January 2023
Nicole
Molesky
,
RN
Emergency Department
SSM Health St. Mary's Hospital - Madison
Madison
,
WI
United States
Nicole took the initiative to advocate for this patient and provided exemplary care.
Nicole Molesky Emergency Department RN, went above and beyond in providing care to a stroke patient. A 59 yo male had an unwitnessed fall in a department store and was found by a store employee to have right sided conflicts with altered mentation. His last known well was unclear and was thought to be 5pm. Recognizing that there was an opportunity to determine this patient’s last known well, Nicole called the department store and had them review security footage to see if they could identify when the change in condition occurred. Instead of estimating that the patient’s last known well was over 3 hours before arriving at the ER, using the camera footage they were able to identify that his last known well was only 45 minutes before arriving. This made all the difference in his care and the treatment options that could be provided to him. With this new knowledge, the patient was eligible to receive a clot-busting medication, an IV thrombolytic called Tenecteplase. Within 2 hours of receiving this medication, this patient’s presenting symptoms of aphasia, right-sided weakness, facial droop, and blurred vision completely resolved. Nicole took the initiative to advocate for this patient and provided exemplary care. This patient is back to his baseline today. Without question, Nicole changed this patient’s life! He presented to the ER with debilitating deficits and today he can return home with a complete resolution of symptoms.