I would like to bring your attention to an act of professional nursing which many people talk about, but few witness on a daily basis. Nurses often discuss the importance of advocating for patients - particularly those patients who cannot speak for themselves. On 2/10/2011, I witnessed an event on 5East ART. My nursing students were wrapping up their day as I made rounds on their patients. One patient caught my attention and I sat with her for 15 minutes to get a better picture of her health status. She was very lethargic, tremulous and unable to complete a single sentence. She was physically unable to process or answer simple queries and was too weak to get out of bed without the assistance of two people. She also came to MUSC by way of several serious substance abuse problems which led to related digestive disease disorders - therefore, she was an overflow patient for 5East.
Upon discussing her care with the student assigned to her, I was stunned to find she had been discharged and was awaiting transport. I sought the staff nurse, Nicholas (Nick) Eleftheriou, who had just learned the same information. I expected him to be mystified by the discharge order but he was unconcerned about the details because he was too busy advocating for the patient. My students left for the day and I stayed behind to watch him work. Within the next hour, he mobilized various multidisciplinary resources to apply the needed amount of persuasion to reverse the discharge decision. But he didn't stop there.
He proactively moved his patient in front of the nurse's station and then he collaborated with the patient's home team to determine a better plan of care for the patient that involved the IOP team as well. Discussions among all were professional - not heated or adversarial. Within the next day, the patient's medical condition was stabilized and she was transferred to IOP.
Nick displayed moral courage and a determination to provide truly patient-centered care to a human being who was too helpless and powerless to fend for herself. His actions were in keeping with the highest traditions of the nursing profession and reflect great credit upon himself and the profession as a whole.
As an outside observer, I witness many care events which could stand improvement. But I also see greatness in your nursing team that makes me more optimistic about the world of nursing my future graduates will enter and shape for the better. I often see MUSC and other nurses save lives and move on with their day as if nothing out of the ordinary had occurred. This was an event that spoke to our focus on both safety and quality in patient care, and a month later I find myself reflecting on his actions and wondering if I would have done as well in all regards. I thought I would share one of many good reasons to be optimistic about what is really happening at the tip of the spear.