I am reaching out to you to make you aware of an experience 1 had recently in the ICU that, in my opinion, represents the very best of healthcare delivery and stands out as perhaps the most impressive display of nursing and ancillary care that I have seen in my career, through my varied experiences in different medical settings both academic and private.
Recently, an inpatient who had initially been transferred from Baptist for further workup of clinically significant obscure GI bleeding and been with us here for some time suffered a massive, destabilizing episode of presumed upper GI bleeding. He was seen immediately by the rapid response team and was quickly transferred to the ICU where he was promptly placed on pressers and immediately transferred to CT for emergent CT angiography in an attempt to locate the bleeding site. While in CT he developed further bleeding and further hypotension and was immediately taken back to the ICU and was again stabilized. I tell you about this particular part of his care because this patient had literally been undergoing a weeks-long workup including multiple endoscopies, angiograms and bleeding scans that were unrevealing. He and his family were understandably at the end of their rope wondering if a source would ever be found. If it were not for the excellent clinical care rendered in an expert and expedient manner, coupled with the unflinching flexibility and professionalism of our CT staff, we would have never gotten him imaged in time to find the source. Because of all the people involved in this phase of his care, we were able to locate the source.
He underwent urgent EGO but due to the amount of clot in his stomach, we could not adequately visualize the area targeted for treatment. He was then kept stable and plans were made for a repeat endoscopy the following morning. That evening he again became unstable. I was regularly kept abreast of his status by Lauren Zalewski, RN, his ICU nurse and late that evening after multiple measures it became clear that he required repeat, emergent endoscopy.
In addition, he required significant resuscitation due to his significant blood loss. Lauren and her co­worker, Tyler initiated the massive transfusion protocol after a cordis was placed. He then underwent repeat EGO with identification and successful treatment of a gastric bleeding source. This was all between the hours of midnight and 4 am. There is no other way to describe Lauren and Tyler's actions that night except to say that they saved that patient's life. Period. No question.
To ensure that his significant risk of re-bleeding was addressed, the interventional radiology team was then called in at 4 am to conduct an empiric embolization in their typically expert, kind and professional manner; this is after that had just gone home 2 hours before after working since early the previous morning.
This patient is now at home with his family and looking forward to a future of riding on his tractor and playing with his many grandchildren, thankful for the days ahead; he is acutely aware of what he survived. The quality, speed and compassionate, tender delivery of the care he received was something to behold! I can confidently say that he would have received no better (and perhaps inferior) care at the biggest, most prestigious centers in the country. It is a true testament to the people named above and the others whose names are regrettably not available to me right now; the quality of their skills, their dedication and visible compassion that this man is alive. I am lucky to experience a version of this daily with my team in OPD, but to see this executed so perfectly across so many departments was something truly amazing to see. I was so proud to witness it and left that morning so grateful to work here.