I was witness to a conversation that Melinda Bates, RN was having on the phone with a Veteran. Ms. Bates called a Veteran for a follow-up phone call after a previous ED visit, and he stated that he woke up and his left arm was numb and felt like a dead arm. He stated that he was able to move his arm but had limited use of his left hand. He stated that it didn't hurt, there was no redness, and it wasn’t inflamed. He had had pacemaker lead changes at Winston Salem previously.

The Veteran had called the call center for the VA and triage sent him to the local county hospital. He stated that the ED provider told him they couldn't find a pulse in his left wrist. An Ultrasound was done from the underarm to the wrist and no blockage. He was then sent home.

He said that his arm had seemed to wake up and was no longer a "dead arm", but it still with some tingling and some limit to movement of his left hand. Veteran stated, "It is better but it just doesn’t feel right."

Melinda was extremely upset the Veteran was discharged home from the local ED and told they could not find a radial pulse. Ms. Bates spoke with the CBOC provider and told her she was going to have the Veteran come in right then to have an evaluation as very concerning as he did not have a pulse and had just left an ED. Ms. Bates's compassion and concern were enormous.

The Veteran was assessed and determined that he needed to be seen by the ED in Asheville. The provider called the Asheville VA ED provider and advised they were sending the Veteran there for evaluation. Once he arrived, he was sent to the OR for a blood clot in his left arm. This saved this Veteran’s arm. If not for the expertise and the persistence of Ms. Bates in her concern for the Veteran, this outcome could have been horribly different. The Veteran would have probably lost his arm.

Kudos to Ms. Bates for her compassion, persistence, and knowledge to do the right thing for this Veteran.