Amanda Shonkwiler, RN, is a fairly new nurse, but she has the keen insight of a seasoned nurse and the idealistic quality of empathic compassion.
One of her male cardiac patients was in a 2nd degree heart block (Type 2) Mobitz 2. The patient was in a room with his wife who had Alzheimer's. He was unwilling to undergo pacemaker insertion because he was afraid no one would keep an eye on his wife and take care of her (even though she was admitted under our care).
The patient had been with us for approximately 48 hours and was scheduled for discharge with his wife the next day. Amanda was concerned that the cardiologist was unaware of the Mobitz 2 Type 2 even though the AOD showed her the EKGs were the same since admit. She argued successfully to transfer the patient to CICU for pacer insertion and convinced the patient by persuading the AOD to supply a sitter to help care for his wife as needed for safety.
The patient underwent pacer insertion a few days later and was discharged with his wife to a local nursing home. Amanda shows this assertive advocacy for all her patients.