Anxious and Distraught Cancer Patient — Nurse Clinicians in Action-03

Anxious and Distraught Cancer Patient and how the Vascular Access clinician pacified the patient and placed the correct Vascular Access device is the focus of this Nurse Clinicians in Action.

Anxious and Distraught Cancer Patient

– Clinical Case

This case took place in a hospital with a patient that recently underwent major gut (gastrointestinal) surgery, resulting from an unexpected complication from his colon cancer. Not only was the patient in great pain, but he was also angry, bitter, and sad as he just learned from his managing physician that he had only 3-6 months to live. He had been battling cancer against the odds for a long time and he knew that this was a losing battle. In addition, the patient’s wife was distraught, adding to the intensity of the situation.

With respect to Vascular Access, due to his medications, his peripheral IVs had failed and caused swelling, and the physician requested that Vascular Wellness place a Peripherally Inserted Central Catheter (PICC). The clinician placed the PICC and confirmed proper placement using the Ultrasound, Sherlock, and ECG (the Tip Confirmation System); however, the line did not have good blood return, which indicated an issue.

Anxious and Distraught Cancer Patient

– Diagnosis and Treatment

A chest X-ray showed that the PICC line had looped in his upper arm with the tip barely in the Superior Vena Cava (SVC) where it needed to be, and this was likely due to the patient’s physical and emotional condition. The managing physician and Vascular Wellness clinician consulted, and they decided to remove the PICC line and place it again but this time, on the left side, which is the less direct route to the SVC and more difficult to insert. Vascular Wellness clinician operate wiht the benefit of a comprehensive and extensively skilled support team, and as such, the clinican requested assistance from another more experienced Vascular Wellness clinician who was serving the same hospital.

The second clinician joined her at the bedside to assist, and despite the difficulty of the procedure and the intensity of the situation, which included the patient threatening violence and lawyers, the clinicians successfully placed the PICC on the left side and at the same time, calmed the patient and de-escalated the situation.

The “success” was not just defined by the line placement but that both the patient and his wife were much calmer and relaxed by the end of the procedure.  The stress had left the room, and the clinicians, the patient, and spouse engaged in delightful conversations about food and family. The patient commented that he couldn’t wait to eat Toaster Strudel, but only from the oven, not the microwave, which is how it is served best.

The Clinician checked on him every day while she was at the hospital and, over time, brought him a plant, balloons, Pepsi, and Toaster Strudel from the oven. The hospital team appreciated how much the Vascular Wellness clinician cared for the patient and was very impressed by this extra effort. As a final measure of achievement, the patient now looked at the clinician as his ally in his medical treatment.

Vascular Access Expert

– Key Points

Vascular Wellness clinicians care about their patients and this caring approach goes beyond the Vascular Access medical procedure.  Our clinicians try to do everything possible to help ensure that each patient is comfortable with the clinicians and the procedure before beginning. Anxious patients are part of any nursing career and our clinicians do not take negative comments personally. Instead, we understand that the comments come from a place of fear and uncertainty and we do our best to help alleviate the concerns. We believe that being a good clinician is more than the number of procedures or other numerical measurements; it is about being a kind, empathetic, good listener, as well as a nurturing human being.

Vascular Wellness clinicians have placed many thousands of central venous catheters and this experience enables us to assess a situation properly and if a line is not performing, diagnose and address the issues. Further, by having the tools of Ultrasound Guided PIVs, Midlines, PICCs, Small Bore lines such as Internal Jugular lines (IJs) and Mid-Thigh Femoral lines (Mid-Thigh Fems), and Large Bore lines including Quad Lumens, Vascaths (Temporary Dialysis Catheters), Permcaths, and Tunneled Central Lines, Vascular Wellness is able to create clinically appropriate access in virtually all patients, even in situations such as above when a line loops or is not performing for any number of reasons. These factors, along with a consultative approach with the treating physician, are just a few reasons why Vascular Wellness improves patient outcomes, reduces costs, and strengthens infection control.

Nurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician, as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA (Health Insurance Portability and Accountability) compliant communication app. In addition, our extensive training program and diverse client base, including Level 1 Trauma Centers, Short Term Acute Care Hospitals, Long Term Acute Care Hospitals, and Skilled Nursing Facilities, provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.

If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today.
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Vascular Wellness provides:
(1) Comprehensive vascular access services to North Carolina, Oklahoma, South Carolina, and Virginia; and
(2) Customized vascular access services to Arkansas, Delaware, Georgia, Mississippi, Pennsylvania, Tennessee, and West Virginia; and
(3) Support vascular access services to Ohio and Kentucky.