I have had many positive interactions with Mary Beth as a coworker at CHP, but the experience that I had in December deserves special recognition. She is a member of the IV Team at Children's, a position that often comes without thanks. She is responsible for procedures that are often painful to our patients, and often come after multiple failed attempts from the primary RN. This particular evening, I was the primary nurse for a trauma patient who was incredibly sick and only 11 days old. The patient had a central line and needed lab work. This is typically a fairly simple task in a patient with established central access, but I was unable to receive adequate blood return from this particular line. The physician was willing to attempt to fix the line but was uncomfortable with the unfamiliar procedure. They were paged and she answered. I was instantly able to breathe a sigh of relief, knowing confidently that she would be able to assist.
After reviewing the patient's x-ray, it was determined that the PICC line was out of place and needed to be pulled back several centimeters in order to be used. She (with the assistance of an X-ray) was able to pull the line back to a point where she felt that it was both functional and safe for the patient. On repeat X-ray, the radiology resident reported that he felt that the line was still in the incorrect anatomical place and he suggested that she pull the line out 2 additional centimeters. She felt that (from experience) if she followed this recommendation, the line would be pulled out too far and be unusable. This would eliminate IV access entirely, require the patient to be stuck for access and force the patient to undergo another procedure the next day. She decided to wait at the patient's bedside for the final read from the attending physician before pulling the line out any further. She ensured that the attending radiologist was paged directly, who agreed with her assessment. The attending agreed that if she would have pulled the line out any further it would have been unusable.
Her persistent actions to advocate for the patient directly benefitted him in a huge way. She avoided more pain for this fragile patient, avoided the need for him to have another procedure, and the need to be NPO overnight. The entirety of her interaction with this patient took multiple hours, and undoubtedly put her other work behind but she did not mention it once. It was only because of her and her willingness to take the time to put this patient first that the outcome was positive.