We recently cared for a patient who had a very long labor and eventually delivery by a cesarean section. The patient had a very unusual postpartum course and the care she received by her nursing staff was outstanding. The nursing care was extremely vigilant and attentive to detail. The team was aware that after almost 24 hours post-delivery the patient still did not have any urinary output. The OB providers were aware and every differential diagnosis was explored. After a cystogram at 22 hours post-op, there was still not a definitive diagnosis. According to urology, the question was raised, "are we dealing with pre-renal issues vs. obstruction?". The plan created by urology for night shift was to continue IVF and check labs in the morning.
This is when Hayley started caring for the patient. Hayley remained vigilant throughout the night shift. She was in frequent communication with urology and the obstetrician. She used her nursing judgment and critical thinking to advocate for the patient. She respectfully challenged the provider's orders when they did not seem beneficial. She involved her available resources and sought out expert opinion from the mom baby charge nurse, labor and delivery charge nurse and house supervisor. Hayley remained present with the patient, provided reassurance and used her amazing assessment skills to help advance the patient's plan of care.
Our team is grateful for Hayley's vigilance. The morning following Hayley's care, the patient returned to the operating room and interventional radiology. Per the urologist's note, "because of your nursing assessment, persistence, and clear articulate communication you helped prevent a significant, long-term injury to the patient's ureters".
Thank you, Hayley, for your vigilance and outstanding, compassionate care. We are grateful you were the nurse caring for this extremely complicated patient. We recognize this was a challenging situation and we are grateful you were there to respectfully advocate for her.