Chime Jaimes is one of the most caring, committed and compassionate nurses that I have had the pleasure to work with. She is always focused on what is the best for the patient, as in this example.
We currently have a developmentally delayed patient who is medically ready for discharge after his bone marrow transplant. BMT patients need a 24-hour caregiver following discharge until they meet a certain level of recovery. Through a series of unfortunate events, he lost his initial caregiver and his current caregiver is his adult sister, who also has cognitive deficits. There has been an incredible amount of talk back-and-forth throughout the team about whether or not he should be discharged into his sister's care and about her ability to care for him. He has a complex medication regimen (all liquid medications that have to be pulled up into syringes to administer), frequent temperature and symptom checks and clinic visits to contend with. Many of the staff had ideas on how we could support these two individuals, but Chime took charge of the situation.
She determinedly sat down and called the pharmacy, found out the mL amount of each of his medication doses and proceeded to make a daily schedule for the patient and his sister. Due to the decreased cognitive ability, the patient and his sister often forget to do things that seem simple, like eat and brush their teeth. Chime added these tasks to the schedule, with checkboxes next to each one. Then, she coordinated with the charge nurse in the outpatient BMTU clinic to let her know of her concerns and emailed the CN the schedule so that they can continue to print it for the patient and check it at clinic visits.
Chime didn't stop there. She was not scheduled to be back the next day, so she coordinated with the nighttime charge nurse to pick a nurse she knew would keep the plan going, and to make sure that the nurse had a lighter assignment to account for the huge amount of teaching that would be involved to get this patient discharged. Chime and the next day's nurse talked on the phone about the checklist and the plan for teaching. She called the pharmacy and got it approved for the patient to take his home medications the next day so that the sister's med administration technique could be observed.
When we came in this morning, the patient's sister proudly showed that she had already helped the patient eat breakfast and brush his teeth, and she had checked off the boxes! The whole team is still holding our breath but breathing a little sigh of relief that maybe with Chime's special attention, planning, and care coordination, this patient will get to enjoy time away from the hospital.