Phuong Le
April 2024
Phuong
Le
,
DNP, MSN, BSN, RN, CDP
Senior Health and Memory Clinic
Kaiser Permanente San Jose Medical Center
San Jose
,
CA
United States
You just saved a life, and I may have to consider changing my health care to Kaiser so I could be well taken care of too.
One of our patients came to receive services at our hospital with her husband. She speaks English, and her husband only speaks Spanish. Therefore, a Spanish interpreter was used for the encounter. The patient's husband reported that due to her short-term memory loss, she has to depend on him for some activities of daily living. The patient's PCP ordered a head CT scan, but the patient failed to keep the appointment. So, another CT scan was ordered, and the radiology department was unable to reach the patient.
The radiology department notified Phuong Le that they were not able to contact the patient, and the referral was closed. Phuong did a detailed review of the patient's medical record and discovered that her primary caregiver, her husband, has cancer, and the patient is estranged from her son. There was questionable short-term memory loss that has gone undiagnosed for several months, therefore, this nurse made a follow-up call on the same day. While on the phone with the patient, she assisted her to book with radiology directly. Her CT scan was scheduled for the next day. The patient completed the scan.
While having lunch, Phuong received a call from the radiologist, who said that the patient’s CT scan had concerning findings. Phuong immediately contacted the patient to perform a neurological assessment. If the patient had symptoms, they would be advised to immediately go to ED.
During the neurological telephone assessment, using the Spanish interpreter so the husband could hear and understand, the patient confirmed having dizziness, headaches, a recent fall, and blurred vision. The call lasted 40 minutes and resulted in instructions to immediately go to the ED for further evaluation. By the end of the conversation, the Spanish interpreter stated, "It may not be my place to say this since I am done with the interpretation. However, I want to say that you just saved a life, and I may have to consider changing my health care to Kaiser so I could be well taken care of, too.”
Phuong called the ED to provide a warm handoff and alert the team of the patient's current symptoms of dizziness and the fear of a long wait, which might result in her leaving without being seen.
The radiology department notified Phuong Le that they were not able to contact the patient, and the referral was closed. Phuong did a detailed review of the patient's medical record and discovered that her primary caregiver, her husband, has cancer, and the patient is estranged from her son. There was questionable short-term memory loss that has gone undiagnosed for several months, therefore, this nurse made a follow-up call on the same day. While on the phone with the patient, she assisted her to book with radiology directly. Her CT scan was scheduled for the next day. The patient completed the scan.
While having lunch, Phuong received a call from the radiologist, who said that the patient’s CT scan had concerning findings. Phuong immediately contacted the patient to perform a neurological assessment. If the patient had symptoms, they would be advised to immediately go to ED.
During the neurological telephone assessment, using the Spanish interpreter so the husband could hear and understand, the patient confirmed having dizziness, headaches, a recent fall, and blurred vision. The call lasted 40 minutes and resulted in instructions to immediately go to the ED for further evaluation. By the end of the conversation, the Spanish interpreter stated, "It may not be my place to say this since I am done with the interpretation. However, I want to say that you just saved a life, and I may have to consider changing my health care to Kaiser so I could be well taken care of, too.”
Phuong called the ED to provide a warm handoff and alert the team of the patient's current symptoms of dizziness and the fear of a long wait, which might result in her leaving without being seen.