We are writing this letter to express our sincerest gratitude toward Latrina Crossland for her care of the patient who was admitted and treated at Providence recently. The patient was admitted for COPD exacerbation. His hospital course was complicated by heart failure and worsening kidney functions. Initially all treatment and diagnostic procedures were unsuccessful and it was difficult to find a proper diagnosis. Team 1 received a call from the nurse. Latrina reported that after careful review of the patient's chart there was an unusual change of BP between the right and left arm. Further investigation revealed that the patient had severe high grade stenosis of subclavian on the right lateral side. The care team together with the attending physician would like to thankthe nurse for her professionalism that helped find a clear diagnosis for the patient.