I would like to recognize the outstanding care, compassion, empathy, patience, advocacy and therapeutic presence that Danielle Cotton exemplifies daily by providing the following example. While receiving bedside handoff report at 0645, the patient that Danielle was assuming care for began pressing the call bell. Danielle quickly entered his room to assess his need mid-handoff report. The patient demanded ice chips despite knowing his NPO status for a possible procedure. Danielle patiently explained the rationale for his NPO status but informed the patient that she would discuss the plan of care with the provider team after the conclusion of the RN handoff report. Upon exiting the room, the patient immediately pressed the call bell again, demanding a different request for pain medication. Again, Danielle patiently entered the room and assured the patient she would meet his needs immediately upon the conclusion of handoff report. Upon exiting the room, the patient again pressed the call button, demanding yet another need. This cycle continued to escalate throughout handoff report, with the patient pressing the call button many times, making multiple demands from Danielle. This caught the attention of the entire staff on the unit. Recognizing that this cycle was likely more a pattern of behavior rather than actual needs, Danielle communicated to the staff on the unit that she would work to determine the root cause of the behavior, address his needs and work to set boundaries.

Upon the conclusion of handoff report, Danielle sat down with the patient and discussed his needs, fears, concerns and feelings. With this information, Danielle expertly assessed his feelings of powerlessness, fear, and a need for autonomy and control. Danielle addressed his fears and empowered the patient by providing assistance to take a shower, change his linen, administering pain medicine, and advocated for an order for ice chips. In addition, Danielle encouraged the patient to ambulate around the unit within the given ICU safety restrictions. Through further advocacy and discussion with the provider team, Danielle facilitated the escalation of the patient's NPO status to clear liquids, as his procedure would not be completed that day. Danielle efficiently and effectively recognized an escalation in her patient's pattern of behavior, met his immediate needs and worked toward the root cause of this behavior in the first hour of her shift.

After Danielle's interventions, the patient rarely pressed the call bell, expressed gratitude toward all caregivers who entered the room, and was transferred out of the ICU that afternoon. To further exemplify how Danielle's care affected this patient, I would like to share the words this patient wrote on a thank you note he submitted for leadership review: "Yes, I want to give my [nurse] Danielle a Big Thumbs up for being a great nurse to me even though I gave her a hard time. She put up with my headache. She is a great nurse, and I recommend a good recommendation or a raise because she's very understanding and a great nurse. Thanks Mrs. D. Thank you so much, you helped revive me, I think you saved my life. I'm in tears. God Bless You."