A Magnet story...
Some of them read like telegrams. Short burst sentences, the staccato fire of crisis in a hospital. Others reveal a complexity of medical conditions layered on top of deep emotional needs. Obscuring the picture are descriptions couched in medical lingo and abbreviations, road signs of urgency. Here is one Magnet story (condensed from the original with the patient’s name removed):
Patient was a very pleasant lady with a zest for life, and a direct admission to 6A (general surgery/transplant). She was admitted for nausea, vomiting, abdominal pain, hypotension and hyponatremia. Her history included End Stage Renal Disease (on home hemodialysis), a mild stroke and hypertension.
Upon assessment and testing, she was diagnosed with a small bowel obstruction. Non-invasive treatments were ineffective and surgery was required. After surgery she went to the Surgical Intensive Care Unit (SICU). While in SICU, she had difficulty breathing, requiring a tracheostomy. Because of the tracheostomy, she could not eat and a Dobhoff tube was placed. As a result of the bowel surgery, she had a colostomy and Short Bowel Syndrome. She stayed in SICU approximately three weeks.
When she was “stable,” she was transferred back to 6A. She was a totally different person. She now had a tracheostomy, colostomy and a Dobhoff tube. She was very deconditioned, unable to ambulate and still hypotensive. Not only did this sweet lady physically change, but also her spirits had been dampened.
After being on 6A for another two weeks, she had started to make a turn around. With the care of the 6A nurses, physical therapy, occupational therapy and speech therapy, she began to care for herself and breathe without the tracheostomy. She was ambulating with a walker, and the Dobhoff tube was removed and replaced with a J-tube for feedings. However, a she could not care for her colostomy, and her hypotension and fatigue were not resolved.
Physicians were considering discharge to a long-term acute care facility. Nursing staff was not happy with this idea, related to her unresolved hypotension, so they intervened on her behalf. The physicians decided to take a closer look at the issue. What they discovered was that she had right-sided heart failure and required medication changes. Finally, she was feeling much better. She even had enough energy to care for her colostomy, and when her heart failure was treated she gained strength and was able to start eating.
By this time, she was a new woman, healthier than she was upon admission. She was now able to care for her colostomy, provide ADLs (activities of daily living) and feed herself. The day of discharge, she was able to safely ambulate with a walker.
If the nurses had not taken the initiative to intervene, she might still be in a long-term acute care facility or worse. Today, she is a happy, active and very grateful lady.
There are many Magnet stories at UTMB. This has been one of them.