Nursing student helps patient escape life-threatening crisis

UB nursing student Gabrielle Hafner always introduces herself, not only to her patients, but to their roommates as well. That routine — but crucial — nursing skill led to what her instructor called “remarkable” judgment and action that could very well have saved a deteriorating patient’s life.

“Nursing is a team effort,” says Hafner, 23, a senior in UB’s Accelerated Baccalaureate Degree in Nursing Program, who agreed to talk about her experience if she could maintain the privacy requirements for patients. “All patients, regardless of if they are assigned to me, are still my patients.

“My patient’s roommate, who I was not assigned to — we’ll call him ‘Joe’ — was a character,” says Hafner, who was seeing patients in late September while working under an assigned nurse on the floor of one of the School of Nursing’s community partners.

Following her practice, Hafner made it a point to speak to Joe every time she checked on her assigned patient in the adjacent bed.

“I do this because I want them to feel comfortable with me and be aware of who is coming in and out of their room,” she says.

Whenever Hafner checked on her patient, she had a conversation with Joe, who, she says, “always had something to say.” Around 12:45 p.m., she went into the room to check on her patient and noticed Joe was not as talkative as he had been that morning.

“As soon as I noticed a change in his demeanor, I walked over to check on him. I had overheard his nurse mentioning that she administered a dose of Dilaudid for pain control about 30 minutes prior.

“This triggered a response in me to do an assessment,” she recalls. “I knew from my textbooks and classes that after any opioid administration, a patient check needs to be done shortly afterward to ensure the patient is handling the opioid well and does not go into respiratory depression.

“I noticed his respiration rate had decreased to seven breaths a minute, with difficulty and periods of apnea,” Hafner says. “He was not responsive to my verbal or physical stimuli. I performed a quick cardio and respiratory assessment, and knew something was wrong. This all happened within a minute or two.

“I stayed calm and quickly went out in the hallway where I did not see his nurse, but I saw a few other nursing students. I made them aware of the situation, and we knew we had to tell someone. A minute later, I found his nurse, and together she and I tried to wake him up with a sternal rub, which he was somewhat responsive to.”

While the nurses attended to Joe, Hafner checked his records and chart to verify his code status. They quickly issued a rapid response, and signal for extra personnel.

“We called the doctors and it was determined that he was in a life-threatening condition, and a code needed to be called to keep him alive,” Hafner says. “The code team arrived quickly and Joe was intubated and rushed to the ICU.

“Two days later, I was made aware that the patient, Joe, was alive and coming back down to the floor.”

Hafner’s swift and decisive action won high praise from UB nursing instructors. Faculty stress the importance of learning assessment skills and developing clinical judgment when teaching students, says Maria T. Lalley, the nursing instructor supervising Hafner’s clinical experience.

“It is remarkable that Gabrielle, after observing changes in mentation in this patient, remained focused and realized after further assessment that the patient’s condition was deteriorating,” Lalley says. “By alerting the staff to her findings, the patient was further evaluated and treated before being transferred to the ICU.”

Hafner never did see Joe again, something she regrets. Nevertheless, the experience left her with a deep impression.

“This experience was eye-opening for me in recognizing the skills and knowledge that I have gained throughout the past few semesters of school,” she says. “Having the opportunity to challenge my skills and critical thinking while being a part of saving a patient is an extremely rewarding feeling, and I wish Joe and his family the best.”