Marianna was recognized by one of her patients after he was discharged from LGH. This patient came in to visit with his spouse in hopes of seeing Marianna but unfortunately she was not working. Three days later the patient called the contact line and stated "This is not a complaint but I need to recognize the care I received on 7 Lime during my stay by all caregivers but especially Marianna, who was so kind, patient, and compassionate to me during a very difficult night when I was out of sorts and having difficulty communicating my needs. She never lost patience with me and stayed with me while I was scared. Marianna, along with the rest of the staff on this unit are the kind of people that you want to invite to your birthday party!" The patient then stated that "I know I am alive because of her warm and compassionate care."

Marianna was also recognized by a nurse she is precepting:I had to make sure I sent you an email regarding how great Marianna is...not just as a preceptor but she's an exceptional nurse in general. I'd have said this weeks ago but after Thursday night, I knew I had to be sure she was recognized. You've definitely chosen the right nurses as preceptors! She always engages me and asks questions to make me think why I would do something, why I would give a specific med, why I would think a person could have a specific problem.

Thursday night showed me what makes her exceptional compared to others. It makes me strive to be like her. It's amazing what these women at 23-24 years old teach me at 38.

We had Mrs. Y admitted to 7608 at the beginning of our shift. Of course it was busy because an admission came in right away which made me end up behind until after midnight or so. The first part of this is that Marianna knew I was feeling defeated and discouraged and made sure to encourage me and remind me that it takes time to adjust. She never lets me get down on myself. Most importantly, Mrs. Y came in with textbook seizure activity symptoms. She was having episodes of staring and she felt them come on so she had the auras too. Dr. H came in and had an EEG done, no seizures during that but I saw the tail end of one during her admission questioning. I was typing some stuff into the computer and she said, "I feel it. It's coming on." So I documented what I noticed and it was over before we knew it. She just felt "everything was shutting down." She was adamant that it was not cardiac related because she's had cardiac issues and all signs turned to seizures. I know as a new nurse, I would not have thought, "well she had an EEG, has a Holter monitor scheduled for tomorrow, what else could I investigate?" because I think, "docs know what tests to order." Not Marianna!

She said, "Maria, what else could cause the symptoms she had tonight?" Besides seizures (and already being in the mind-frame of seizure/brain issue) I did not know. She said, "Let's go check the tele monitor during the time of the episode you saw." We did, right to the minute when I was in the room and Mrs Y was having 8-10 second pauses! She was coming up asystole on the monitor. And so many times we say "leads are off, they're moving around" or with this, we wait it out and it resolves. But this time, the lady truly had nothing but maybe a few barely recognizable p waves here and there. Bottom line, she was in IICU by the end of the shift after her 3rd episode of pauses/asystole (which was beginning to be symptomatic by that point) and we were told later her "ticker" was in bad shape she was getting a pacer ASAP. So my head was spinning.

What if Marianna wasn't such an awesome and thorough nurse? What would I have done? How can I remember to be so thorough? She could have saved a life that night in my opinion. She really is amazing. I needed you to see the 'behind the scenes' of this scenario because I didn't want it to go unrecognized.