I happened to be covering a few nights ago when I got a call about a patient who was supposed to go home after a lengthy hospitalization for horrible burns after a house fire. He'd had a long SCU stay, and had required a tracheostomy, but after several weeks had recovered to the point that he seemed ready to go home. The plan was for him to be discharged home the next day. He had been decannulated for a while, had had some trouble with intermittent respiratory distress related to secretion management. Robin Merrill was impressed enough to communicate her concerns to the night team, who felt it was likely anxiety related and that he wasn't in imminent danger. It sounds like what Robin saw was scary enough that she kept a close eye on him after the acute episode and related her observations and concerns to Ann Marie Neal, who took over on the day shift. Ann Marie was able to convince the team to get ENT to see him prior to his 4 hour ride home. The ENT surgeon called me after seeing him and related his concerns that the patient had a very small, tight airway and needed to have a new tracheostomy placed soon. I went up to check on him and saw why they were so worried. We were able to support him long enough to get him to the OR and place a new tracheostomy, without incident.

These two nurses saved his life. Intelligence, good observation and analysis skills, persistence when the answers didn't fit what they were seeing and knowing how to communicate those findings. This was a great example of superb nursing care. In a way it's no different from what the nurses do for my patients - I mean, the level of consistent professionalism and compassion the nurses exhibit is one of the best parts about my job. But this example so well illustrates how the elements of top-notch nursing make a difference that I felt compelled to call it to your attention.

Robin Merrill and Ann Marie Neal deserve this DAISY Award for their excellent nursing care.