8 east has had a complicated and difficult patient for over 2 months. “Babs” has schizophrenia with paranoid delusions since the 1970’s and renal failure with all of the associated co-morbidities (hypertension, diabetes) for the last 3 years, and distant history of breast cancer. Upon her admission to our floor Jennifer was instrumental in negotiating with the patient, General Medicine MDs, and IOP staff and physicians’. Intricate medication and dialysis treatments were instituted and Jennifer coordinated these with the patient’s son and the 8 east staff.

As the weeks wore on Jennifer was also called to negotiate care with the dialysis team and Security. Since the patient’s son lived in another state and worked during week day daytime hours, Jennifer had to discuss his mother’s care over the phone often in the evening and weekends, when she was off from MUSC work. Early in the admission of “Babs,” Jennifer realized the need for the Ethics committee review this case and advise us, so Jennifer arranged arranged for weekly meetings with Dr. Cawley, General Medicine, Psychiatry, Psychiatric Nurse Liaison, Dialysis and 8E staff, Case Managers of different services, and Psychiatry administrators. It is no small feat to get 15 people of many levels and service lines in a room for a full hour but Jennifer was able to manage this and managed to do it for several events.

Another aspect of Jennifer’s comprehensive knowledge and approach to this unique situation was also how Jennifer could articulate the issues of this patient, wishes of the patient and patient’s son, and the medical, nursing, and legal needs of MUSC. All the while “Babs” was phoning Jennifer to question the intentions of the health care system and individuals – part of her paranoia as well as needing to control whatever she could. A conversation with this patient would routinely take 30+ minutes of Jennifer’s time and of course Jennifer had a plethora of other patients needing her services. Jennifer had to be the person to bring up end-of-life issues with the patient’s son and to discuss intimate family considerations as she looked for alternative care and long term placement for “Babs.” Jennifer became a friendly voice to the son. Jennifer lovingly participated in the patient’s birthday party, buying her a gift and joining all of us in singing “Happy Birthday.” Again, Jennifer was taking time out of the day, using her own money to bring a light of humanity to this dire situation.

Jennifer’s job requires that he/she explain the complicated scenarios about this patient’s care to judges, mental health professionals, dialysis clinics, and long term care facilities all over SC, NC and GA. Jennifer called every possible facility in SC – hours spent on this activity alone. Because of Jennifer’s thorough understanding of this case, she was asked to present to the Ethics committee for its formal consideration and recommendations. This says volumes about the respect all parties have for Jennifer.

We thought Jennifer had been able to convince multiple outpatient entities to assume care for “Babs” but at the last minute a dialysis clinic reneged on their previous commitment and Jennifer had to start all over again. This time Jennifer was coordinating care between different clinics, different Nephrologists and the leadership team at MUSC. Throughout this round of service coordination Jennifer maintained a smile and was ever hopeful.
Finally the day of discharge came but Jennifer’s job was not over. Every day since “Babs” was discharged, Jennifer has called her to check in and reinforce the basic rules of living outside of the hospital – every day. Jennifer’s plan is to call “Babs” for the rest of her life. “Babs” and her friends and family could not have made this transition without Jennifer.

Jennifer is an extraordinary Nurse, deserving recognition for her compassionate care.