Alda Huska
June 2021
Alda
Huska
,
BSN, RN
Inpatient Oncology
WellSpan York Hospital
York
,
PA
United States
Had Alda not pushed further, this patient would've likely died from a herniation that very same night.
Alda Huska cared for apatient that had initially come in with recurrent pancreatitis, who I had just taken over care. I received a message in the morning that he was somewhat confused, and at the time it seemed "obvious" to me because his sodium had dropped on my review of his labs. The cause of that wasn't exactly too clear at the time. He was somewhat slow to respond, but otherwise seemed appropriate and he had no focal deficits. I saw there was some initial concern for possible meningitis two days prior. Infectious disease had been called in and even went so far as to CT scan his neck to see if there's any possible abscess. At that time, there was very little suspicion for meningitis. He had been put back on antibiotics as a result of an increase in his white count that was initially thought to be his pancreatitis getting worse. A CT scan of his abdomen/pelvis didn't show any sign of this. Regardless, seeing as how he was sick, I did attribute is to possibly SIADH, in which case the solution would be to fluid restrict him and possibly put him on salt tablets. I consulted nephrology and worked him up for his hyponatremia.
Later in the day, I got a call from Alda, who asked me if there was anything else to do. I ordered a CT scan of the head, more for completion than any serious concern. Transport came to take him for the CT. It was at this time that he showed some left arm drift. Ultimately, he had a subarachnoid hemorrhage, which explained the increase in his white count, the drop in sodium, and the neck pain, although he did not have the classic "thunderclap" headache. I urgently called neurosurgery and he ultimately went to the ICU after getting a coil. Had Alda not pushed further, this patient would've likely died from a herniation that very same night. Instead, although he had to duke it out for almost a month, he did leave the hospital. I definitely feel that this merits the label of an "extraordinary nurse."
Later in the day, I got a call from Alda, who asked me if there was anything else to do. I ordered a CT scan of the head, more for completion than any serious concern. Transport came to take him for the CT. It was at this time that he showed some left arm drift. Ultimately, he had a subarachnoid hemorrhage, which explained the increase in his white count, the drop in sodium, and the neck pain, although he did not have the classic "thunderclap" headache. I urgently called neurosurgery and he ultimately went to the ICU after getting a coil. Had Alda not pushed further, this patient would've likely died from a herniation that very same night. Instead, although he had to duke it out for almost a month, he did leave the hospital. I definitely feel that this merits the label of an "extraordinary nurse."