I am always so proud of my team, but on this particular day, they shined among the stars. David Gillespie was in the G pod where only patients who need beds are placed. In the outpatient world, even though we do get patients from SNIFFs on stretchers, these patients can communicate or usually have a caregiver with them that can help to communicate their needs. David had a patient arrive from a SNIFF in Richmond who was here for a first-time treatment Ocrevus infusion.

Ocrevus is for patients with MS. This particular patient not only had MS, but also had other neurological problems. He would respond to David, but with jumbled words that did not make sense. One really did not know if he understood what he was told, or if he just couldn't respond with the right words. When patients receive Ocrevus, they can have a reaction. Though the nurse is not far away, a curtain or door usually hinders visibility. Normally, patients can easily call out for help verbally or with their call bell. David was very concerned for this patient. He placed the IV and gave the ordered pre-medications. He then proceeded to give the Ocrevus. I went to find David to help me with moving a patient, and he was standing in the room with the patient making sure that if the patient reacted, he would be able to intervene. I was so touched by David's compassion to making sure this patient was safe. All day long, David tenderly watched over this patient. The infusion center closes at 7:30p.m. This patient had to be here most of the day.

At 4:30 in the afternoon, David called the transportation company and arranged for the patient to be picked up at 6:30 p.m. The nurse I had been orienting to infusion, Jenny, took report from David. Jenny and I were closers along with Ali, another nurse. David showed the new nurse, Jenny, all he had done for the patient and detailed with phone number and name of whom he talked to and the pick up time for the patient. Jenny went with David to meet the patient. David was clearly concerned for the patient who was bedridden, and connected to oxygen. He also pointed out that he had a Foley catheter with poor urine quality. David had taken care of this patient all day with tender care. David was concerned for the high acuity of this patient for being in the infusion area. David clearly documented in his note the time he had called for transportation and the name to whom he had spoken. David left at 6:30 while Jenny (new nurse) took over.

Meanwhile, Ali joined us as we waited for this last patient to be picked up. At 6:40 p.m., Jenny became concerned that the transportation team was late. She called the number to see when the patient's transportation was going to arrive. Jenny learned that they were not coming as called because they had another "priority" that trumped the care of this patient. No one had notified our team of the change. The transportation company then said that they would not have another driver for pick up until after the 8:00 p.m. transportation shift checked in. Pick up would be at the earliest between 9 -9:30 p.m. Jenny and Ali both hurt so much for this patient. Jenny then called the SNIFF, and they just said, "Ok, we will see him when you get him to us." They took no responsibility.

We all agreed that we were willing to stay until the transportation company came, but could we trust them to come? We were now the only ones in the building beside our one LIP and the cleaning crew. Ali then called the social worker in the ER. I do not know her name, but she said that she too would call the transportation company. The transportation company then said no one had called them during the day. Of course, the social worker could see the documentation in David's note of the name and time the person had been called. Her name was the same as the documented note. The social worker said that if we would bring the patient to the ER, she would make sure he was picked up there at the ER. However, medic 5 was not available to transport the patient. Ali was so tender-hearted with the patient. She rubbed his shoulder and told the patient so sweetly that we would be taking him to the ER for him to wait for transportation. She was so moved by his situation.

Now the problem was getting him over safely to the ER. The Hoyer lift was brought over, but the plug kept pulling out and was not charging the lift. Ali ran down to the third floor to get the lift. The team was going to try to get the patient into a wheelchair because that is all that was available. Discussion and concern were verbalized if this patient could sit up enough in the wheelchair to wait in the emergency room. The team was concerned that he would fall forward. Within a few minutes, Ali came upstairs with a great find-a stretcher that was kept on third floor. Jenny quickly got a transfer tube from the store room. The team was able to place this under this rather large patient and roll him onto the stretcher. It was quite surprising how easy it was. Then Ali, Jenny, and I connected him to a portable oxygen tank and rolled him over to the ER.

Once in the ER, Ali found the social worker. The social worker stated we were to leave him in the waiting room for transportation. Ali was very concerned and did not like this. She went back to the person in charge and stated that the transportation team could easily not know whom they were picking up, nor would anyone know when he left or even who picked him up. Ali wanted more oversight for this man who had no way of communicating to anyone his needs. When she came back, instructions were given to place him in a room on his stretcher. Ali and Jenny gave the patient an update and compassionately told them that he was being taken care of. The patient would now be taken care of until he would be picked up by transportation. This team made such strides and effort to ensure that once this patient was in our care, that not only was he taken care of with due diligence while getting his infusion, but the team took that same diligence in making sure he was safe until picked up by transportation. Ali then reported to the manager and other team members her concern for future patients with transportation needs so that these issues could be resolved in the future