We had a patient admitted to the observation unit after weeding her garden and performing some exercises. That evening and throughout the next morning, the patient complained of intractable pain that was nonresponsive to all interventions, including strong narcotics. While tending to the patient's psych-social needs to help with pain management, Vanna had multiple contacts with the attending doctor advising of her assessments, as well, Vanna had pushed for a pain management specialist consult. Up until the arrival time of the doctor, the patient's pain had spread from flank pain, across the lower back, to her pelvis and stomach, rolling in bed in a curled position.
The attending, listening to Vanna, ordered MRIs of the pelvis and L-spine, as well as urinalysis. Radiology attempted to run the MRI, however, our patient was unable to lie still and refused, asking if she could wait another day. Vanna, not giving up on the situation and reading the situation to be something that should not wait another day, called radiology who stated they could try again and possibly get a good enough image with the patient lying on her side. As our patient continued to writhe in pain and discomfort, Vanna pushed for retiming the MRI for this same day and begged with our patient to try just one time to complete the MRI. Prior to our patient leaving for the MRI, Vanna provided a timely dosage of Dilaudid to help with pain management to complete the imaging.
This was all performed and completed as planned. The outcome of the MRI showed our patient had a very large hematoma compressing on her spinal nerves, and if let go another day could have possibly rendered our patient paralyzed. This resulted in an immediate neurosurgery consult and an emergent surgery to evacuate the hematoma as well as laminectomies to Lumbar 1-2-3.
Because Vanna did not give up on the patient, her condition, and the situation, this patient had a very positive outcome that could otherwise have resulted poorly. Because of Vanna's astute nursing and willingness to not give up, our patient received the best care at the most urgent time.
Vanna Hoang is a wonderful and caring nurse who delivers a high quality of nursing care to all of her patients. The excellent level of nursing care and concern she gives to her patients' well-being, comfort, and safety is her utmost priority. She is a strong patient advocate, a team player, and always positive. It is a pleasure working with Vanna every day.