A few months ago, a patient was brought in via EMS with a complaint of shoulder and neck pain after moving heavy boxes throughout the week. This patient also had an elevated blood pressure which in turn led the EMS crew to start an IV and perform a 4 lead EKG, to which there was no gross indicator of any impending cardiac issue. On the patient's arrival, he initially maintained a complaint of neck pain and was placed into a room for triage. Melissa Bonasera, the pivot nurse for the day, went into the room to triage the patient and found, on her examination, that he was having neck pain that was radiating into the shoulder, more on the left side. The patient’s blood pressure was still elevated and he was placed on a cardiac monitor. With the patient's complaint and continued hypertension, Melissa used excellent nursing judgment and performed a 12 lead EKG. The EKG performed by her showed the patient was having an ST Elevation Myocardial Infarction and would need immediate intervention. The patient's status was quickly relayed to the Doctor, the attending ED physician, and orders were carried out within minutes. On the way out of the department via EMS, the patient had a good understanding of the situation and his wife thanked us for our quick action. Because Melissa followed her good judgment and intuition in a seemingly non-cardiac case this patient was transferred to Cardiac Cath Lab in less than 30 minutes after recognizing the cardiac emergency, with a hopeful outcome.
Melissa will say she only did what she thought was right. I would say I am very thankful for her, as I did the initial intake on the patient who did not appear to be in any significant distress. Melissa triaged the patient out of her willingness to help her team and potentially saved a life by utilizing excellent nursing assessment and judgment. Melissa is an amazing example of blending clinical skill and compassion for her patients and coworkers.