Njeri Cooper
June 2021
Njeri
Cooper
,
RN
Case Management
Methodist North Hospital
Memphis
,
TN
United States
Njeri worked hard to safely transfer the patient via ambulance at no cost to the hospital to her waiting family in Florida.
A patient presented to the Emergency Department (ED) with progressively worsening shortness of breath (SOB) and generalized edema. The patient was admitted to the intensive care unit (ICU) where she spent 15 days of her 62-day hospital admission. Notably, the patient relocated to Memphis from South Carolina 6 weeks prior to her admission at Methodist North Hospital.
On day 2 of her admission, the patient’s condition worsened necessitating mechanical ventilation, but on day 5, the patient insisted on extubation. Palliative was consulted to discuss goals of care at which time the patient’s wish was to focus only on comfort measures. Unfortunately, the patient’s condition continued to decline, and her Code Status changed to Do Not Resuscitate (DNR), and she was admitted to GIP hospice. Sixteen days into her admission, the patient was transferred out of ICU, but still required high flow oxygen. While on 2D, her condition started to decompensate again at which time, she revoked her DNR status and dis-enrolled from hospice.
Subsequently, she was transferred back to ICU and re-intubated. While in ICU, she and her family elected extubation and re-enrollment into hospice. Miraculously, the patient was transferred. During her stay on 3N, the patient shared with the case manager and physician that she wanted to be discharged to Florida on hospice. Needless to say, her post-acute care needs were comprehensive and compounded by the fact that she was uninsured. To honor the patient’s wishes, Njeri and Kurtil worked closely with the patient, family in Memphis (nephew), family in Florida (brother), and the Alliance hospice liaison to safely transfer the patient via ambulance at no cost to the hospital to her waiting family in Florida. This is merely one example of the amazing work this team does on a daily basis to meet the individual needs of our patients and families.
On day 2 of her admission, the patient’s condition worsened necessitating mechanical ventilation, but on day 5, the patient insisted on extubation. Palliative was consulted to discuss goals of care at which time the patient’s wish was to focus only on comfort measures. Unfortunately, the patient’s condition continued to decline, and her Code Status changed to Do Not Resuscitate (DNR), and she was admitted to GIP hospice. Sixteen days into her admission, the patient was transferred out of ICU, but still required high flow oxygen. While on 2D, her condition started to decompensate again at which time, she revoked her DNR status and dis-enrolled from hospice.
Subsequently, she was transferred back to ICU and re-intubated. While in ICU, she and her family elected extubation and re-enrollment into hospice. Miraculously, the patient was transferred. During her stay on 3N, the patient shared with the case manager and physician that she wanted to be discharged to Florida on hospice. Needless to say, her post-acute care needs were comprehensive and compounded by the fact that she was uninsured. To honor the patient’s wishes, Njeri and Kurtil worked closely with the patient, family in Memphis (nephew), family in Florida (brother), and the Alliance hospice liaison to safely transfer the patient via ambulance at no cost to the hospital to her waiting family in Florida. This is merely one example of the amazing work this team does on a daily basis to meet the individual needs of our patients and families.