Amanda is the true definition of an exceptional nurse, always going the extra mile for her patients. Recently, she had a patient with liver disease who was rapidly declining and not getting any answers about new symptoms that were very concerning for the patient and his wife. Increased confusion, a fall, and debilitation brought him to an outside Emergency Room. The Veteran was sent home with a diagnosis of no acute findings.

To ensure the Veteran was taken care of at this outside medical facility, Amanda completed her follow-up call to the Veteran and his wife. And luckily, she did. The Veteran's wife answered, and Amanda could hear the frustration in her voice. She did not get the answers she was looking for. Amanda immediately put her critical thinking hat on, remembered what the wife told her in the recent past. Mr. R had serial paracentesis(s) which was mostly stemming from renal issues, but his wife did mention there was some liver damage. She immediately told his wife that she needed to take him to the WNCVAHCS to have his Ammonia level checked. Report was called to the ER and a Teams message was sent to his Palliative Care Team. Later that day the Veteran was seen and admitted for Hyper ammonia. Amanda went above and beyond by communicating with his doctors ensuring a crucial lab test was performed for the patient, despite it not being initially ordered by the outside doctors.

Her proactive approach, attention to detail, and unwavering commitment to patient well-being exemplify the true spirit of nursing. Her actions not only safeguarded the patients’ health but also highlighted the importance of advocacy and thoroughness in patient care. Amanda’s extraordinary efforts are a testament to her professionalism and compassion, setting a shining example for all of us.