Two weeks ago, my second week, at the Shaker Heights Health Department I came back from Lunch to find the office in a bit of chaos. The atmosphere was very heavy with tension and the office the intern and I use was occupied by a man who was laying on the exam table. When I asked Sandy, the nurse director (and only nurse) of the health department she explained to me that on her way out to lunch she had decided to check her email when this community worker came in to see her because he just was not feeling right.
His story: this community worker was a Russian immigrant who has been in Shaker for close to 30 years. He has had perfect attendance at his job for 10 years and was very worried because he had left his sweeper outside in the street, and it might be a traffic issue. He told Sandy that he had been out of his blood pressure medication for about 2 days, and because she knew him as a very honest person she took his word that it had only really been 2 days, because sometimes when someone says 2 days they really mean 4 or more days.
Sandy decided to take this man's blood pressure and it was a little on the high side, but she waited until he relaxed and took it again 10 minutes later, and listened to his apical pulse.
She said she heard some irregular beating and asked him if it was ok that she called the squad from the fire department. Arriving withing 5 minutes of the call (its really nice to have a small department because everything is close by) they hooked up the worker to a heart monitor and we watched as his heart rhythm showed on the screen. Sandy picked up some p-wave irregularities and as the minutes passed she realized his answers, to the questions asked by the squad, were changing. She asked the squad to send him to the emergency room.
Last week we got a call from this worker telling us that his life was saved and that Sandy was working in the right place. He was having a stroke when he was in the Health Department with us and he had gotten to the emergency room with only 10 minutes to spare; he as able to get tpa. He has started doing therapy already and will be able to keep his job, because his boss called us to thank Sandy as well. He only has a droop on one side of his lips and a limp but he is alive and it was wonderful being able to see this kind of care at a small Department. It truly lets us know that no matter where you are, you don't know what could happen, and nurses are really needed everywhere.
Wow, that was some experience!!! It goes to show that assessment skills are essential to functioning at a high level as a nurse. Her ability to recognize that this man was ill and not himself and then take the appropriate action saved his life.
ReplyDelete