Nurse’s Quick Thinking Saves Member in Crisis
It was 10 a.m. on a Monday when Kida Tisdale, RN case manager, called to check on her patient Byron*.
The 43-year-old Florida Blue member from Jacksonville was struggling with some serious health challenges. Not only was he diabetic, but he had also been hospitalized twice in recent weeks for other issues and was recovering from major surgery.
In her role as a nurse with Florida Blue’s Place of Delivery care model (PODs), Tisdale often cares for high-risk patients. The PODs coordinate care for members with chronic conditions, improving the quality and cost of their care. The collaborative approach leverages a team of nurse case managers, pharmacists, social workers, nutritionists and a population care manager.
In the short time she’d been working with Byron, Tisdale had been helping him learn to control his blood sugar. She also regularly spoke with Byron’s mother, Jackie, who was his caregiver.
But on this occasion, something was very different.
That day, when Tisdale spoke with Jackie, she sensed a heightened level of concern. When Tisdale asked if everything was okay, Jackie advised that Byron was “not acting like himself.”
Tisdale asked to speak with Byron and quickly realized he was in danger. He was not able to answer her questions or speak clearly.
She encouraged Jackie to check his blood sugar—and upon hearing a reading that was over five times the normal level, Tisdale told Jackie to call 911. Initially, Jackie hesitated because she had already spoken with Byron’s home health nurse from another company who was expected to visit later that day.
Tisdale knew they did not have time to wait.
She stressed the seriousness of Byron’s condition and urged Jackie to call 911 immediately.
Tisdale advised she would call back in five minutes to allow Jackie time to summon an ambulance. She then stayed on the phone with Jackie until paramedics could get there.
When EMS arrived, Byron’s vital signs were unstable and his blood glucose level was so high that it could not be read. He was airlifted to UF Health Shands Hospital in Gainesville, where his blood glucose reading was nine times the normal level and it was determined that he also had a life-threatening infection. He was admitted to the intensive care unit.
When Tisdale called Jackie the next day, Byron had been upgraded to stable condition and his blood glucose levels were close to normal.
While Tisdale’s strong instincts and quick thinking potentially saved a life, she humbly suggests it was all in a day’s work.
“The role of a case manager is to figure out how we can help patients manage their health better,” she says. “I have always been a problem solver; I love to help solve issues.
“Patients and their caregivers don’t have the benefit of the same level of knowledge we do,” she continues. “Those seemingly simple things lead to big issues if they’re not addressed. But once patients know the right things to do, they are empowered to better manage their care. I really take pride in helping them.”
Any one of the “simple things” that Tisdale has helped with recently could have led to disaster without her intervention: replacing a lost insurance card to prevent delays in care, teaching Byron and Jackie how to use a continuous glucose monitoring system and providing guidance on the warning signs of a diabetic emergency and what to do if one occurs.
After a long ordeal, Byron is back at home recovering. And while he is still dealing with the challenges of a chronic health condition, Tisdale’s ability to always find solutions is making it a little easier.
“It’s meaningful for me to be a patient advocate,” Tisdale says. “Whether there’s a breakdown in care, a medication issue or a need for new equipment, I love having the opportunity to step up and speak up on behalf of my patients.”
*Name changed to protect the member’s identity.
Filed under: Health Education