I had a 5th semester student, Monet Poulin, at clinical Saturday whom I want to honor for great critical thinking in catching a concerning medical condition and preventing a patient's inappropriate discharge. The patient she had was post TKA and had a rapid the previous day for CP and respiratory distress. Cardiac work-up was negative, but the patient still had high O2 needs, underlying COPD- No IS and Monet had decided to be proactive and start IS. Monet also recognized that the patient never had a d-dimer or imaging done to rule out DVT/PE the prior day.

Her resource nurse was getting ready to discharge the patient when Monet saw that the patient had an LE ultrasound that had resulted, which showed a new DVT. The d-dimer was supposed to be ordered but had been missed. She immediately showed her resource nurse, and the discharge was canceled.

The patient went for a CTA to r/o PE and was promptly started on anticoagulation. If the care team had missed the ultrasound results, the patient would have been discharged with the untreated DVT ( and potential PE). Overall, I felt the Money showed great initiative and critical thinking, and helped the patient receive timely, potentially life-saving treatment.