May 2026 Honoree
Rachel Bayless, RN, BSN
Rachel made an amazing catch that likely saved the life of a patient. She was caring for a patient who has Dermatomyositis and is dependent upon NG tube feeds for nutrition. Rachel had been administering bolus feeds to this patient throughout the day and took the time to stop and check placement prior to each administration.
Rachel was about to administer a feed, but this time, when she checked placement, she was unable to draw back any gastric aspirate. Nothing had changed. The patient's tube was in the same spot; she was asymptomatic and had no signs of distress. But Rachel stopped. She notified the rehab provider, who appreciated her concerns and ordered an X-ray to check NG tube placement.
After being taken to X-ray, Rachel received a phone call from the attending provider letting her know there was concern for bowel perforation and to prepare the patient to go to surgery. This patient is severely immunocompromised for treatment of their myositis and is on high-dose chronic steroids, also increasing the risk of NEC.
Upon being taken to the OR, the surgeons found free air in the abdomen and beginning signs of NEC, but there was no perforation. The NG was in the right stomach, but if this patient would have continued to receive feeds, we likely would not have had any physical indications of her changing situation because of expected delay in presentation with steroid use.
This finding was subsequent, but if not caught early, a bowel perforation could have led to this patient's demise. Rachel had a very busy assignment that day, and it would have been easy to overlook the inability to withdraw gastric contents, but she did not. She stopped and did not proceed in the face of uncertainty.
Thank you so much for keeping our patients safe. Rachel potentially saved this patient's life because if her bowel condition had not been assessed, it likely would have perforated, and we expect the signs of infection would have been delayed because of the steroids she needed to take for her condition.
Rachel was about to administer a feed, but this time, when she checked placement, she was unable to draw back any gastric aspirate. Nothing had changed. The patient's tube was in the same spot; she was asymptomatic and had no signs of distress. But Rachel stopped. She notified the rehab provider, who appreciated her concerns and ordered an X-ray to check NG tube placement.
After being taken to X-ray, Rachel received a phone call from the attending provider letting her know there was concern for bowel perforation and to prepare the patient to go to surgery. This patient is severely immunocompromised for treatment of their myositis and is on high-dose chronic steroids, also increasing the risk of NEC.
Upon being taken to the OR, the surgeons found free air in the abdomen and beginning signs of NEC, but there was no perforation. The NG was in the right stomach, but if this patient would have continued to receive feeds, we likely would not have had any physical indications of her changing situation because of expected delay in presentation with steroid use.
This finding was subsequent, but if not caught early, a bowel perforation could have led to this patient's demise. Rachel had a very busy assignment that day, and it would have been easy to overlook the inability to withdraw gastric contents, but she did not. She stopped and did not proceed in the face of uncertainty.
Thank you so much for keeping our patients safe. Rachel potentially saved this patient's life because if her bowel condition had not been assessed, it likely would have perforated, and we expect the signs of infection would have been delayed because of the steroids she needed to take for her condition.
Thank you, Rachel, for your exceptional compassion, advocacy, and dedication to your patients. You truly make a difference.
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