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Patient Advocacy in Action: Clinical Support with Lifesaving Results

Posted by Carolyn Harmer on Feb 21, 2015 10:00:00 AM

Residential in the Real World

Residential nurse and case manager Ladd provided advice and advocacy that led to a remarkable discovery and saved one patient’s life.Disease, surgery, and recovery can come with high stakes and uncertainty, sometimes more than can be appreciated in the fast-moving, high-volume world of health care. A patient’s question may be channeled to a physician and the response passed back, but in this chain of communication, sometimes the answer arrives but the associated fears or concerns remain. Merely attending to a symptom may be all that’s needed to get the job done, but a more personal and nuanced approach can help identify the best course of action for an individual patient.

One Residential Home Health nurse was able to exemplify the power of addressing not only a symptom, but the concern behind it. Ladd is a case manager who always wants his patients to lean on him as an available resource. Read on to learn how his supportive advice and advocacy helped one patient decide to take action, and the remarkable and lifesaving outcome that no one could have foreseen.

Building a supportive patient relationship

Ladd’s patient had come home after undergoing total knee replacement surgery. During their first home care visit, Ladd encouraged the patient and his wife to contact him any time, with any concern. Ladd also carefully reviewed the post-operation instructions with both the patient and his wife and imparted some advice about the initial recovery period; importantly, he instructed them to monitor bowel movements. Based on his years of experience with post-operative patients at home and in long-term care settings, Ladd explained, he gets leery if a patient has not had a bowel movement within 72 hours after surgery.

The trust and friendly relationship between the couple and their clinician had already started to grow, and continued after the visit. The patient’s wife indeed called Ladd a few times with questions about the patient’s health and recovery, which he answered with explanations and advice until each concern was relieved.

Helping to make a tough judgment call

However, when the patient’s wife called to report that her husband had starting passing watery stool, Ladd recognized this as a warning sign. He explained to them both that this was not a healthy occurrence after surgery, and provided some information about what this symptom pointed to: bowel obstruction. Following Ladd’s concerned lead, their next call was to the patient’s physician.

But soon enough, they were reaching out to Ladd again. The doctor had advised a wait-and-see approach for a few days, but Ladd recognized that this had not eased their anxieties. Again drawing on his own clinical judgment and personal experience with the couple, he suggested to the patient’s wife that if they simply could not endure the wait, they could seek immediate answers by going to the emergency room and requesting an ultrasound.

Enabling a lifesaving discovery

The patient and his wife decided that getting the ultrasound was the right course of action for them — but nobody was expecting the result. The procedure did confirm Ladd’s suspicion of an obstructed bowel; however, it also exposed a number of malignant tumors covering one of the patient’s kidneys. The cancer had previously gone undetected, yet it was growing rapidly, so fast that the patient’s entire kidney had to be removed.

Had the patient not undergone the ultrasound, his cancer would have remained undiscovered, and he was told that he would have likely died. He credited this fortunate discovery to Ladd’s determination to be accessible and invested in the well-being of the patients in his care. The patient personally expressed his gratitude to Ladd throughout his course of treatment, and he further wrote to Residential Home Health to express, in no uncertain terms, “Your nurse Ladd saved my life.”

To learn whether you or your loved one might benefit from the individualized, expert support of an in-home nurse or other Residential Home Health care team members, call (888) 930-WELL (9355) to discuss your specific situation with a Home Care Specialist.

Topics: Joint Replacement, Real World Stories

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