Remote nurses race against the clock to save a patient's life

It was a regular morning for our Denver metro area Triage & Transitions (T&T) ambulatory nursing team. Nurses Jillian and Fallon were handling the triage calls coming in from patients with a variety of health needs, while the four other team members conducted outgoing transitional calls to help patients who had recently left hospitals. The team of six were all working remotely in their homes and using a Teams chat to relay any necessary information.? ?

Even though these nurses work remotely, they all have had experience working in hospitals and clinics. Jillian has been a nurse for 15 years and has experience in the ICU and in the NICU, and Fallon has been a nurse for five years with experience in the ICU. Fallon joined the T&T team four months ago and Jillian has been with the team for a year and a half. Even though they all have various clinical experiences and years as an RN, they know how to work as a team of nurses by supporting and relying on each other.

“We work well together,” Fallon said. “I'm happy to be on this team because we all trust each other and can rely on each other. This team is phenomenal.”? ?

Jillian was in her home office monitoring calls, talking to patients, and going about a regular workday when an unexpected message came in from the Patient Contact Center (PCC). The message said, “actively suicidal patient.” Suicidal patients are common phone calls, but an active patient was new for Jillian. Her nursing instincts kicked in, and she immediately contacted the PCC member who sent the message to get more details since calls like that were transferred to the triage team.??

Patient calls are filtered through the PCC. This team listens for trigger words during phone calls with patients like “swelling” or “difficulty breathing.” These words help the PCC determine who to send the patients to for further care. And in this case, it was the triage team.? ?

“I messaged the call center rep directly and asked what's going on — are we calling him, or were they going to transfer him to us?” Jillian said. “She said that the patient had hung up on her, and he needed a call right away.”??

The PCC rep shared the vague details the patient had relayed to her about his location and what had happened. He said he was on a bridge, gave the name of the street he was on, and that he wanted to end his life, and already had hurt himself. However, the nurses needed more information to pinpoint his location since their phone calls covered the whole Denver metro area, and with the patient actively hurting himself, they were racing against the clock. Jillian quickly messaged Fallon on teams and the four other nurses and told them about the situation. Together, they worked as a team to shift duties while Jillian and Fallon worked to solve this critical call.? ?

Fallon made the first calls to the patient while Jillian gathered what she could from the PCC rep, but the patient wasn’t answering. Still communicating on Teams, Fallon suggested calling the patient’s family while Jillian called the patient.? ?

“I called his mom, who was his emergency contact,” Fallon said. “She said he had been going through some health complications and had an appointment that morning. And as I'm on the phone, I'm messaging Jillian and the team to call the center to see what had happened at the appointment, and if he had made it.”? ?

Jillian tried to contact the patient repeatedly with no success. She saw the message from Fallon about that earlier appointment and asked another team member to continue outreach to the patient while she got information from the center.??

“I really started to play detective when I called the center to get any information I could to help find the patient,” Jillian said.??

She learned that the patient was going through some difficult things with his insurance, and he was in a lot of physical and emotional pain. The patient had left before the appointment ended because he was uncomfortable.? ?

While Jillian was trying to track down more information, the patient’s family was actively trying to get a hold of their son but wasn't getting through. Fallon stayed on the phone with his mother, gathering details that might help them find their son. The mother gave her a description of her son and the car he was driving and shared that the center was not far from their home. Fallon sent all this information to Jillian on Teams who took the next steps that were desperately needed.? ?

“At that point, I called the police department because we were able to get a description of his vehicle from his mother and knew the street name and that he was at an overpass,” Jillian said. ?

Jillian relayed all the team's detective work to the police who used that to locate the patient.??

“We don't know what transpired after that with the authorities, but they found him," Fallon said.? ?

The day went back to normal for the team of six. Jillian sat back in her office chair in her quiet home and joined Fallon in taking triage calls, and the other team handled the transitional calls. The situation only lasted 20 minutes but it gave a young man a lifetime to live.? ??

"They had taken him to the emergency room, and he eventually ended up receiving inpatient psychiatric care, which was the ultimate best-case scenario," Fallon said. “We deployed every single resource we could to find him. If we hadn’t, I don't know if it would have come out the same way.”??

“Situations like this can be a challenge in a remote arena,” Jill said. “But that's the great thing about our team, we all worked together, and there was no duplication of efforts. Everybody was doing something effective at the time.”??

Even though the team worked remotely, they worked together to save this patient’s life. Nursing work happens in hospitals and clinics, but ambulatory nurses play a huge role in helping patients in the community who can’t get to a facility or, in this young man’s case, feel uncomfortable being in a facility.? ??

“This man was actively suicidal, and even though we weren’t there to physically grab his arm, we inadvertently did it through a police officer who told him to stop,” Fallon said. “This was incredible detective work from the whole team. I don’t know why nurses are such good detectives, but we work to figure things out so we can save lives.”? ?