A young man suffered a traumatic brain injury as a result of an assault. He required a maxillary repair, tracheostomy, and PEG tube placement. Upon admission he was agitated, not following directions, and requiring restraints to maintain the medical devices. While on the unit we ruled out the CVA and they were in the process of placing him in an ECF. Kim had the patient for a few days in a row and felt like she was seeing improvements in his cognition and that he was attempting to speak. She contacted the physician to see if they would hold the discharge and have pulmonary come see the patient. Pulmonary capped the trach and the patient was able to speak. The family and staff were all extremely emotional and crying. A swallow screen was ordered and he was able to eat and drink again. He became much calmer, the restraints were removed and he was able to follow basic directions. The family passed along to the manager how grateful they were that Kim fought to make sure the patient was given every opportunity to improve his quality of life and not just get sent back to an EC. The unit case manager also expressed what an amazing job Kim did advocating for the patient. This is an amazing example of compassionate care and trusting nurse’s intuition to question orders while maintaining the patient’s best interests.