April 2017 DAISY Award
Bruce Lewis, RN III – E4-Medical/Neuro ICU
Congratulations to Bruce Lewis, RN III for being selected as the DAISY Award recipient for the month of April!
Bruce works in the Medical/Neuro ICU on E4 and was nominated for the award by his manager and APP. The nomination below reflects how Bruce impacted a patient’s life in a very special way.
“The APP and I were talking and wanted to recognize one of our nurses for his diligence in caring for a hemorrhagic stroke patient. This patient was admitted and continued to deteriorate. Because of mental status changes and increased deficits, Bruce contacted Neurosurgery and their APRN. A stat MRI was ordered. Bruce was told there would be a delay of greater than one-and-a-half hours for the test. After multiple phone calls and efforts to get bumped up higher on the priority list, he found that he was able to take the patient to the old MRI (outpatient—in the dungeon). This is not typical or expected for him to do given the gravity of the patient’s declining condition. He stated, “I made a decision to do anything that could possibly be done for this 46-year-old patient. I hope someone would do that for me or anyone else.” Because of this, multiple other procedures were ordered and the patient was taken to IR for IA verapamil. This potentially could have been a turning point for the patient. It probably saved this patient’s life. The patient continues to improve gradually.
This RN is well respected for his knowledge and skills, so the APN/resident took his concern very serious. When the doctor received the MRI report, she ordered the CT and Angio. The RN notified the doctor (neurosurgery) and APRN. They ordered an MRI, CT, and then Angio to reopen the cerebral aneurysm coiling and decrease the vasospasm.
MRI told the RN that it would be 1½ hours before they could get to it. The nurse did not know why there was a deficit (rebleed, occlusion, and vasospasm) but he knew there was a big change in the patient’s condition. The nurse was concerned that if he waited, the patient could continue to get progressively worse or the condition might not be reversible due to the length of time from the event.
If the nurse had been less educated/skilled, they may not have noticed the change on the intubated/sedated patient. IF the nurse had not been educated on possible complications of cerebral aneurysm, he may have waited for 1½ hours to get an MRI which would have caused the patient to lose valuable brain cells.
The patient is still weak on the left side but appears to be improving. This patient was intubated during the event (which makes an assessment even more difficult to detect) so I am not sure if he will remember anything. He has recently been extubated and his speech is slurred and a little delayed in response.
Great job, Bruce!
To learn more about The DAISY Award or to nominate a deserving licensed nurse, please visit: http//nurses.uams.edu.