Jaysa K Golding
November 2022
Jaysa K
Golding
,
BSN, RN
Emergency Department
Trinity Health Ann Arbor
Ann Arbor
,
MI
United States
One could say, "She was just doing her job," however, I say she demonstrated the essence of the practice of nursing…unconditional regard for the patient.
I am writing to you to express my gratitude for your patient care teams and the care that was and continues to be delivered to my family member. In addition, I would like to commend one particular nurse, Jaysa (Wegrzyn) Golding, BSN, RN for her professionalism, compassion, and dedication in the delivery of care to M during his initial visit to the Emergency room on 7/22/2022. M had not been feeling well all week and was advised to come in through emergency services for evaluation. Upon arrival, your triage and intake areas were very busy, and it was obvious that your triage nursing teams were overwhelmed. After one hour he was triaged and made to go back and sit in the waiting area though he could barely stand and after an additional 40 minutes, he was called back and taken via wheelchair into his emergency treatment room. Within 5 minutes, it was noted by Jaysa and her team that his blood pressure was not responding in a normal fashion to position changes and Jaysa using her evidence-based practice knowledge and insight stepped forward to manually check his blood pressure and immediately upon confirmation called a rapid response as his blood pressure was dropping to critical levels. During the rapid response, she co-led the medical and nursing team in a collaborative respective manner assuring that the information gathered from ongoing dynamic assessments was clearly articulated to the medical and nursing team staff. At the same time, she listened to M, and when he explained that he felt something more was going on as he had two previous emergency room evaluations for similar symptoms of weakness and low blood pressure and was in the process of being worked up for lymphoma. She demonstrated what we call at my institution (the Veterans Health Administration) the I-C-A-R-E philosophy of practice and went above and beyond even when later challenged and demeaned by an attending hospitalist for using the standard of care when measuring blood pressure. She continued to be respectful and articulated that she would continue to document the manual blood pressure readings at the appropriate intervals to assure that his blood pressure was being adequately managed. Also, she mentored her nursing techs demonstratively through this occurrence siting that treating the patient and not necessarily the monitors will most appropriately direct your care interventions. The initial plan was for M to be discharged with a presumptive diagnosis of dehydration and orthostasis however again upon listening to what he was telling her she re-evaluated him and supported his wishes did not rush him out the door and reconsulted with the attending medical team. It was at that time that his CT scan resulted, and his hypotension was not due to dehydration but rather to metabolic alkalosis secondary to adrenal insufficiency, as adrenal masses were present. He was then given the appropriate treatment of intravenous hydrocortisone and magnesium along with maintaining parenteral fluid administration and was admitted to oncology, as likely lymphoma was the underlying cause. He surely would not have been able to maintain his blood pressure on fluids alone. He ended up being admitted for several days with oncologic and other specialty consolations. He was discharged however he has been readmitted due to complications from COVID-19. Please keep him in your thoughts and prayers as prepares likely for a bone marrow transplant in a few months. I know that you have a shining star among the nursing staff and that Ms. Jaysa Wegrzyn, BSN, RN not only has mastered the science of nursing practice but in addition demonstrates the art of compassion and patient-centered care. One could say, "She was just doing her job," however, I say she demonstrated the essence of the practice of nursing…unconditional regard for the patient. She serves as an exemplar for all of us not only in nursing and medicine but in our World and Nation. Thank you for taking the time to read this letter and for leading such a great nursing team.
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