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Megan Jackson, a licensed vocational nurse with the Orthopaedic Clinic, William Beaumont Army Medical Center, was recognized for her efforts in recognizing and treating a patient who was suffering from a Pulmonary Embolism (PE), a life-threatening blockage to one of the pulmonary arteries in the lungs caused by blood clots. When the relatively-healthy patient fell ill it alarmed Jackson, a native of Oxnard, California, resulting in outside-the-box thinking to help identify the cause of the illness, the fatal-if-untreated PE. (Photo Credit: Marcy Sanchez)

WBAMC Nurse’s Persistence Prevents Deadly Outcome

Only six months on the job and a nurse with William Beaumont Army Medical Center’s Orthopaedic Clinic is being recognized for her tireless attention to detail, possibly saving a patient’s life earlier this year.

Megan Jackson, a licensed vocational nurse and native of Oxnard, California, was recognized for her efforts in treating a patient who was suffering from a Pulmonary Embolism (PE), a life-threatening blockage to one of the pulmonary arteries in the lungs caused by blood clots.

The patient had recently undergone knee surgery, but had recovered well. Following a short stay at the hospital the patient was discharged but a few days after began feeling delusional.

“The patient came in saying he did not feel well,” said Jackson. “He was a little out of it, sweating a lot, had a fever and chills.”

Jackson’s first steps were to check the patient’s vital signs.
“All vitals were fine except for O2 (blood oxygen levels),” said Jackson. “He was a young gentleman and doesn’t smoke so it was very alarming.”

Normal oxygen levels range from 95 to 100 percent, the patient’s levels were fluctuating between 79 and 92 percent, which raised red flags for Jackson.

While below-normal blood oxygen levels may be a sign of hypoxemia, one of the underlying problems in hypoxemia cases is related to circulation. Jackson immediately called for a doctor who ordered an ultrasound and CT scan for the patient. While the ultrasound didn’t show anything of concern, the CT scan images revealed the PE.

“(Following surgeries) we watch out for deep vein thrombosis (DVT),” said Carmen Salcedo, head nurse, Orthopaedic Clinic. “DVTs can lead to a PE.”

According to the Centers for Disease Control and Prevention, while the number of Americans affected by PE is unknown, it is estimated 60,000-100,000 Americans die from PE each year. Approximately 25 percent of those figures are sudden deaths where the cause of death, a PE, is first discovered.

Because of the post-operation risks associated with surgeries, the Orthopaedic Clinic has an open-door policy for post-operation patients feeling any kind of excruciating calf or lower extremity pain, both of which are early signs of DVT. One mistake post-operation patients may make is remaining sedentary for long periods of time following surgery, a common cause for DVTs and other blood clots.

“We want (post-surgery patients) to move, they need to keep the blood flowing,” said Salcedo. “We try to remind patients that pain is a good sign as long as they’re not suffering.”

Thanks to Jackson’s instincts, the patient was treated and recovered fully. Jackson credits her training and tenacity in helping the patient in what could have been a fatal oversight.

“When I was at nursing school I didn’t think it was for me until I had an actual patient,” said Jackson, a mother of two. “I just knew (what to do) and went by my gut feeling. If I think about it I start to second guess myself.”

Jackson’s knack for caring is evidenced by her reluctance to discharge a patient if they still have concerns.

“If someone says they don’t’ feel well, (Jackson) will hold them in the room all day, if she has to, in order to get them seen,” said Salcedo, also Jackson’s supervisor. “In the (PE) case that’s exactly what she did, she held on to the patient until a doctor came to see him. Nurses with her (tenure as a nurse) may have dismissed it, (LVNs) may not have thought critically like that. For a lot of nurses it can take them years to get to that point.”

Jackson, who has been an LVN for just over a year, has also broadened her experience beyond the Orthopaedic Clinic. Jackson’s participation in WBAMC’s nursing float pool has provided her with experiences in other wards throughout the hospital.

“I worked every chance I was able to,” said Jackson.

“(Jackson) knows what each (Orthopaedic Clinic provider) likes and it’s helpful for her to go up to the floors and assist,” said Salcedo. “(Jackson) has earned a reputation in the hospital and any (hospital ward) would be happy to take her.”

Author: Marcy Sanchez – WBAMC

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