Care Delivery
Instinct, Action, and Recognition in the Emergency Department
Emergency Department (ED) nurses Margaret Tomich, MSN, RN, CPN, CNL, and Nicole Wang, BSN, RN, ECRN, were working the triage desk together in January 2024 when two children presenting with the same symptoms – fever, vomiting, fainting and confusion – were checked in by their mothers simultaneously. Tomich and Wang learned the group of four was from the same household, who, during the standard check-in, reported that everyone in the home had been experiencing some unusual symptoms as of late.
Tomich and Wang huddled to discuss what they were hearing from the family and promptly agreed on suspicions of carbon monoxide poisoning. Proactively, these nurses briefed the doctors caring for the patients on their concerns, which significantly informed the direction of their ED visits. Initially, the care team was leaning towards a different diagnosis, but with the advocacy and persistence from Tomich and Wang, the team ordered the carbon monoxide test. Soon after, the blood test confirmed carbon monoxide poisoning in one child and subsequently in the other.
With the official diagnosis and knowledge that the family lived in an apartment building with other tenants, Tomich and Wang contacted the Chicago Fire Department (CFD) to alert them. CFD was dispatched to the site where a carbon monoxide leak was found, and evacuated the residents present at the time; some were taken to local hospitals for further evaluation.
Due to the proactive communication and escalation demonstrated by Tomich and Wang, there were no reported fatalities from this emergency.
“In the moment, I felt like I was just doing my job. You try to do your best every day, trust your gut, follow your hunches and consult with your fellow nurses.”
said Margaret Tomich, MSN, RN, CPN, CNL
These nurses’ attention to detail and ability to connect dots quickly were life-saving skills in action. In June 2024, they, along with the interprofessional team who cared for the patients, received the Illinois Department of Public Health 2024 Hero’s Award, recognizing the role they all played in keeping these patients, family, and their neighbors safe.
“I feel so proud of Margaret and myself for following our instincts and advocating for the two patients and family, which then helped so many more people,” says Wang. “I’m grateful and proud to have been recognized and nominated, and to work with an amazing team of nurses and doctors.”
Emergency Medical Services Hero Awards, Award recipients
Elevating Care, Empowering APPs: A Collaborative Model for the Future
Powerful solutions emerge when brilliant minds unite, and that’s exactly how Lurie Children’s Advanced Practice Providers (APP) Hospital Based Medicine (HBM) program was brought to life.
The creation of the APP HBM program at Lurie Children’s was a result of collaboration between APPs, physicians, and hospital leadership in response to the Accreditation Council for Graduate Medical Education changes. This program expanded the role of APPs to the general pediatric service, which has enabled a new workflow in order to maintain high-quality care on medical subspecialty service, while addressing evolving staffing needs. Notably, Lurie Children’s is the first pediatric hospital in Illinois to utilize APPs on general hospital based medicine teams.
This innovative program, led by Laura Finn, DNP, APRN, CPNP-PC/AC, Director of Inpatient APP Practice & Professional Development, launched in the Spring of 2024. Through the accredited Transition into Practice Program, each APP begins their career at Lurie Children’s as an APP fellow. Each fellow participates in didactic, simulation and case-based learning experiences, as well as mentorship to support their professional and personal transitions into their new roles. For the APP HBM team, the training also consists of cross-training to medical subspecialty services including Pulmonology, Rheumatology, Endocrinology in addition to general pediatrics. Over the course of the last year, the APP HBM team has grown and has successfully onboarded a total of 14 APPs — allowing even more patients to benefit from the consistency, skill and compassion of dedicated APPs at Lurie Children’s.
Alicia Dellazoppa, PA-C, Physician Assistant (left) and Laura Finn, DNP, APRN, CPNP-PC/AC, Director of Inpatient APP Practice & Professional Development
Looking ahead, the role of APPs in Hospital Based Medicine at Lurie Children’s will continue to evolve, expanding their impact and enriching patient care. The APPs we train today will be the future mentors and leaders for tomorrow, helping to guide the next generation of nurses and healthcare providers. With their dedication and expertise, APPs play a critical role in our mission to create a brighter, healthier future for every patient.