Helen Shapiro, R.N., enters data into Blood Center apheresis system before leaving for the hospital.

Patient Services can be Counted on to Answer the Call

It’s not always the middle of the night and it’s not always cold and rainy when the calls come in.

Somehow, though, it seems that way.

But it’s just part of the job for the Patient Services staff at Puget Sound Blood Center, and for the Facilities Department personnel who support them.

Little known to the public is the fact that Blood Center nurses visit hospitals every day to deliver quality care and state-of-theart apheresis and cell collection procedures, which involve the withdrawal of whole blood from the body, separation of one or more of its components, and its return to the patient.

While Patient Services provides a broad scope of procedures daily at the Blood Center’s Central location, the department’s direct care also extends to hospitals.

Such therapies include plasma exchange, red cell exchange, leukodepletion (removal of white cells for leukemia patients), or platelet depletion for blood cancers and other conditions. All are lifesaving procedures performed with special equipment and Blood Center expertise under emergency conditions.

And emergencies are not reserved for daytime.

(Left) Laura Gill, R.N., checks the doctor’s order as soon as she arrives at the Blood Center; (Center) Jeff Davis deftly manuevers the KOBE unit and equipment cart into the truck; (Right) The Blood Center provides escorts for nurses walking to local hospitals. Here, Northwest Protective Services’ Robert Griffin accompanies Mary Vela, R.N.

Sample Night
The phone’s uncompromising ring is a harsh intrusion on the silence that blankets Helen Shapiro’s dreams at 3:14 a.m.

The on-call nurse’s soft, sleepy “hello” is met by the understanding voice of Blood Center Assistant Medical Director Theresa Nester, who shortly before has been paged. A hospital physician is requesting Blood Center help.

There’s been a fire; the patient needs a plasma exchange and Dr. Nester dictates the medical order to Shapiro. It’s the beginning of the roughly 40 minutes that Shapiro is on the phone while getting ready for the drive to the Blood Center.

After discussing the situation with Dr. Nester, Shapiro calls the hospital and instructs the staff on how to prepare the patient for the procedure.

Then she dials another phone number; it belongs to Jeff Davis, the Facilities engineer who is on-call this week. At separate ends of the city, Shapiro and Davis each confront the cold, dark and eerily quiet pre-dawn atmosphere and drive to the Blood Center.

Once there, Shapiro calls the hospital floor nurse for the patient’s basic information: height, weight and hematocrit level, or the percentage of red blood cells to plasma. She plugs the data into a machine -- the COBE Spectra Apheresis System -- along with Dr. Nester’s order, and then calls the Blood Center lab to order the plasma or albumin.

More calls are made to the hospital staff and attending physician to finalize the process.

While that’s happening, Davis is taking the COBE and a medical supply cart to the loading dock to put into a Blood Center truck to transport to the hospital, where he meets Shapiro. She hops into a Blood Center car and makes her way to the hospital.

When they both arrive, Shapiro and Davis go to the patient floor and set up the equipment. Davis’ portion is done for now.

Shapiro gets consent from the patient or family for the procedure, checks medications and vital signs, and starts the procedure, which can last from two to three hours.

(Left) Patient Services (from left): Liz Hopper, Mary Vela, Helen Shapiro, Jeri Staley-Ernst, Geta Moldovan, Kerri Grover, Gloria Gaor, Camille Howell, Lolita Pereyra, Laura Gill and Dee Fritz; (Right) Even at 3:30 a.m., Jeff Davis finds a reason to smile.

On-call Frequency
It happens enough, about every week. Each of the seven Patient Services nurses are on-call four to six days throughout the month.

Sometimes the same patient undergoes procedures several days in a row. And sometimes one nurse can perform several procedures on different patients in different hospitals over a 24-hour period.

The medical reasons vary. “The procedures are performed for a variety of conditions and diseases,” says Liz Hopper, director of the Blood Center’s Clinical Services, which includes Patient Services.

“At night, it’s mostly an acute-care situation, a patient in crisis,” she says. “This is someone who has to be taken care of now. It could be a burn patient – and not just a local case, but one flown in from Alaska, for example.

“Or it could be a sickle-cell patient having a serious episode at that particular time. The hospital has assessed that the patient could die if we don’t perform a procedure right away, so we get there and do it.”

There are unusual cases, too, says Hopper. “We have had cases of necrotizing fasciitis, the so-called ‘flesh-eating bacteria,’ and we recently saw a case of malaria. Both were treated by our on-call nurses due to emergent circumstances.”

Where
As for coverage area, the Patient Services/Facilities on-call staff have traveled to and performed procedures as far north as Anacortes and Bellingham and as far south as Vancouver, Washington.

Just getting to the Blood Center before actually starting out for the hospital can be a trip on its own, especially during inclement weather. The registered nurses of Patient Services – Helen Shapiro, Geta Moldovan, Mary Vela, Laura Gill, Kerri Grover, Lolita Pereyra and Dee Fritz – have anywhere from 20 minutes to an hour or more (Seattle traffic!) on the first leg of their evening’s assignment.

It’s the kind of duty that affects families. For instance Pereyra’s husband, Chito, worries. He wants her to call him as soon as she arrives at the Blood Center. Other couples do the same.

But Moldovan’s husband, George, has more experience with his wife’s work, “He just says ‘Have a good night,’” she laughs.

For those who find the nighttime cityscape less than inviting, the Blood Center provides security guard escorts to and from the hospitals within walking distance.

Why?
Few hospitals have the specialized equipment or training to perform the procedures that the Blood Center offers. Additionally, an individual hospital’s need for either cannot justify the cost of both.

“It would be a big expense for only a few procedures at each hospital,” says Hopper.

Besides, the Blood Center’s Patient Services staff delivers expert treatment successfully where it’s needed, and when it’s needed.