I am a nephrologist in Honolulu, and I attend a monthly clinic in Kona. On Friday, a hemodialysis patient under my care at the Kona Keauhou Dialysis Unit was found to have a thrombosed dialysis access. Initially, it appeared that there might be no possibility of securing dialysis access in a timely manner. Our patient would occasionally have episodes of severe, sometimes symptomatic hyperkalemia; thus, the need to restore access was a serious priority.
The urgency of the matter was heightened by the occurrence on a Friday, with reduced resources available during the upcoming weekend. Among the venues pursued was to seek assistance from Hilo Medical Center. This brought about contact with your on-duty Nursing Supervisor, Cathy.
Cathy immediately realized the urgency of the matter and readily sought a remedy through the resources available at HMC. She later contacted me with a tentative arrangement with an Interventional Radiologist at your facility, who would perform the emergent thrombectomy of the access. It had unfolded that the patient's previous surgeon in Honolulu was able to accommodate our patient in Honolulu, on the next day, Saturday. Dialysis access was obtained, and dialysis performed.
When Cathy contacted me with her tentative arrangements, the plans for remediation in Honolulu had just been confirmed. Cathy expressed relief (as did I), that the situation would be addressed, but remained fully willing to assist us.
What's remarkable about this situation was that Cathy had readily embraced the problem as if it was hers, while the patient remained in Kona. She had made tentative arrangements to see the situation through and clearly took "ownership". Undoubtedly, she had spent much time and effort trying to coordinate a complex arrangement, and under difficult circumstances. All for a patient who was not even yet her formal responsibility.
I have been practicing in the islands since 1984 and have been part of a group that had maintained a nephrology clinic in Hilo, as well as on other islands. Over the years, there have been many difficult circumstances, many emergent transfers into Honolulu. The very large effort required to arrange emergent, specialized care is deeply acknowledged and deeply appreciated.
It was a heartwarming and extremely satisfying experience to have had this cooperation from Cathy and your institution. Her efforts were exemplary of her professionalism, her ethic, and her humanity. I am proud that we have such people in healthcare.