Latonya approached me with concern about her patient’s auscultated vitals. I went to her patient’s room and took a manual that was slightly off from mine. We took an automatic pressure which was comparable to her manual. She stated her patient was not currently on any antihypertensives and I advised to alert her bedside RN which she promptly did.

Not long after, Latonya approached me with a concern regarding her assessment and the concern that something was really wrong with her patient. Based on her patient’s neurological condition and motor strength yesterday, there was a change that she felt was indicating something was wrong with her patient. She told me she had trouble transferring him to the bedside chair for breakfast due to increased weakness, so she assessed his grip strength and noted a change with right-sided weakness. She asked him to lift his legs, but he could not lift the right leg or wiggle his toes. She reported no slurred speech or facial droop as well.

I started an NIHSS assessment as Latonya was reporting her concerns and findings to the bedside RNs. Soon after, they took over the questioning, and we all agreed there was concern for a stroke. A stroke alert was called and quickly the teams funneled into the room. Latonya stayed with the patient the entire time and remained the center of focus with the patient due to the fact that she was the only person who had assessed the patient at that point for a baseline to answer the questions for the team and physician. She escorted her patient to CT, which was negative, and soon after, to MRI, which was unable to be completed due to patient movement and anxiety. It was deemed likely a TIA at that point, and the patient was brought back to the room.

Latonya continued to remain bedside and obtain vitals every hour and observe the bedside RNs perform an hourly neurologic exam. Neurology diagnosed the patient with acute encephalopathy, but required amiodarone infusion after determining the patient was in AF with RVR.

The prior week, Latonya was sitting at the computer to enter her assessment and began updating me on what she was doing. She advised that she went in to assess her patient, and just as I have witnessed her doing, she asked the patient how they slept the previous night and if they were in any pain. The patient said his abdomen hurt. Latonya assessed his abdomen and noted it was distended. She asked when he voided last due to his being on a Lasix drip and he said he hasn’t voided all night and couldn’t void.

She left and got the bladder scanner and advised his RN on her way to get it. With the bedside RN at the bedside, Latonya performed a bladder scan, which was around 650 mL. She asked him if he could void, and he said he didn’t want to do it right now. He was given the option of trying to void in a urinal with assistance, standing, or a straight catheter. He chose to let Latonya help him stand to void, which totaled 950 mL. The bedside RN left the room to call the physician for orders.

I was very impressed that she caught something the bedside RNs did not from the previous shift. I started to tell her about PVR scans moving forward, and she said: “I got it…it was zero”. She entered everything immediately into Cerner, not quite realizing how proud I was at the time.

Latonya’s thorough assessments and advocacy for patients have actually led her to discover several wounds as well that were not yet noted or reported by staff. She has shown so much independent and critical thinking in N201 that an RN on the floor told her that when she starts her transitions, she would love to be her preceptor because they were so impressed with her bedside care and patient-centered focus was clearly Latonya’s priority.

I am impressed by her every single day, and no one deserves recognition more than Latonya Young.