My mother-in-law is a retired nurse and was hospitalized on 5 North for 16 days. There were many wonderful nurses and PCA's who cared for her, but one of them, Amy Watkins stood, out for the special care and concern she gave to C and her family support system during her final days on 5 North.
C, who was living independently with her German Shepherd Sammy, suffers from a mild to moderate case of dementia along with other co-morbid conditions such as HTN and diabetes. As a result of a significant stress in her life, she became almost catatonic and was hospitalized at the end of July with severe dehydration and electrolyte and metabolic imbalances (blood sugar 43). A urinalysis showed a UTI and not surprisingly, C's mental status was deteriorated from her previous state. By the 2nd hospital day, she went into delirium and her overall condition slowly deteriorated.
Although her UTI cleared up, C began complaining of abdominal pain and as it progressed, a CT scan was ordered. The findings included a perforated diverticulitis with inflammation and infection. Our 2 initial options by the surgical PA were not ideal (do nothing and she'll die within two days to two weeks or operate and she'll probably die in a few weeks most likely on some sort of life support). The surgeon came in and offered us another option (as her vital signs were stable and her pain minimal); bowel rest, continued antibiotics and repeat CT scan in a few days to see if her belly improves or see if there might be something to drain.
We chose to wait and hope that bowel rest would suffice, but unfortunately, C developed significant rectal bleeding; blood transfusions did not have sustainable benefits. The follow-up CT scan was now worse, an abscess that formed could not be drained by Interventional Radiology, so we were truly left with no options, her chance of survival if they did a surgical intervention now was poor. We made the decision to discharge to Hospice inpatient care to spend her remaining days of life, at that time estimated to be two to three days.
I've spent a long time sharing C's background story with you because, as you can imagine, this is a patient where nurses and families often feel helpless; that's where Amy comes in. Amy never sugar coated what was happening, she kept us informed and included us in what was going on, in a calm and caring way. When there were times of increased bleeding, Amy maintained a professional, yet caring sense of calm. Knowing C loved her own dog, Sammy, Amy and the staff brought in pictures of their pets to share with C to try and boost her spirits; as the staff soon realized, C would rather see pictures of their pets than pictures of their children.
The most meaningful gesture, and the reason we wanted to nominate Amy, occurred during C's last day (of 16) on 5 North. Not knowing if Hospice would accept her, and recognizing that she might not survive the night, Amy asked us if we could arrange to bring in C's dog, Sammy, to see her one last time before passing; you can imagine the flood of emotions we had. Although we did not take Amy up on her offer (C was accepted at Hospice that day), the effort that she was willing to take for our mother, mother-in-law, and grandmother, meant so much to us, because we knew it would mean so much to her.
C went to Hospice, saw her dog, and that night began slowly but surely improving. She actually was ultimately discharged to a rehab facility 4 weeks after going to Hospice to die. Unfortunately, 4 months after her initial admission to LGH, in the end, C succumbed just last night as a result of all of the insults to her body. Sammy of course was by her side with members of her family.
Clearly, to us, Amy was accountable, positive, she listened and exceeded expectations. As an RN and employee of Lancaster General, I couldn't have been prouder of all Amy and the team did to help C when it mattered most.