July 2020
Lauren
Ignarra
,
RN
Oncology
Hackensack Meridian Health - Riverview Medical Center
Red Bank
,
NJ
United States
In doing a chart review, I came across documentation by Lauren Ignarra. I was touched by the care she provided. She went above and beyond in her approach to end of life care. I know this is the culture that we strive for as an HRO and it is important to recognize the front line staff. What Lauren documented was beautiful and this is certainly not something I can say I see often from a quality and outcomes perspective when doing a mortality chart review. I attached a snip of the note that this particular nurse wrote.
"2200 Noted change in patient's breathing and mental status. Unable to obtain manual blood pressure. Received in report that daughter is POA and is accepting poor prognosis that the patient is actively dying.
2220 Called to inform daughter in changes in hopes daughter would be able to come in and have a STAT hospice consult. The daughter is overwhelmed emotionally at this time and is unable to make the trip to the hospital. She would like to give permission for hospice over the phone but speaking with hospice that is not possible as consent needs to be signed for treatment. Spoke with the daughter at length for 30 minutes on the phone. With the daughter's request, reached out and called the patient's brother, and the family's friend, a Pastor. Exchanged several phone calls between all 3 individuals while bedside with the patient.
2300 Patient has declined further no longer responsive to verbal or painful stimuli with labored breathing and still no obtainable blood pressure. Called to inform daughter again that patient's death may be imminent tonight and stressed the importance that she has the informed choice on whether she wants to come to see her mother or not. That it is not required she be here but that I want to ensure she has an informed choice. Held the phone to the patient's ear to ensure the daughter could speak to her one last time. Also reached out to the patient's brother again so he could say goodbye. Stayed with the patient at the bedside, comforting and speaking to her, repeating the things her family told her so she could hear their love at her side until her passing."
"2200 Noted change in patient's breathing and mental status. Unable to obtain manual blood pressure. Received in report that daughter is POA and is accepting poor prognosis that the patient is actively dying.
2220 Called to inform daughter in changes in hopes daughter would be able to come in and have a STAT hospice consult. The daughter is overwhelmed emotionally at this time and is unable to make the trip to the hospital. She would like to give permission for hospice over the phone but speaking with hospice that is not possible as consent needs to be signed for treatment. Spoke with the daughter at length for 30 minutes on the phone. With the daughter's request, reached out and called the patient's brother, and the family's friend, a Pastor. Exchanged several phone calls between all 3 individuals while bedside with the patient.
2300 Patient has declined further no longer responsive to verbal or painful stimuli with labored breathing and still no obtainable blood pressure. Called to inform daughter again that patient's death may be imminent tonight and stressed the importance that she has the informed choice on whether she wants to come to see her mother or not. That it is not required she be here but that I want to ensure she has an informed choice. Held the phone to the patient's ear to ensure the daughter could speak to her one last time. Also reached out to the patient's brother again so he could say goodbye. Stayed with the patient at the bedside, comforting and speaking to her, repeating the things her family told her so she could hear their love at her side until her passing."