May 2020
Theresa
Weiss
,
RN
Regional OB/GYN
Cleveland Clinic Main Campus
Cleveland
,
OH

 

 

 

Terry was gently persistent as usual until the patient agreed to go to Fairview ER. After speaking with the patient, Terry told her co-worker, "I just have a funny feeling about this, pregnant patients just don't pass out without reason".
Terry demonstrated incredible nursing judgment while triaging an OB patient in need of emergency medical care. When the patient was reluctant to agree with the advice, Terry was gently persistent to make sure the patient received the care needed. 8:30 am Terry returned a call to a patient of the doctor who was 35 weeks pregnant complaining of waves of nausea for a few days and feeling sick to her stomach intermittently. Terry triaged both mother and fetus and advised home care for nausea and reviewed signs and symptoms of dehydration to watch for and recommended a call back in the afternoon with an update. 11:23 am the patient called back to report she had gone to the hairdresser and while there she fainted and hit her head. 911 was called and the attendants triaged the patient but not her fetus. Terry advised the patient to go to Fairview Hospital ER for further assessment of herself and the fetus. The patient was frustrated with this advice and just did not want to go to the hospital but preferred to go home and rest. Terry was gently persistent as usual until the patient agreed to go to Fairview ER. After speaking with the patient, Terry told her co-worker, "I just have a funny feeling about this, pregnant patients just don't pass out without reason". We agreed it may be partly dehydration from poor food and fluid intake but a Hospital assessment was in order. 1:17 pm while the patient was at Fairview ER undergoing an EKG she fainted again. After labs, CT scan, and Chest X-ray patient has the following: FINDINGS ARE HIGHLY SUSPICIOUS FOR ASCENDING THORACIC AORTIC (TYPE A) DISSECTION WITH PROBABLE INTRAMURAL HEMATOMA. The patient was transferred to Cleveland Clinic for Cardiothoracic consult and possible emergency surgery for possible aortic dissection. It was Terry's persistence and intuition along with valuable nursing judgment that allowed this mother and fetus to have safe emergency care.