Emily Schwartz
April 2014
Emily
Schwartz
,
BSN, RN
Oncology, Gibson Pavilion
Maine Medical Center
Portland
,
ME
United States
An oncologic emergency is an acute, potentially life threatening event caused by a metabolic, neurologic, cardiovascular, hematologic, and/ or infectious change caused by a patient's cancer or it's treatment. One oncologic emergency particularly difficult to recognize is spinal cord compression. It takes an astute nurse to recognize cord compression and immediate intervention to prevent loss of life or significant loss of quality of life.
It was on a night shift when Emily admitted a patient with newly diagnosed B-cell Non-Hodgkin's Lymphoma with bone metastasis and two recent falls at home with resulting numbness and tingling in her left arm. As Emily began collecting more information and assessed the patient it became apparent that the patient was beginning to have acute neurologic changes. The patient was unable to void. Emily advocated to bladder scan revealing that the patient had over a liter of fluid in her bladder. The patient began to report increasing numbness spreading from mid chest to her lower extremities. The patient was unsteady on her previously strong legs. Emily immediately recognized the urgency of these symptoms, alerting the attending physician on call and strongly advocating for an MRI.
Upon returning to the floor from radiology, the patient's symptoms continued to worsen. Emily's persistence with the attending paid off, she requested that the MRI results be reviewed immediately. The MRI results indicated that the patient did, in fact, have a spinal cord compression from C-7 to T-4 with subsequent cord edema. The neurosurgeon was notified and within 45 minutes the patient was consented for an emergency decompression laminectomy with partial resection of the tumor.
Without Emily's critical thinking, attention to detail, and dedication to patient advocacy, this patient's life would have been changed negatively forever. Emily demonstrated excellence in patient care and compassion by recognizing her symptoms as legitimate and emergent and honoring her fears and concerns. She demonstrated leadership in initiating a conversation with the attending physician (on the night shift, which can be very challenging due to limited resources) and strongly advocating for an MRI. Emily demonstrated sharp critical thinking skills by anticipating this oncologic emergency and by being prepared to carry out the treatments necessary. Emily's swift action had a profound positive impact in this patient's life, all the while remaining calm and supportive of the patient and her family.
The patient and her family never realized how serious the patient's condition had been, and are able to enjoy a clearly positive outcome. Emily's dedication, training, and expertise as a front-line oncology nurse quite literally changed a life.
This is just one account of Emily's exceptional skill and compassionate care, but there are many more. Her work makes a difference, and I am honored to nominate her for the Daisy Award.
It was on a night shift when Emily admitted a patient with newly diagnosed B-cell Non-Hodgkin's Lymphoma with bone metastasis and two recent falls at home with resulting numbness and tingling in her left arm. As Emily began collecting more information and assessed the patient it became apparent that the patient was beginning to have acute neurologic changes. The patient was unable to void. Emily advocated to bladder scan revealing that the patient had over a liter of fluid in her bladder. The patient began to report increasing numbness spreading from mid chest to her lower extremities. The patient was unsteady on her previously strong legs. Emily immediately recognized the urgency of these symptoms, alerting the attending physician on call and strongly advocating for an MRI.
Upon returning to the floor from radiology, the patient's symptoms continued to worsen. Emily's persistence with the attending paid off, she requested that the MRI results be reviewed immediately. The MRI results indicated that the patient did, in fact, have a spinal cord compression from C-7 to T-4 with subsequent cord edema. The neurosurgeon was notified and within 45 minutes the patient was consented for an emergency decompression laminectomy with partial resection of the tumor.
Without Emily's critical thinking, attention to detail, and dedication to patient advocacy, this patient's life would have been changed negatively forever. Emily demonstrated excellence in patient care and compassion by recognizing her symptoms as legitimate and emergent and honoring her fears and concerns. She demonstrated leadership in initiating a conversation with the attending physician (on the night shift, which can be very challenging due to limited resources) and strongly advocating for an MRI. Emily demonstrated sharp critical thinking skills by anticipating this oncologic emergency and by being prepared to carry out the treatments necessary. Emily's swift action had a profound positive impact in this patient's life, all the while remaining calm and supportive of the patient and her family.
The patient and her family never realized how serious the patient's condition had been, and are able to enjoy a clearly positive outcome. Emily's dedication, training, and expertise as a front-line oncology nurse quite literally changed a life.
This is just one account of Emily's exceptional skill and compassionate care, but there are many more. Her work makes a difference, and I am honored to nominate her for the Daisy Award.