I have worked with this nurse for the better part of 3 years. As a then-junior attending, they were a clinical nurse coordinator with whom I shared working privileges with another senior faculty member until that faculty member moved on to another position in another health system. Throughout the years, this nurse has exemplified the qualities of not only an outstanding nursing professional, but one who transcends all fields. Our specialty is spine and pain medicine, where we deal with an often-difficult patient population, not necessarily from a personality standpoint due to a period of persistent pain (whether it be acute or chronic), but also from a medical complexity perspective as we see patients with significant medical comorbidities including heart, pulmonary, renal, and hepatic failure. This requires an ever-astute sense of awareness with a compassionate touch.
A particular example of this would be where we had an unexpected follow-up visit from a patient who lived over an hour away from our medical center. He had driven from home to see us due to ongoing hip pain. He was not the politest person in the intake area or when he was seen by our other team members, as he was mistakenly taken to our procedural suite when he was here for a clinic evaluation. However, through this grouchy demeanor, it was obvious he was not doing well. Aside from his ashen grey skin that carried all signs of dehydration, he started vomiting quite a bit. He was given an emesis bag, and our team was notified. I was seeing another patient at that time, and this nurse went to see him. With one glance, this nurse knew he was not feeling well. The nurse rushed back and notified other team members and me to see the patient. He was waiting in the waiting room, and others who had initially seen him thought he was fine, just nauseous. However, this nurse knew something else was going on. While the nurse tended to him and helped get him to a room to be evaluated, I reviewed his medical history. He has a long history of heart failure but also liver failure. He had his home INR checked the day prior and was drastically elevated to 3.6. He was told it was due to him having a faulty machine that he was going to have swapped. I rushed out to join this nurse, where a glance reaffirmed their concerns. He noted having abdominal pain, fullness, and generalized fatigue. He was sick, and we were worried he was in acute liver failure. This nurse helped coordinate a rapid response, was able to help communicate with the receiving nursing team the relevant issues at hand, and helped stably transfer this patient's care to the emergency department, where a further workup revealed an INR of 5.9 and elevated LFT's in the thousands. Our patient was indeed in severe acute hepatic failure. It would be easy to overlook this patient, and he could have stayed in the waiting room area if it were not for this nurse’s concern and clinical acumen to notify us that the patient needed help. The patient was admitted and stabilized immediately. However, were it not for the nurses’ detection and compassion for the patient, he could have easily waited for his appointment (as he was 2 hours early), where he could have decompensated instead of being resuscitated in the emergency department. This is just one of the many examples and times when this nurse has gone above and beyond the line of duty, which makes me grateful for the opportunity to work with them. It is without reservation that I nominate them for the DAISY Award, as they exemplify everything it means to be a nursing professional who would make Pat Barnes' family proud.