Rose, a Registered Nurse, cared for my close friend a week before the end of his life in the Seventh Floor South Intensive Care Unit of the Kaiser Oakland Hospital.

My father died seven years ago after being in and out of an ICU. To advocate for him, I had to learn how an ICU functions, medically and organizationally. I had long been a fan of Dr. Elisabeth Kübler-Ross, who, by asking terminally ill patients what they needed, was able to alleviate symptoms, moderate the use of sedatives, and give patients and loved ones opportunities to resolve what she called "unfinished business".

Rose gave my friend so many gifts as his ICU nurse:

• Effort: When my friend's Propofol was reduced during the day, Rose interacted with him and taught me that I could interact with him. I, in turn, showed his wife. (In the ICU where my father was admitted, by contrast, it seemed to me that sedation was sometimes boosted to keep the workload manageable.)
• Communication: Rose explained to my friend everything that was happening to him: new medications, scheduled doses, procedures. She also asked him about pain, physical comfort, and basic needs. She successfully elicited answers, even though he could not talk while on respiratory support.
• Attention: Based on her own astute observations and on my friend's signals, Rose provided blankets, extra pillows, ice packs, lip moistening, and other physical comfort measures, from hour to hour.
• Compassion: Rose showed sympathy toward my friend's wife and toward me, taking time to talk with us, answer our questions, and check on our emotional state.
• Diligence: When she learned that my friend's teenage son was afraid to visit an ICU, she went there two days in a row, she specially prepared the room and made my friend look as comfortable as one can be in an ICU. I noticed as soon as I came in on those mornings. I also overheard various staff members comment on the room's perfect condition. I felt comfortable telling my friend's wife that with Rose on the job, she could ask her son if he wanted to visit, knowing that his dad would look peaceful. (As it was, their son was brave enough to make it to the waiting room.) I remembered my last visit with my father in the hospital, and I thought, here is Rose, helping a family to say goodbye in a dignified way.
• Respect: Rose fastened my friend's wrist restraints only when necessary. We give up so much control in a hospital, let alone in an ICU. I believe that my friend knew he was in the "least restrictive environment" whenever Rose was present.

I have been a Kaiser individual-pay member for 27 years. Someone like Rose, who treats the whole person, makes me confident in my choice. Thank you, Rose, for taking good care of my friend at the end of life.

Mr. Scott Blanchard, a Registered Nurse, cared for my close friend in the Seventh Floor South Intensive Care Unit of the Kaiser Oakland Hospital.

Compliment letters matter most to employees early in their career journey. I have no doubt that Scott has accumulated a thick sheaf of them. If I can't persuade him to postpone his retirement until after I need care, I can at least remind him of the difference he makes and encourage him to teach or mentor junior colleagues, so that patients will benefit from his knowledge, skill, and compassion, in perpetuity.

When my friend was re-admitted to the hospital, Scott recognized his name on the daily census. After his shift, Scott came up to the regular floor. He spoke reassuringly to my friend's wife and to me about my friend's imminent transfer back to the ICU. We also requested that Scott be assigned on my friend's last day.

Scott knew every trick for physical comfort: pillow placement, ice packs, blankets, lip moistening, etc., always in a systematic way, and always based on communication with my friend or objective observation of his condition. Scott delivered discretionary pain relief promptly when my friend signaled.

Scott spoke respectfully to my friend, explaining procedures, scheduled and one-time medication doses, and planned actions. Scott treated him like a person, not just a patient.

On my friend's last day of life, Scott set up the room specially, even taking time to display peaceful images on the television. He was so intuitive in deciding when to come in and when to give my friend time with loved ones. My friend's sister-in-law and I were present at the end of life. Scott constantly checked the monitoring system for objective signs that my friend might be in distress, and we all watched for subtle signs like furrowed eyebrows. Meticulous adjustments were made to my friend's medication in the last hours.

Thanks to Scott's diligence, I was confident that my friend died with the least possible physical pain.

After the death, and despite receiving a new admission next door, Scott continued to check on my friend's wife and sister-in-law and on me. Again, it was the perfect balance of attention and privacy. Scott even consolidated the paperwork that my friend's wife had to sign.

Thank you, Scott, for taking good care of my friend at the end of life.