After living with stage 4 ovarian cancer for 14 years, my dearest friend, K, passed away. On the day she died, one of the last phone calls she made was to Natalie. One of the challenges K faced in the past years was a fistula that developed following a surgery to remove abdominal tumors. This fistula presented an enormous nursing challenge as her surgical wound dehisced one week after surgery, as did her bowel -no one knew how to contain the bowel contents leaking continuously. The event was so traumatic for K, her partner, and the floor nurses. Then Natalie was called to evaluate and help. The fistula never healed, although the surgical wound eventually did, as K's illness progressed, the fistula care continued to require frequent adaptations, especially in this final year. I accompanied K to her appointments with Natalie these final months and was able to observe what I would call exceptional nursing care. Not only was Natalie skilled in the actual fistula care, (due to the everchanging presentation of the "stoma," it was her way of being her presence that demonstrated the art of nursing. With every change of the "stoma's" presentation, Natalie had to determine which type of ostomy appliance would work the best - she had to consider the ever-changing shape of K's abdomen, and what would best prevent the ostomy bags from leaking, which they often did. She had to initially teach K and her partner how to maneuver these changes and then teach me when it became too difficult for either of them.

When K was initially diagnosed, I made the decision to remain more in the role of friend, as she had an excellent nurse in the chemo clinic. I heard about Natalie over the years, but when K's health was declining, she needed more help, and I moved into the site of nurse and finally met Natalie when I accompanied K to appointments. The following is what I observed: A nurse with exceptional clinical skills who had to continuously adapt her plan of care; A nurse who had excellent communication skills and used humor appropriately, which K loved; A nurse with compassion who recognized how traumatic this ever-changing wound presentation with subsequent bag leaking and frequent changes of appliances and stoma care. I saw a nurse who, although I know was extremely busy, never indicated that she was stressed, in a hurry, or had to see her next patient. I saw a nurse who provided education for her patient, their family, and other caregivers. I also saw a nurse who guided the family in how to deal with insurance and supply companies who did not understand that the ostomy appliances that worked for K this week, but were no longer were appropriate at the end of the week as the fistula/stoma shape had changed again. Natalie's care of K and her partner made an enormous difference in the quality of their lives; she became a trusted friend and ally. For these reasons, and all I have listed above, I nominate Natalie Martin for the DAISY Award.

Note: This is Natalie's 2nd DAISY Award!