OneWorld triage team use knowledge, instinct and advocacy to care for patient Never Letting Go
On May 17, 2021, a new OneWorld patient entered the Quick Sick clinic. She was 28 weeks pregnant, tested positive for Covid-19 and was experiencing shortness of breath, but her vital signs were in the “normal” range. Because the patient was pregnant, the case management and triage teams called her once a day, including the weekends, to monitor and assess her condition. The phone calls carried the weight of her health and at times, her life. With no in-person assessment, the team relied solely on the symptoms presented by the patient, medical protocols and their own medical training and knowledge. When Ivon Aguilar-Silva, BSN, RN, Covid-19 Case Manager and Nurse Lead, called the patient on May 19, the patient had a fever and her oxygen saturation dropped from 99 to 95 percent. Ivon contacted Courtney Allen, CNM, Associate Medical Director of Women’s Health, who recommended the patient go to an emergency room to be assessed. At the time, patients were typically sent to the ER if their oxygen saturation dropped to 90% or below, but because she was pregnant, the 95% saturation was concerning. “I followed up with her the next day, and she told me she was released the same day she went in because her vital signs were in the normal range,” said Ivon. “Over the course of the next few days we sent her to the ER three times. We just kept reminding her that her concerns for her health mattered until she was finally admitted.” Fatima Gonzalez-Espinoza, BSN, RN, Triage Nurse Lead, and Jesy Delgado, Triage Medical Assistant Lead, called the patient several times leading up to her admission into the hospital. “I remember the patient told me she wanted to get help, but she was worried she wouldn’t get help because the ER kept sending her home,” said Fatima. “I really had to advocate for her. The patient didn’t know a lot of English, and she was very young. You wouldn’t think she would be someone who would be so compromised from Covid-19 or get as sick as she did.”
ISSUE 2 2022 I 5 I OneWorldOmaha.org
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