Melissa Kuhn was the RN assigned to V.O in November 2017, where a patient had been admitted to ORMC with Status epilepticus. It was found that the patient had an intracranial bleed, with an acute communicating hydrocephalus. The patient was taken to the OR by Dr. O, where a ventriculoperitoneal shunt was placed.The patient was doing well and downgraded to 4 North. Melissa had cared for the patient and that day, received notice that she had a good night with no issues or concerns noted.The neurosurgeon had been in to see the patient where he found her to be doing well with no change in her neuro status. Melissa went in to round on patient her to be more lethargic then she was previously. Melissa at this time performed a neuro assessment on the patient and found that while she was arousable and oriented, there was a change in her pupil size and pupil response, and she remained lethargic. Melissa called Dr. N to report the change. At this time, Dr. N was not concerned and instructed Melissa to contact the neurosurgeon. The neurosurgeon was in surgery so his associate Dr. D returned her call. A CT scan of the brain was ordered. Melissa at this time was very concerned by the change in the patient that she began performing neuro assessments every hour as well as rounding frequently on the patient.
Dr. N was the primary physician, Melissa notified her of the CT results. A call was placed to neurosurgeon who was still in surgery, so the call was then referred to Dr. D. Melissa was given the order to make the patient NPO incase surgery was needed. Dr. O who had been in the OR came up to the unit to assess the patient,Melissa again reported to him the assessments. The patient was more lethargic, and her pupil size and response had changed again becoming more dilated and sluggish. At this time, Dr. O ordered a CTA to be completed. He requested the test be done within 45 minutes. Melissa received the results and notified Dr. O right away. Mrs. O needed to be transferred immediately to Westchester Medical Center for emergency surgery. At 5pm Dr. O, Dr. N, and Melissa went to the patient's room to talk with her and her family. The patient was taken by helicopter to Westchester Medical Center. Dr. N had notified us that the patient was doing well.
Melissa Kuhn saved the patient's life. Melissa made multiple phone calls to multiple doctors. She was adamant that something was occurring and needed a physician to come see the patient. Melissa was in the patient's room every 30 minutes to check on her. She performed and documented neuro checks every 60 minutes. With assistance from her team, she monitored her vital signs, neuro checks and mental status constantly. Melissa had 6 patients that she was assigned to care for that day. Melissa huddled with her team and kept everyone updated with her patient's situation. The team worked together to ensure that all the patients were safe and received exceptional quality care. Melissa was professional and compassionate keeping the family calm and aware every step of the way.
Dr. N confided in Melissa that day that she was annoying her with the constant calls, and requests, but she is so thankful that she did. Dr. N came to find me on Monday. She stated that Melissa went above and beyond for the patient and she wanted to make sure everyone knows what an exceptional nurse she is. I am proud to say I work with Melissa Kuhn. This is just one example of what a truly exceptional nurse and person Melissa is.