I would like to nominate Brady Hancock RN for the DAISY Award for his ongoing compassionate and professional care of children and adolescents that "board" on the Behavioral Health service at MCJCHV.

Brady has proven to be calm, kind, compassionate, and professional (both in demeanor and communication) in high acuity situations, promoting and ensuring the safety and well-being of both his patients and his colleagues. Patients on the Behavioral Health Team are patients that present to our hospital in acute behavioral health crisis (suicidal, homicidal, aggressive). They have undergone a crisis assessment in the Emergency Department, and the recommendation is for acute inpatient psychiatric hospitalization due to risk of harm to self or others. These patients are often admitted to our medical hospital for 1:1 observation for safety while we locate an acute psychiatric hospital bed. They are not felt to be safe at a lower level of care.

Brady is a nurse on the 8th floor, where many of our higher acuity behavioral health patients will board due to bedside staff experience, and proximity to the Pediatric Hospital Medicine and Behavioral Health Team office (allows us to respond quickly to emergent escalations in behavior). I would like to highlight a specific example of what I witness in Brady every day I work with him. While this is only one example, Brady displays this level of compassion and professionalism on a consistent basis with all of his patients.

In August of 2022, we had an adolescent male patient with prior diagnoses of Autism Spectrum Disorder, Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder, Disruptive Mood Dysregulation Disorder, Bipolar Disorder, and Behavioral Dysregulation present to our hospital ED via EMS due to aggression toward his family (verbally aggressive, then slapped and choked family member). The crisis assessment specialist recommended acute psychiatric hospital stabilization, but no psychiatric hospital would accept him due to his diagnosis of autism and level of aggression. He boarded at MCJCHV for 5 days with before we were able to locate a psychiatric hospital bed for him, and Brady was his nurse.

The patient was frequently agitated and verbally/physically abusive toward staff and VUPD officers. The patient displayed frequent aggressive posturing, and often yelled inappropriate and hurtful racial and homophobic slurs. He hit walls, threw furniture, and eloped from the room multiple times despite VUPD presence at bedside. He required frequent attempts at verbal de-escalation, and when those failed, multiple PRN PO and IM medications and occasional restraints to prevent harm to himself or other staff, patients and families.

Throughout, Brady maintained his composure, approached and regarded the patient calmly, without judgement, with compassion, through a trauma-informed lens. He communicated with the patient, and with us (the primary provider team) with professionalism in both his spoken word and body language, even when emotions were high, and others felt threatened. He had a student nurse with him that week, and appropriately navigated his obligation as a preceptor to teach and share knowledge, while also protecting their safety and emotional well-being. Given the acuity and emotional distress that accompanies such an assignment, Brady was offered a different assignment on subsequent days. He chose to stay with the patient, both for patient's continuity and to protect/prevent his co-workers from having to endure the difficulty of that assignment themselves.

I have been a nurse for 25 years, and a nurse practitioner for 9 of those 25 years. The majority of my pre-behavioral health experience was in the Pediatric ICU and Pediatric Hematology-Oncology. and I have now worked with the Behavioral health Team for ~ 3.5 years. Working "in the moment" with a highly aggressive patient is one of the most difficult and emotionally exhausting things I have ever done. Brady does it with grace and composure, for days in a row, because he knows the consistency is best for the patient, and he cares about his colleagues.

Brady deserves this DAISY Award for his steadfast compassion and professionalism in the most difficult of situations. Brady's care makes a significant difference in the lives of these very vulnerable patients (who are not in a position to verbalize their appreciation), and also in the lives of his colleagues. Thank you, Brady!