Cheryl Pinuela, BSN, RN

Preparing a 30-year-old patient with cerebral palsy for dental exam and surgery under anesthesia in Pre-op, Cheryl was able to insert an IV into the patient with ease to the relief to both parents who recounted multiple difficulties in the past. The parents shared that she has been known to rip out IVs in the past as well as removing anything attached to her body.

After the patient was mildly sedated with oral Versed, Cheryl calmly explained to the parents what she was planning to do, step-by-step so that the parents understood what would be happening, which involved warming the IV site prior to insertion to make the veins more visible and using a topical numbing agent prior catheter insertion.

Cheryl was then proactive enough to play the patient's favorite TV show, Barney and Friends, on the computer to help keep the patient's attention away from the IV procedure. Then with the assistance of 2 other nurses who held the mildly sedated patient still, Cheryl was able to expertly insert the IV catheter on the first try, quickly checking proper placement, and wrapped the IV site with Coban so it made it difficult for the patient to remove it very easily. Her limbs were then loosely wrapped in towels so the patient couldn't visibly see the IV site or the pulse oximeter that was attached to her foot while the parents sang along with the Barney show with the patient. The patient was in no distress anytime during the whole IV insertion process. She was then placed in spine position with the head of the bed up 45 degrees to keep her airway open and covered with a warm blanket. The patient stayed asleep until her surgeon came to bedside to exam her prior to surgery.

Both parents were so grateful for Cheryl's expertise and kindness as well as taking care of their daughter with the awareness of patient's preference to her favorite TV show. It made the whole pre-op experience a good memory for the whole family.