Haylee Sims, an 8th floor nurse, had a patient who was already admitted for a stroke who was not a TNK candidate on an Argatroban drip who had a pretty subtle neuro change that she noticed immediately.  Given the patient's status as ineligible for TNK she called an RRT immediately (instead of debating what kind of stroke alert to call) and the team at the bedside were able to reach out to neurology and discuss the patient's symptoms and presentation and ultimately get the stroke alert called.  Everyone at this point was worried about a hemorrhagic conversion, which did not mesh with the patient's initially reported symptoms, but getting neurology engaged early at the bedside ensured that we got a CTA, and we found the patient's Large Vessel Occlusion (much to everyone's surprise).  The team kicked into high gear, got the patient down to the ICU, and rapidly flown out to CDH for a thrombectomy.  

After all of this had occurred, the doctor went back to the 8th floor twice to meet with Haylee and the staff on 840 pod to discuss what they saw, and how well they did, and review with them the imaging from the thrombectomy and how much of the patient's brain was saved.  This patient would have had profound motor, sensory, and visual deficits if not for the thrombectomy, and that all started with Haylee noticing a change in grip strength in real time and doing a great job getting the emergency response going.  Several providers were all able to discuss in real time what the right course was and support the 8th floor team in getting the patient down to CT and back.  The new ICU care coordinator did a commendable job in arranging the flight out as fast as possible.  

Long story short, Haylee did a great job finding a problem and acting on it!  And the team did a better job both communicating the clinical elements and closing the loop on the effectiveness of the intervention than I have ever seen before.  It was a pretty great performance by a team that has been stretched pretty thin by both census and acuity this winter.  

I know Haylee got a call from the family thanking her for being amazing, and I will gladly write her up for whatever the appropriate recognition is for this kind of performance, but she started a team effort that honestly ran perfectly.  I don't know how to get everyone recognized, but this performance is what we think of as the goal.  And we got a great outcome.