Intuition is one of those concepts that is difficult to describe. Many say it is a "gut feeling" which factors prominently in clinical reasoning and decision-making by health care professionals. This gut feeling often takes years to develop and is difficult to articulate, especially when on paper your patient looks stable. I want to take a moment to share with the DAISY Committee how a nurse's intuition, unwavering advocacy, and commitment to providing excellent patient care led to a life saved.
Only those who have worked on a COVID unit understand the unique processes and many challenges that these brave nurses face each day. The Med/Surg COVID unit staff are unable to call the RAT team like the rest of the hospital. Instead, a group of ICU staff nurses are called to assist, and often they too are extremely busy with critical ICU patients which makes it difficult for them to leave their patients to assist on other units. Resources available during the night shift are limited already throughout the organization, and even more so during the night shift on a COVID unit.
A patient was admitted to one of the COVID units at the beginning of Kelsey's night shift. This nurse received report and the patient sounded stable enough to send to the ward. Once this patient arrived at the unit, the clinical picture that was painted by the ED was different from what was in front of her. This patient was showing the "normal" clinical signs of COVID (increased work of breathing, requiring oxygen, and a fever). However, one look at her newly admitted patient and something did not feel right to Kelsey. The nurse asked the CN to come to see the patient; however, the patient had typical COVID symptoms and only suggested the nurse call the provider. The nurse paged the provider to come to the bedside. The nurse asked the provider for more labs and an EKG, and she stressed the patient did not "look right". The provider brushed off her concerns and continued to see the next patient. Something still did not feel right.
Kelsey would not leave this patient's bedside because she continued to feel something was just not right. She described to her peers as the patient having a scared look in his eye, and he did not want to be left alone. She asked other nurses to help pass her meds on her other patients because her gut feeling continued. She kept paging and pleading with the provider to come to the bedside to assess the patient as she feels he needed to be transferred to the TCU. The provider continued to state she was busy and would not come to the bedside. Kelsey did not give up and continued to stay at the bedside and make the patient comfortable with her presence.
After a couple of more pages to the provider, they finally agreed to transfer this patient to the TCU. Less than thirty minutes after the patient arrived at the TCU he coded. This patient was able to receive immediate care in the TCU by critical care staff. Had the patient been left on a Med/Surg COVID unit, care would have been delayed and this patient could have had a very different outcome.
Kelsey has an amazing heart, is humble, and oozes compassion. She treats every patient with dignity and respect. This patient was fortunate to have someone like her who continued to advocate for him in a time he nor his family could advocate for him. We are grateful to have her be part of this organization and for her "gut feeling".