During a very busy evening in the Emergency Department, a staff member called Vicki Grenier RN, and informed her that there was a patient, who was 21 years old, checking in for rib pain but had a dog with him. The triage nurse wondered what we do in that circumstance. Vicki immediately took hold of the situation to work as an advocate for the patient's best interest. She contacted hospital security, the House Supervisor, and the department case manager as the patient needed medical care, but did not want to part from his dog, who was the only family member that the patient had left in the United States.

Vicki went outside to the front of the ED to speak with the patient and hospital security. The patient appeared disheveled, only a handful of belongings and his dog was an older dog, very gentle demeanor and the dog appeared very attached to its' owner. The patient explained to me that he was in a MVA a couple weeks ago and was still having rib pain. I had asked him if he had anyone that he could call to take care of his dog until he was seen. He stated that he was somewhat homeless, staying with friends here and there if they would let him and that his parents just moved back to England. He stated he had his friend's phone numbers in his cell phone but didn't have his phone. Acting with great compassion and empathy -not passing any judgment - Vicki listened to him and told him to wait right there as she was going to speak with some of the ED providers to see what the department could do for the patient without trying to add any further duress upon the patient.

Vicki spoke with an ED doctor and gave him all the information about the situation and asked him if he would at least go outside and assess the patient. If the patient needed x-rays or additional diagnostic tests, she would have to come up with a different plan.

During the exam outside the ED doors, social services, case management, and the House Supervisor offered up some different solutions, but they involved separating the patient from his dog, and Vicki saw in the patient's eyes that he would rather live with the pain and discomfort before he would abandon his only companion. Vicki was relentless in advocating for the patient.

It was proposed that a doctor and nurse would go outside and complete the assessment and do vital signs. The doctor agreed without any hesitation. The provider did the medical screening, and spoke with the patient for about 15 minutes. The doctor informed the patient that he felt that he didn't need any x-rays as the patient just had them a couple weeks ago. The patient was extremely happy that the healthcare team, led by Vicki, went that extra mile to help him giving his situation. She apologized to him that we had to have him wait outside, as it was a little chilly, but she wanted to make sure he was seen and taking care of while being very aware of the patients circumstances in this unusual situation.

The patient was offered something to eat and drink as well as an extra sandwich and water for the dog as they both appeared to be hungry and thirsty. She expressed to the patient that there was no trouble whatsoever and it would be our pleasure to do that. He was very grateful and thankful; the dog was definitely hungry and thirsty and so was the patient. While the discharge paperwork and prescriptions were being reviewed outside, Vicki saw that the patient was given a couple of disposable ice packs, another sandwich for the dog, a couple teddy graham snacks and a sports drink for the patient.

Metropolitan ED's typically operate in such a hurried pace, however Vicki embraced the spirit of what a DAISY nurse stands for and compassionately cared for this man and his dog.