December 2023
Lori
Schneider
,
BSN, RN
Cardiac Rehab
Inova Alexandria Hospital
Alexandria
,
VA
United States
Although the patient was not enrolled in pulmonary rehabilitation for long, Lori played a critical part in getting him adequate care and, ultimately, a diagnosis that he did not have prior to enrolling in a pulmonary rehabilitation program.
Lori is a phenomenal nurse, advocating above and beyond for her patients every single day when she comes to work. A patient was recently admitted to IAH pulmonary rehab program and although he was a pulmonary patient, the pulmonary rehabilitation clinician who did his initial evaluation thought that his medical issues may be more than just pulmonary in nature. The patient presented to pulmonary rehabilitation with the following symptoms: progressive fatigue, cough, dyspnea on exertion, bilateral lower extremity edema, abdominal bloating, and loss of appetite since November 2022. He was hospitalized in May 2023 for the above symptoms and was diagnosed with Bronchiectasis and Pneumonia. However, even after his discharge from the hospital, the patient stated that he felt as though “his health has been on a decline.” Lori worked with this patient during his second appointment in the pulmonary rehab program.
Due to the patient's symptoms, Lori used her clinician's judgment and put the patient on a telemetry monitor during his second pulmonary rehabilitation appointment. The patient was asymptomatic with exercise during pulmonary rehabilitation, however upon further review of his telemetry Lori noticed that he had brief episodes of Wenckebach through his pulmonary rehabilitation session. Lori called and faxed this telemetry report to his primary care doctor in Maryland and helped to get an appointment scheduled with his doctor’s office in the next 2-3 days to discuss his ongoing symptoms and telemetry report from pulmonary rehabilitation. Lori also followed up with the patient to discuss his telemetry report and, while talking with him, learned that he had recently had an episode of lightheadedness at home associated with a low resting systolic BP in the 70s and HR in the 40s. Lori instructed him to go to the ED, given his symptoms, and then proceeded to call his primary care doctor to inform him about his recent event at home and that he was heading to the ED. The patient was unfortunately discharged from the ED quickly, but had a follow up appointment scheduled with his primary care doctor.
Due to Lori’s advocacy for this patient and the close communication with his out of network physicians the patient called pulmonary rehabilitation department about 3-4 weeks later to inform them that he had been hospitalized again and after multiple tests and procedures had been conducted, he was given a diagnosis of cardiac amyloidosis. The patient asked to be discharged from pulmonary rehabilitation program to focus on his new diagnosis and fully understand treatment options with his physicians. Although the patient was not enrolled in pulmonary rehabilitation for long, Lori played a critical part in getting him adequate care and, ultimately, a diagnosis that he did not have prior to enrolling in a pulmonary rehabilitation program. We are so lucky to have Lori as a nurse on our pulmonary rehabilitation team and the above and beyond care she provides for our patients.
Due to the patient's symptoms, Lori used her clinician's judgment and put the patient on a telemetry monitor during his second pulmonary rehabilitation appointment. The patient was asymptomatic with exercise during pulmonary rehabilitation, however upon further review of his telemetry Lori noticed that he had brief episodes of Wenckebach through his pulmonary rehabilitation session. Lori called and faxed this telemetry report to his primary care doctor in Maryland and helped to get an appointment scheduled with his doctor’s office in the next 2-3 days to discuss his ongoing symptoms and telemetry report from pulmonary rehabilitation. Lori also followed up with the patient to discuss his telemetry report and, while talking with him, learned that he had recently had an episode of lightheadedness at home associated with a low resting systolic BP in the 70s and HR in the 40s. Lori instructed him to go to the ED, given his symptoms, and then proceeded to call his primary care doctor to inform him about his recent event at home and that he was heading to the ED. The patient was unfortunately discharged from the ED quickly, but had a follow up appointment scheduled with his primary care doctor.
Due to Lori’s advocacy for this patient and the close communication with his out of network physicians the patient called pulmonary rehabilitation department about 3-4 weeks later to inform them that he had been hospitalized again and after multiple tests and procedures had been conducted, he was given a diagnosis of cardiac amyloidosis. The patient asked to be discharged from pulmonary rehabilitation program to focus on his new diagnosis and fully understand treatment options with his physicians. Although the patient was not enrolled in pulmonary rehabilitation for long, Lori played a critical part in getting him adequate care and, ultimately, a diagnosis that he did not have prior to enrolling in a pulmonary rehabilitation program. We are so lucky to have Lori as a nurse on our pulmonary rehabilitation team and the above and beyond care she provides for our patients.