On the 5th floor Medicine Unit, there was a very confused and altered mental status patient that had been in our unit for several weeks. The patient had no supportive family or friends. The patient was ordered to have nothing to eat or drink for a pending PEG tube placement.
After Alex Oliden diligently researched the patient's history, orders, and information, Alex discovered that it had been 3 days since the patient had received any nutrition or medication. The patient was just receiving Normal Saline IV, which had led to the patient being more agitated, confused, angry, and unable to voice his concerns and frustration. According to the progress notes the PEG tube procedure kept getting pushed back every day for different reasons.
However, with the pending procedure looming, there was a failure to address the issue that the patient had not eaten or drunk anything or taken any medication for 3 days. Alex advocated for his patient who couldn't speak up for himself. Alex called the physician right away asking for a Dobbhoff placement with tube feedings and IV dextrose so that the patient could receive his scheduled medications and feeding after 3 days of missing meds and food. Alex called the Rapid Response Team to quickly get the order and place the Dobbhoff for the patient.
The passion and empathy Alex demonstrated for his patient prevented patient harm, an extremely ethical issue. Almost 13 days after the original PEG tube placement was ordered and 10 days after Alex's intervention the patient still has the Dobbhoff, as the PEG tube was never placed. Alex displayed empathy and compassion for his patient and clearly demonstrates the PROMISE standards in action and Alex is an excellent nurse providing the very best care possible for his patients.