Karen cared for a lady in her 60s who was a school teacher recently diagnosed with heart failure requiring cardiothoracic surgery. Her daughter, an LPN, was at her mother's bedside. That afternoon, Karen told me she was worried about the patient as she was having increased lethargy and subtle changes in her breathing pattern. She called the primary MD and we asked for a rapid response nurse to see the patient; he called primary back and obtained an ABG order. When we called the MD with results, she had already spoken to transplant service about transferring care and had written the order to transfer to critical care. The cardiologist and cardiothoracic surgeons were already in the room waiting on the patient upon arrival with a balloon pump and swan-ganz catheter set-up, ready for immediate insertion. The changes displayed by the patient were subtle and did not trigger any high-alert warnings like MEWS because her BP, oxygen saturations, and HR were stable and she was still waking up. Had it not been for Karen's vigilance and advocacy, the patient would have progressed to full-blown cardiogenic shock. Not only did Karen take care of her patient, but she also took care of her scared daughter by listening to her, answering all her questions, and explaining the plan to her.
Karen is always in her patient's rooms. She gets to know them and their families very well so that she is able to immediately recognize even the slightest changes in her patients' conditions. She establishes a genuine connection; her patients know she cares about them and they are comfortable telling her when they "just don't feel right." Karen does the same with their family members who know she will really listen to them if they say, "I'm worried about Mom, she's different than she was this morning." Her assessment skills are excellent, and she is one of our strongest patient advocates. Patients ask to see her when they come back to visit us and she always remembers them. The day Karen saved the patient's life was also the patient's birthday.