Joanna took time to speak with the family, showing compassion and empathy.  Joanna noticed that the patient was getting increasingly confused, tremors and diaphoretic.  Although the patient did not have a CIWA ordered for alcohol withdrawal, Joanna conducted a CIWA anyway.  The patient scored very high.  While Joanna was reaching out to the MD, the family came to visit the patient and expressed concerns, explaining she was a heavy drinker, and her behavior was not her baseline. This confirmed Joanna’s suspicion.  

The MD ordered some medication, but the CIWA score was very high, and Joanna advocated for the patient to be moved to a higher level of care.  The patient was transferred to a step down so she could be monitored more closely.  The family was very appreciative by letting leadership know what a great nurse Joanna is.  Joanna demonstrated critical thinking, compassion, and the need to keep her patient safe from all else.