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Efforts of Fort Fairfield Health Center Employee Prevent Possible Tragic Situation for Inhabitant

AROOSTOOK COUNTY - The efforts of a dedicated and caring TAMC employee at the Fort Fairfield Health Center (FFHC) are being credited with preventing a possible tragic situation for an inhabitant in that community. Debra Nicholson, who has worked at the FFHC for 14 years, may not view her actions as heroic, but her co-workers and the patient she helped certainly do.

It all began last Wednesday when Nicholson placed a follow-up call to 68-year-old Dr. Ted Shields, a retired University of Maine at Presque Isle professor, who had seen Dr. Dan Fowler for a regularly scheduled appointment at the Fort Fairfield Health Center the day before. When she phoned Shields to arrange for a referral appointment with TAMC’s orthopedic services, Nicholson could tell something wasn’t quite right.

“When I was talking to him on the phone it was quite clear he didn’t remember being here the day before. I’ve known him for 14 years and I knew that something wasn’t right,” said Nicholson.

“I asked him where his wife was and he said he didn’t know. That made me all the more concerned as it appeared he was home alone.”

At that point Nicholson went to work to ensure Shields would be okay. She first spoke with Dr. Fowler’s medical assistant Julie Jencks and the nurse care managers housed at the Fort Fairfield Health Center about her out of the ordinary conversation with the patient. She explained the circumstance and asked the team members what might cause such short-term memory issues.

After hearing some of the possible causes from her colleagues, including a cardiac event or stroke, and their strong recommendation that the patient be taken to the emergency room, Nicholson knew she needed to do something and quick. She quickly accessed the electronic record of Shields’ wife and found a cell phone number.

“I called her cell phone and reached her,” said Nicholson. “I told her about my conversation with Ted and the circumstances and learned from her that she was six hours south.”

Immediately after getting off the phone with Nicholson, Ted’s wife called family friends living nearby asking them to go over to the house and check on her husband. By then Shields had returned outside to continue his work cutting a tree that had fallen in the yard during a heavy storm that moved through Fort Fairfield two weekends prior.

“When Deb called it didn’t ring a bell. I was confused,” said Shields. “It’s a good thing she caught on to that and that she called when she did. I just happened to come in to get something to drink and a quick bite to eat when she phoned. Otherwise, she would not have reached me.”

Upon arriving at the house, the family friends called Crown Ambulance and stayed with Shields until the EMT crew left to take him to the emergency room at TAMC. In the meantime, Shields’ wife had called his son in Presque Isle who was awaiting his arrival at the ER. At the same time Mrs. Sheilds was headed north from downstate to be at her husband’s side.

Work on the part of the team at the Fort Fairfield Health Center was ongoing as well. Nicholson had called the emergency room and learned that Sheild’s son had arrived. She also updated Dr. Fowler, who had been out of the office and had now returned.

After Sheilds arrived at the ER, Dr. Fowler called to check in on his status. He then called Mrs. Shields on her cell phone to let her know he was in the ER and doing fine.

“The outcome could have been tragic. There are all sorts of things that could have happened, including the worst case scenario. It turned out to be a TIA (Transient Ischemic Attack – an event sometimes called a mini-stroke, with stroke symptoms that last less than 24-hours before disappearing), but he could have gone on and had a major stroke,” said Dr. Fowler. “It was a very good pick up on her (Nicholson’s) part to recognize something was wrong and to have the presence of mind to act.”

Dr. Fowler says Nicholson’s actions are both impressive and consistent with the work the TAMC team is currently engaged in as it relates to the patient centered medical home and accountable care organization approach that are all about ensuring access to medical care in a timely fashion.

“In the larger picture, it’s an example of how involving more people in health care is great and will help ensure better outcomes,” added Fowler.

At a follow-up appointment this week, Shields took a moment to thank Nicholson for going above and beyond.

“You called at just the right time. Had you called earlier I wouldn’t have been in the house to answer and I could have been on the ground and stayed there,” said Shields. “You could have just moved on to something else. I really appreciate it.”

Nicholson appreciated the kind words, but is reluctant to accept praise for her efforts.

“I think I did what anyone would have done. When you know your patients, you can tell when something isn’t right and you do what you can to help,” said Nicholson.



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