I am one of the patients that goes into the IPOP clinic every day to get treatment for my severe aplastic anemia. I recently received a bone marrow transplant and have been doing very well each day I come into the clinic. 

I am also a Johns Hopkins Nursing School graduate and former Johns Hopkins Hospital nurse. I was working as a travel ER nurse and as a critical care transporter before my transplant, so I know a good nurse when I see one. It turns out that every nurse I have come across in IPOP has been amazing with mastering the skills to properly care for bone marrow transplant patients. But it is obvious that Kate stood out significantly from the rest and for good reason. 

The day after my transplant, I had an abrupt change in clinical status. I went from a temperature of 98.3 to 103.2 degrees in 30 minutes. I became very fatigued and drowsy. My PICC line site appeared to have minor swelling and had slight redness on inspection. Despite these changes my temperature would fluctuate from abnormal back to normal. 

I also kept manipulating the clinical situation in my favor by using key words and data points to convince the nurse that I was well enough to go home with IV antibiotics. I basically just wanted to go home to the comfort of my own bed and come the next morning. 

I was also using my vital signs as a reason to send me home because my heart rate was normal, my blood pressure was great, my breathing was not too fast or too slow, my spo2 was 100%, and I didn’t have a fever. I was basically challenging the nurse so that I could get my own way. 

I was also giving full answers to questions that were never being asked and I was never actually speaking. Meaning, I was becoming delirious and confused without telling anyone. Despite my mental state, It got to the point where I was in a wheelchair to go home, my care giver was getting instructions on what to do when we got home, and I was almost outside the door with my discharge paperwork. 

That was when Kate did something very hard. She made a judgment call and followed her gut. She wanted to take my vital signs one more time because she was clearly uncomfortable sending me home. 

It was a good thing she did because I was becoming pale, spiking fever again, had low blood pressure, and had a very fast heart rate of 136. I was starting to show signs and symptoms of sepsis. She made the call to have me admitted right away. If she had stalled or had not been tenacious about getting me admitted, I would have had to come back anyway. This would have delayed me from receiving lifesaving treatment, which could have led to poor clinical outcomes. 

Kate was right, too, because my blood cultures were positive for a bacterium that infectious disease described as “a nasty little bug that can do some very serious damage.” I was hospitalized for a week and needed around-the-clock medical care. 

It is always best to over call and be wrong than not make a call and be wrong for not saying something. Thanks to Kate and a few others, I could have ended up in the ICU or even worse. The nursing performance in this situation for me is not just worthy of being a recipient of the DAISY Award, I credit her for saving my life.