Rosalind Alverez

Rosalind Alverez, CCRN, ASN

NICU
Saint Peter's University Hospital (NJ)
New Brunswick, New Jersey
United States

~
~ Had it not been for the critical thinking and the persistence of these
~ four nurses, the outcome for this patient and family may have been
~ devastating.
~
~
~
~ On 4/06/10, the NICU received a desperate telephone call. The woman
~ calling asked to speak with Daniela or Yolanda. Neither was working.
~ She then asked to speak with someone in Spanish. She verbalized that
~ she had an emergency. Edith Legaspi who speaks some Spanish came to
the
~ phone to assist and was able to ascertain that the baby's cardiac
~ monitor was alarming and that the baby was blue in color. She
directed
~ the woman on the phone to call 911. The woman never identified
herself
~ before ending the call.
~
~
~
~ Concerned by the phone call, the nurses with the help of Ruth
Fletcher,
~ the unit secretary, checked the phone log and retrieved the number
from
~ which the call was placed. Rosalind Alvarez placed a call to a 911
~ operator and explained the unusual circumstances of the call and the
~ concern of the NICU staff for the well being of the infant. She
~ provided the phone number of the caller to the operator and remained
on
~ the line. The 911 service directed a Spanish speaking operator to
~ contact the caller. Tina, Rosalind and Edith questioned which mother
~ might have been calling. They asked Linda Stroumtsos, who sees
patients
~ in the Neonatal Clinic if she might know who it could be. She was
able
~ to match the phone number of the caller to the family through
discharge
~ information and was able to retrieve an address which was provided to
~ the 911 operator. An ambulance and police could then be dispatched to
~ the family's home. The patient had indeed spent several months in the
~ NICU and the nurses were well acquainted with the baby and family.
~
~
~
~ The four were even more upset and shared their disturbing call with
~ other NICU staff. Everyone experienced this sense of despair,
concerned
~ about the baby and uncertain if the baby would be brought back to
Saint
~ Peter's. All four nurses and the other NICU staff now waited
anxiously
~ for some news about this baby's outcome. About 30 minutes later, an
~ overhead page for "Respiratory STAT to Peds ED", was announced. The
~ manager and clinical coordinator went to the ED to see if it was
indeed
~ the former NICU patient. Not far behind them, both Tina and Rosalind
~ responded to the page and were quickly involved in the care in the ED.
~ The baby was in respiratory distress, experiencing apnea with
duskiness
~ and had tenacious secretions. Her temperature was well below 96
~ degrees. She was placed on a warming mattress, suctioned and placed
on
~ Nasal CPAP, then quickly transported to the NICU in a transport
~ isolette. Upon arrival in the NICU, she was immediately intubated.
Her
~ chest X-ray was positive for pneumonia.
~
~
~
~ The father accompanied the infant to the ED and to the NICU. He spoke
~ some English but received a thorough report via the Cyraphone.
Despite
~ Edith's instructions to call 911, the father stated that the mother
had
~ never placed the call to 911.