Patricia Molinelli
December 2019
Patricia
Molinelli
,
MS, DNP, NP, APN-C, AOCNS
Palliative Care
Chilton Medical Center
Somerset
,
NJ
United States

 

 

 

Trish provides compassionate and caring patient/family-centered care every day. An example of this is a patient that 2 East had with a terminal illness. Both he and the family were struggling with this new diagnosis. The social worker was working with them at 5 pm yesterday; the patient made a turn for the worse.
Trish did not have this patient, but the 2 East team was having difficulty getting his Doctor, and Hospice was there only one hour previous and decided he was not a candidate for hospice. Trish hearing this sprang into action. She immediately changed his code status to a DNR-A. as per the patient's request. The patient was very dyspneic at this point - begging everyone to "help him." Trish ordered morphine. Then put a call out to his physician to let him know the patient's request and plan of care. She spent time speaking with hospice and requested that she re-visit the patient to see if he met the criteria; at this point, it was 7:30 pm, but the patient was comfortable and was admitted to hospice and had a plan which allowed him dignity, which he deserved.
This is just one example of Trish's commitment to Chilton Medical Center and her patients. Many nights, Trish is in the building at 10 pm. Families and the staff call her throughout the night whether for advice, orders or just to talk. She always makes herself available to them.
***
I had a very difficult case involving a potential hospice patient who was declining in our unit. The primary MD would not give us any orders for pain control. The hospice RN denied this patient for inpatient hospice (GIP). The patient was at this point a full code and after we ran out of options (other than RRT) Trish was leaving to go home and I asked her if she could help.
Immediately Trish put her belongings down and started digging into the case. The patient went into pulmonary edema and we had to RRT the patient for comfort. Trish immediately examined the patient with me and called the hospice RN back to re-evaluate this patient. Trish was not at this point consulted on this case but intervened and helped me to help my patient breathe more easily and alleviate his pain.
The hospice RN re-evaluated the patient and he was now accepted to hospice and made a DNR-A and put on comfort measures. Trish spent a lot of time helping me to achieve the goals of care this patient needed without any hesitation whatsoever. She was on her way home after a long day and did not leave our unit until after 7:30 pm, making sure the patient had everything he needed to be comfortable. This act is definitely above and beyond! It is reassuring to know that I feel comfortable enough to reach out to Trish and she will help without hesitation - even on her way out of the door.