Jackie is the person who everyone looks for when there is a problem that needs to be solved. She is known by staff and patients alike, to be a "fixer"; if there is a difficult situation, Jackie will not stop until she finds a solution. Today was no different. Jackie received a call from a patient's wife. The wife was very upset because her husband, a Veteran, had been in the ICU for 2 weeks with heart failure. He was started on IV inotrope (dobutamine), and the inpatient team had been working with the Cardiology service to titrate his medications to stable doses. The time was getting close for him to go home; all that was needed was a contract with a home care agency that could manage a heart failure patient on home dobutamine infusion.

Despite multiple calls and multiple nurses, doctors, and social workers working towards this goal, a home care agency could not be found that had staffing in the area where the patient lives. The team offered the Veteran a bed in a nursing facility that could manage his infusion. The Veteran refused as he wanted to go home, and was feeling well enough to go home. Sadly, the other option that was offered was to discontinue the infusion and allow the Veteran to go home with hospice care.

When Jackie received the call from this Veteran's wife, and was told this story, she immediately got to work. She enlisted help from staff at other hospitals to find another option. She searched for a home care company that could meet the Veteran at a hospital close to his home to draw labs, perform PICC line care, and oversee medications; all of the same duties they would do in the Veteran's home, but in a clinical setting.

Through these contacts, a home care company was finally found that agreed to cover the territory in which this Veteran lives and pick up his care at discharge. He could go home, with his infusion, and receive home visits to provide heart failure management. All of this went into motion because Jackie used her imagination and community contacts to coordinate the care that this Veteran needed. She did not quit until his desired outcome was achieved. He is now able to go home with dignity and continue advanced heart failure therapy that, only a few hours before, he was told he could not receive.

This is just one example of how Jackie goes above her "job description". She treats every patient she comes in contact with like he or she is family, not a stranger. She is able to quickly offer solutions to make care easier for the patient. Sometimes this looks like active listening as the Veteran recalls his time in military service, sometimes it is helping a Veteran go home for the last weeks or months of his life because he wants to sleep in bed next to his wife as many nights as he can. Jackie is the most extraordinary nurse that I know.