharge, Laura noted that the patient's arm was ecchymotic and edematous. Upon further assessment, she found that the patient was developing a hematoma to her AV fistula that had been used for dialysis days before. She contacted the patient's nephrologist and surgeon who both agreed that the patient was bleeding from her AV fistula. The patient was taken to surgery immediately. The patient did well post-operatively and was discharged home that evening. Laura is an outstanding nurse. Her patients are very fortunate to be in her care and we are fortunate to have her on our team in PACU.
At the same time Laura had the wherewithal to pull nurses in with less experience to change the chest tube chambers as they filled up with blood and teach the importance of milking the chest tubes so they would not clot off and create Tamponade. The team recounts how Laura took control of that intense scenario also while talking to the patient and reassuring her the whole time. She coordinated the resuscitation as the patient was reintubated and returned to the OR within 30 minutes. Dr. S, Chief of Anesthesia, was part of the team that day and says, "Laura showed incredible expertise and prioritization. She was just fabulous. She did a wonderful job." Our team credits Laura with saving this patient's life by acting quickly and providing exemplary care. The patient was discharged 5 days after surgery. The Cardiovascular Nurse Coordinator spoke with her on the phone 2 weeks post op and she is doing well at home.
In the same week, Laura had another great save! She was taking care of a patient after a dialysis catheter was inserted in the patient's chest in the OR. Prior to discharge, Laura noted that the patient's arm was ecchymotic and edematous. Upon further assessment, she found that the patient was developing a hematoma to her AV fistula that had been used for dialysis days before. She contacted the patient's nephrologist and surgeon who both agreed that the patient was bleeding from her AV fistula. The patient was taken to surgery immediately. The patient did well post-operatively and was discharged home that evening. Laura is an outstanding nurse. Her patients are very fortunate to be in her care and we are fortunate to have her on our team in PACU.