Krista Tkacz, FNP-C, MSN

Krista and I shared a patient who, on chart review, had a history of substance abuse, a recent motor vehicle accident, and extremely high levels of chronic back pain.

As I was seeing the patient, he would have short-term relief but still considerably higher pain levels than would be expected. As Krista was managing him as his primary care physician, she had ordered a CT scan, which went unfulfilled, and plain radiographs were completed by Shiprock. She called Shiprock radiology to advocate for this patient, as she had been met with resistance from the radiologist when attempting to perform this scan. The staff radiologist said that further examination would not reveal anything. Had it not been for Krista strongly advocating for this patient to receive the CT, we would have missed the diagnosis of osteomyelitis infection that was confirmed by MRI. The patient was then flown emergently to Denver for surgery and biopsy to clean out the infection.

I wrote Krista's DAISY recommendation for her insight and diligence in advocating for the patient to obtain more detailed imaging, despite the radiologist's recommendation.