Kathy Krumrei

Kathy Krumrei

Kathy Krumrei, BSN, RN, RN-BC

Case Management
UnityPoint Health St. Luke's Hospital (IA)
Cedar Rapids, Iowa
United States
Kathy took that difficult task and added ingenuity, research, and persuasion to make a discharge happen early for one patient.

Coordinating care after a patient has major surgery is sometimes a very difficult task. Kathy took that difficult task and added ingenuity, research, and persuasion to make a discharge happen early for one patient. This was one of the first times that a patient has been sent home with a pneumostat/chest tube waiting for a post-operative pneumothorax to resolve. Early in this patient’s stay on 3W Kathy started to think about sending him home with “the tube”, knowing how tricky it would be given the fact that he lived in the country. He was very nervous at first that something would happen to his tube, or he would have a complication. Kathy took the time to research the tube, common complications and provided to the patient and his wife several educational handouts. Knowing that he was closer to JRMC, she then called the ER and let them know that no problems were anticipated but she provided them education on the tube and that he was instructed to go there in case of an emergency. Typically, while the pneumothorax is resolving patients receive periotic chest x-rays.  Not wanting the patient to incur an extra fee for an office visit, she arranged for the patient to have an OP radiology visit at St. Luke’s. Once the time was set up, she also arranged for the ARNP to see the patient while he was in the radiology department just to look at the tube insertion site to make sure that it was still good. She accompanied the ARNP to see how this was going. The patient was so excited to be out of the hospital, he told her how much he appreciated what she had done. The pneumothorax had still not resolved even at 7 days out so additional office visit is needed, however, the skeptical surgeon was pleased with how well this process went for his patient. This resourcefulness that was demonstrated in the planning of this discharge showed great care. Not only did it save this patient at least 10 days in the hospital, it also lifted his spirits so that he could heal that much quicker.