Janet received a patient from the ER after getting a telephone report. Upon arrival to the unit at 0155am, Janet noticed immediately the patient’s condition was not stable. She saw a unit of blood on the patient’s cart, not infusing. Janet did a set of vitals with a B/P of 86/35. The patient was lethargic, so she called anesthesia immediately. She started the unit of blood within minutes. The second set of vitals 5 minutes of arrival, B/P was 58/31 and heart rate of 101. The doctor arrived at the bedside and confirmed patient needed to be in the OR STAT. The patient continued to decline. The doctor said Janet saved the patient’s life. She was in hypovolemic shock and would have coded soon. Janet’s critical thinking skills saved this patient. This all happened with limited staff. She gave life-saving extraordinary care to this patient.