Michelle works at an ambulatory family medicine clinic and one of our patients sent a myChart message saying that he was having blurry vision and could barely type the message without closing one eye. Inbox messages are reviewed routinely throughout the day but often the flow of clinic does not allow for patient questions to be answered immediately.
On this day, within six minutes of receiving the message, Michelle had picked up the phone and called the patient. He reported that he was at work and he was having blurred vision. He denied any weakness or difficulty speaking, but he told Michelle that he was confused. Michelle explained that we needed to call 911. She calmly asked the patient if he had a coworker that she could speak to. She spoke with the patient's coworkers and explained that he was having vision and confusion and that she needed to call 911 immediately. The coworker hung up the phone and called EMS who brought the patient to the UVA ER. A stroke alert was called in the ER and after imaging, he was given TPA. The patient suffered a posterior circulation stroke but thanks to early identification by Michelle, the patient was evaluated and treated aggressively. He was discharged from the hospital less than 48 hours later with resolution of all of his symptoms. Michelle's clinical expertise and telephone triage made a significant impact on a patient outcome. The patient, his family, and his PCP were all so thankful for the support that the patient received and that he survived this potentially deadly event.
At the clinic in Crozet, Michelle is identified by patients and families as an extraordinary caregiver. When they call the clinic, they ask for her by name because of the trust that she has built with them over the last eight years. She is quick to listen, eager to help and supports the entire team throughout the patient experience. As her coworker, Michelle is often heard going above and beyond for patients. She has built strong relationships with the patients who come into clinic or call regularly. Michelle is a trusted partner in their healthcare. For example, a patient was admitted to the hospital this week with sepsis from a diabetic foot ulcer. The patient had appointments in the office monthly, and a home health nurse was seeing the patient in the home weekly. After the patient was discharged home, Michelle was following up with the patient and discovered that the home health nursing order was not reordered at discharge. Michelle reached out to the patient's PCP and got a new order the same day so that the nurse could visit the patient at home that afternoon. Michelle's performance is consistent, team-oriented and dependable. She is a pleasure to work with and makes a difference in the lives of patients every day at UVA.
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Last week, Michelle answered a triage call from a patient complaining of new-onset double vision and dizziness. As a former ER nurse, Michelle immediately recognized that these could be symptoms of a stroke. The patient was calling from work at the time and was reluctant to heed her advice to go to the ER. Rather than stay on the phone and argue with him, she asked to speak to a coworker from his office and explained the situation. The coworker immediately agreed to dial 911. The patient was stroke coded on arrival to the UVA ED and was able to receive TPA. He was just discharged from the Neuro ICU with almost no residual deficits from his stroke. I give Michelle's experience and quick thinking credit for saving this man's neurologic function, and likely his life.