Since I started working in EP, one of the things I quickly noticed was how valuable Jessica was to the Electrophysiology Lab. She is the go-to person when it comes to everything from big emergencies to small nuances in charting or equipment. There is no answer she won't find out, and she is just one of those "make it happen" kind of people. I know that any day I work with Jessica, or if it's a week that she is charge nurse, our patients and our department are in good hands.

One thing I have always admired about Jessica is her advocacy for both patients and staff members. She stands up for what is in the best interest of the patient first and foremost, and when she is a charge nurse, she also stands up for the staff and what is reasonable.

Recently, we had a situation arise in the department where Jessica's actions, advocacy, and experience resulted in quick intervention and a good patient outcome in a true emergent situation. We were performing a routine ablation procedure on a patient under conscious sedation (without anesthesia), and suddenly the patient began to become extremely hypotensive. Our providers quickly diagnosed a pericardial effusion causing tamponade as the culprit.

Jessica was charge nurse that day and quickly came to the room and was able to quickly align the appropriate interventions. We, as a department, are prepared for what to do in the event of an effusion, and it is a scenario that we can typically quickly remedy, but this time was different, and Jessica recognized that immediately. She mentioned to me that something was telling her this was going to need further intervention than what we could handle amongst ourselves.

She quickly reached out to Anesthesia, and we got an anesthesia team in the room to take over managing the patient's airway and hemodynamics. Meanwhile, as our providers were performing a pericardiocentesis, the effusion did not seem to be decreasing as we expected. Our provider in this case had only been at UVA a few months and, therefore, had not been in a situation such as this at UVA, but luckily Jessica was there to suggest the appropriate escalations.

She asked the provider if they would like to initiate an "Open Chest Emergency." We were still hopeful that we would not have to take it that far, but it would at least have all of the appropriate people in place in the event that we did. She explained what all that entailed, and they agreed, and she promptly initiated it. She also coordinated with the blood bank and made sure we had blood in the room ready to infuse.

The Open Chest Emergency was called, and all the necessary personnel arrived in the lab. Despite our providers' best efforts, the effusion was still not adequately diminishing, so with the CT surgeon, the decision was ultimately made to open the patient's chest and search for what needed to be repaired. This was done successfully, and the patient was stabilized.

This is not a common scenario, especially for the type of procedure we were performing, but Jessica's prompt recognition, intervention, and escalation very possibly saved this patient's life. If she had not acted so quickly and initiated the Open Chest Emergency when she did, the outcome may not have been the same.

This is just one specific scenario that highlights Jessica's extraordinary contributions to the electrophysiology department!