Grace Maina 2, MSN, APRN, CPNP-PC

Grace was the charge RN on L&D West one Saturday recently. Nurse staffing was very short that day. There was a patient in ECU who was prepped to begin Buprenorphine to treat her Opioid Use Disorder (OUD) and was in moderate withdrawal and needed continuous fetal monitoring during that process. There was a second patient with OUD who also was seeking buprenorphine. When patients are in moderate withdrawal, they are very uncomfortable, often with nausea, vomiting, diarrhea, sweating, runny nose and teary eyes, and severe bone/joint aches. Initially, there was not a bed /nurse available in L&D. Grace saw the patient in ECU while she was experiencing significant withdrawal symptoms and was ready to run out the door against medical advice because she was so uncomfortable. Grace was empathetic and realized that if the patient left, she would certainly go out and use fentanyl off the street. Grace then went to work to coordinate care so that both patients needing buprenorphine could be cared for in L&D. Two addiction medicine providers were willing to stay at the patients’ bedsides to monitor the administration and effects of buprenorphine induction, while the nursing staff monitored the fetal heart rate tracing and vital signs. Because Grace was willing and able to coordinate the care of these two patients without overburdening her nursing staff, two mamas and two babies received the care they needed. I truly believe that Grace advocated for and coordinated the care for these patients, and she saved four lives that day. 

Note: This is Grace's 2nd DAISY Award!