We had a young pregnant patient on Mother/Infant suffering from severe hyperemesis and dehydration. Additionally, the patient was a very hard stick and had one 22g peripheral IV that had been placed by anesthesia. The patient required fluid and multiple other medications via IV. The Physician had ordered PICC placement, however, there was no PICC nurse available to come in. The on call PICC RN suggested CVC placement. However, the patient will likely have to go home with vascular access in place for the next few weeks. Had a CVC been placed the patient would have likely had to undergo 2 separate Central Line placements prior to discharge causing increased stress, risk, cost, and pain to the patient.
Joe from the ER volunteered to go up to Mother/Infant and start an Ultrasound guided peripheral IV on this patient. Joe took time away from his busy assignment in the ER to do what was in the best interest of our patient on the Mother/Infant unit. Joe went above and beyond what is expected of him as ED staff to make sure our pregnant patient was able to be treated appropriately. Because of Joe's willingness to go above and beyond, the patient will be able to receive the hydration, electrolytes and medications she needs until a PICC can be inserted. In addition, I would also like to note that the patient divulged that last year she lost a pregnancy due to similar circumstances of dehydration secondary to hyperemesis. Joe's actions demonstrated to the patient that we, as a community of health care providers, care about her and the life of her unborn child and that we will all work together to ensure she receives the highest quality care.