We all give magnificent and compassionate care each and every day as nurses at Maine Medical Center. It was a normal day of that care that Stephanie Delisle went above and beyond for a particular patient.
I came on as the charge nurse for our floor on a Monday; Stephanie had already been working a few days prior. She had been caring for an unfortunate woman who five months earlier had given birth to a beautiful baby girl. This should be a time of joy but after she had the baby she had significant complications including admissions to the hospital multiple times along with multiple surgeries to her pancreas and abdomen. Stephanie was able to get to know the patient, family and her unfortunate situation during the previous days that she was caring for her. Starting during interdisciplinary rounds that morning she alerted the staff about her possible need for emotional support to help with the bonding process with her daughter since she had been in and out of the hospital during those months prior. She also advocated with the attending physician and residents that the patient needed to have some emotional support and suggested a mental health consult in addition to getting the east tower social workers involved.
This patient just wanted to go home; she is a young woman with a new baby and at this point would do anything to be there, even if it is not in her best interest. The patient was frustrated with the lack of communication in her care. She felt as though no one on the team caring for her was paying any attention to what she was saying or experiencing. Stephanie understood what the patient was expressing to her since over the weekend there were multiple miscommunications. One of these was when Stephanie had intervened on behalf of the patient when one part of the team was looking to discharge her but the attending physician was not. Stephanie remained a strong advocate and helped everyone be on the same path so that the patient was not sent home too soon resulting in a readmission.
This amazing commitment to making sure that the entire team communicated properly continued on the day I was there. The patient had lost IV access on Friday and was unable to get a peripheral or a PICC line so they had ordered one to be placed by interventional radiology that Monday morning. This IV was initially intended for the patient to get IV antibiotics for an abscess that the patient had, it was also to get hydration since the patient was unable to eat or drink anything. Over the weekend the patient was able to tolerate some oral medications and able to tolerate some food because Stephanie suggested that the patient receive antiemetic and pain medications regularly. This was a significant change for the patient and since Stephanie had been with her for a few days prior she knew that it was significant progress. That was the catalyst that made Stephanie question if it was still appropriate for the patient to get a central line. The team felt that she needed it for hydration, Stephanie still pushed to have the team reconsider this due to the progress that the patient was experiencing. The team felt strongly that this patient needed to have a line despite the information that Stephanie was sharing and she went to have it placed.
When the patient was getting her line other orders started being entered that did not seem appropriate such as blood cultures with one off the line just being placed. With the awareness of CLABSI's and the patient having an abscess already but with no fevers and a trending down WBC count Stephanie again questioned the care being pursued for this patient. Stephanie worked hard to not only question these cultures off a new line being placed but the rationale behind it. This included contacting the attending to confirm that this was the plan for the patient and resulting in the cultures being discontinued since they were truly not needed. She was also able to educate the team about CLABSIs and the risk for this patient.
Stephanie's advocacy for this patient did not stop there; the patient was frustrated with her own communication with the team that was caring for her. The patient felt that she was not being listened to and that things were just being done to get her out of the hospital rather than fixing what was wrong. The patient felt as though the attending physician would come to her and say one thing then the other part of the team would come and say another or not know what the other was doing. Stephanie was present during some of these conversations and helped the team and the patient understand what the other was saying. She became the voice of the patient resulting in a better outcome that was satisfactory to the team and the patient.
Her leadership did not stop at the bedside; she was able to meet with some of the team members over the next day to help educate them about central line infections and the need to make sure the lines are being chosen for the right purpose. She also continued the education about CLABSI's and drawing cultures off a brand new line and possible better options that would have been appropriate for the patient. She was also able to communicate to them the frustrations over the four days that she worked with this patient regarding the communication with the staff and with the patient.
All this communication was done without sacrificing the care for her other patients. She did not become angry or demeaning to any part of the team. She appropriately used the chain of command all the way up to her medical director to articulate the needs of the patient to the appropriate people calmly holding her composure and not letting her frustrations influence how she presented the information. She also did not let the patient feel the frustrations that she felt, instead she significantly impacted this patient's care and the future care of the team members that care for her in the background.
Stephanie is one of the many reasons why Maine Medical Center is a great hospital. This situation is just one of the many times that I have seen her give compassionate and excellent care for patients. I have been a witness to her proactive leadership that impacts the quality of care that our patients receive. I am nominating her for this DAISY Award because she gives this care each time that she is with patients and families. She is a strong leader and role model of what caliber nurses are working here at Maine Medical Center.