Van Billingsley
August 2020
Interventional Radiology (IR)
Audie L. Murphy Memorial VA Hospital
San Antonio
United States




Van Billingsley was conducting COVID-19 and Moderate Sedation telephone screening call, noted that there had been four unsuccessful attempts to reach a veteran, a retired RN of 39 years, scheduled for a percutaneous feeding tube in Interventional Radiology (IR). Mr. Billingsley was successful in reaching the veteran and took the initiative to conduct both screenings: I am very thankful he did.v

During the Screening for Moderate Sedation, Mr. Billingsley noted the hesitation of this veteran, as evidenced by his tearful and halting communication. Mr. Billingsley took this time to fully discuss not just the procedure, but the patient’s mental anguish as well. The veteran had lost his wife recently to ovarian cancer in which she also needed a feeding tube. The veteran had not had proper time to grieve the loss of his wife of 51 years, nor had he had the time to focus on himself as he was caring for her.

It was during this call that Mr. Billingsley discovered through his assessment that the veteran reported some bleeding from the nose and mouth. It is Mr. Billingsley's expertise in IR and his knowledge that active bleeding could cause an increased risk of aspiration under moderate sedation. This led him to contact his Assistant Nurse Manager via Skype for help in coordinating Anesthesia assistance.

Mr. Billingsley remembered there were unsuccessful attempts to reach the veteran, so he continued to provide emotional support and service recovery allowing the veteran to discuss his feelings, his life, his loss, and his future, all while communicating with his ANM via Skype. Anesthesia Service was contacted and agreed with the assessment. This veteran's case was moved into the first time slot to minimize his wait time and anxiety. Bed flow was contacted to pre-arrange a bed for post-procedure admission.

Before disconnecting the call, Mr. Billingsley was able to provide this veteran with the IR plan of action which greatly eased his fears and anxiety. Mr. Billingsley was transparent in his discussion that he could not guarantee the PEG placement would be successful, however, he assured the patient IR would do everything possible to ensure his safety and if necessary, collaborate with the appropriate services on the same day should the PEG placement prove unsuccessful. Finally, to exceed the veteran's expectations, arrangements were made to ensure Mr. Billingsley would be available to care for this veteran upon his arrival.

This is an excellent example of both a great catch and a demonstration of ICARE values. This veteran quickly, efficiently, and safely received his much-needed feeding tube through the excellent care of Mr. Billingsley's compassion and dedication.