A Veteran had been screened for residential treatment in DOM-SUD for alcohol use disorder (AUD). The Veteran was receiving mental health care on the 5th floor, so Jimmy went and met him in person. The Veteran shared that he recently had lung cancer and surgery but never followed up to receive the necessary chemotherapy due to fear, which ultimately caused him to relapse. There was a concern he would need to prioritize his cancer treatment before starting treatment for AUD.

Jimmy discussed his goals with him, which included completing chemo for cancer treatment. Jimmy made a plan that once he is admitted to the DOM, Jimmy facilitated the placement of consults by providers to ensure cancer care was received. Jimmy reached out to Banner MD Anderson Cancer Center and was able to schedule an appointment and arrange a ride for the Veteran. Jimmy went with the Veteran to his appointment as a support and took notes for him.

During the appointment, the Veteran had perceived that chemo was going to kill him because someone else in the program told this Veteran that chemo had killed their parent. Jimmy met 1:1 with this Veteran to explore fear and questions and help the Veteran make an informed choice about his care. Jimmy discussed the Veteran's goals with him, and the Veteran said his goal was to live as long as he could. Jimmy revisited what the oncologist had said about chemo preventing the cancer from coming back after surgery. Jimmy discussed the risks and benefits with the oncologist there to help the Veteran understand so that he could make a self-determined, informed choice about chemo. The Veteran decided that chemo was his goal while in the DOM-SUD.

Jimmy worked directly with the Banner MD Anderson oncologist to coordinate care between Banner and DOM-SUD. It was a significant undertaking to develop a treatment plan that supported both chemo and SUD residential treatment, but Jimmy did it. Once the treatment plan was made and the Veteran began chemo, the Veteran shared that he didn't follow up originally because he was really scared. He relayed he was afraid to have to do this alone, and so he went back to drinking to pretend that his problems were gone. The Veteran expressed thanks to Jimmy for coming with him to his appointment, coordinating care, and supporting his individual goals even before he started in DOM-SUD from the time Jimmy went up to meet him on the 5th floor.

This is a Veteran who easily fell through the cracks after being diagnosed with cancer. Someone who struggled with addiction. Someone who had no medical knowledge and was facing day-to-day life challenges without any help to navigate it. He needed someone to recognize his needs and be there for him so that he wouldn't do it alone, and that was what Jimmy did. To manage this kind of medical complexity in the DOM-SUD is incredible and unprecedented. A national goal for MH RRTP is to facilitate the management of medical complexity in this level of care, which Jimmy has achieved. As his supervisor, I could not be more proud of Jimmy. His medical and mental health knowledge, combined with who he is as a person, honest, approachable, supportive, committed, and flexible, makes Jimmy an incredible, one-of-a-kind nurse who is a healer with both his heart and mind.