Nikki Auen refused to take no for an answer when advocating for her patient’s needs. Photo by Donn Jones
Early on the morning of Christmas Day 2020, some residents of downtown Nashville were getting in those last few hours of sleep before the holiday – a unique one marked by the many challenges faced in 2020. Some were out on early morning walks with their dogs. Some were already awake, opening presents with their children.
No one was expecting that by 6:30 a.m., an RV bomb on Second Avenue would detonate, leaving the street in ruins. Luckily, residents and pedestrians were evacuated before the explosion.
Without the vest or any of her medications, the patient was at risk for a chest infection. Knowing that chest infections in people with CF could lead to long-term lung damage, Auen got to work.
Due to an ongoing police investigation and structural damage to buildings, residents were not allowed back in their homes for an unknown amount of time. For one Vanderbilt patient with cystic fibrosis (CF), this meant not having access to vital medications that ease her CF complications.
That’s when Nikki Auen came into the picture. When Auen, a specialty pharmacy technician in Vanderbilt’s cystic fibrosis clinic, started her day of working from home on Dec. 28, she noticed the clinic had a voicemail from a CF patient affected by the bombing.
“She was not allowed back in her apartment for her own safety,” Auen said. “But that meant she had no medication and no nebulizer. She had nothing.” Auen explained that the patient also did not have access to her high frequency chest wall oscillation, commonly called “the vest,” which creates bursts of air to loosen mucus and clear the lungs.
Without the vest or any of her medications, the patient was at risk for a chest infection. Knowing that chest infections in people with CF could lead to long-term lung damage, Auen got to work.
She started by calling the patient’s insurance company, where she ran into a speed bump. “When you’re calling that early in the morning, you usually get someone who is not in the United States,” she said. “The bombing was in the national news, but the person I was speaking to overseas had no idea what the bombing was or how it affected residents.”
Auen did her best to explain the situation, but since the company had little information about the bombing, and it was not considered a natural disaster, they were not required to approve insurance overrides. Another part of the holdup was due to some of the medications’ costs running upward of $30,000.
“We got it all sorted, and the patient was able to pick up every single medication she needed the next day.”
“Since the patient had just gotten her monthly refills on a few of the more expensive ones, it was that much harder to convince her insurance to refill them again in short succession,” she said. Luckily, Auen did not take no for an answer, and eventually she was connected with someone in the U.S. who was aware of the bombing and was able to approve the overrides.
Auen could have stopped there after handling the patient’s Vanderbilt prescriptions, and left the patient to sort out the rest of her medications from other specialty pharmacies. Instead, she looped in the rest of the CF team to ensure the patient was fully taken care of.
“The patient wasn’t filling all of her medications with us due to insurance, so I sent a message to our cystic fibrosis nurses to get entirely new prescriptions written and filled for her,” she said. “We got it all sorted, and the patient was able to pick up every single medication she needed the next day.”
Auen says the entire CF specialty pharmacy worked together to make this happen for their patient. The nurse team had new prescriptions ready within five minutes of her request, and they also worked together to get the patient a new vest and nebulizer.
Auen hopes the team relieved even a small amount of stress their patient was feeling that day. By handling insurance companies, specialty pharmacies and expensive prescriptions, she and her colleagues ensured their patient had as little to worry about as possible. Patient care was at the forefront of their minds – proven by their willingness to go the extra mile.
“We will always advocate for our patients in any way we can,” Auen said. “It’s just what we do.”
