In an Intensive Care Unit a nurse can become so focused on maintaining a patient's critical vital functions that being able to investigate emotional and cognitive motivators of patients can sometimes be seen as a luxury.

Elaine had worked with this patient over the course of several weeks. Her patient had transitioned from being intubated to a tracheostomy and was ready to begin work on regaining the power of speech. The patient was not very motivated to work on swallowing. Elaine, over the course of her involvement with this patient, learned where he was originally from and some of his likes and dislikes. She focused on learning some of his stronger likes and found that food from his home town of Boston was a very positive motivator. With this knowledge she found out that this Veteran was a big fan of New England clam chowder. Over the course of the days that followed she searched for recipes that were indigenous to the Boston harbor area and she communicated to the patient that once he had completed his swallow reeducation that she would make him a big pot of Boston Clam Chowder. This daily interaction and motivation has helped this patient develop stronger skills in navigating the speaking valve of his trach and also the difficult skill of relearning how to swallow.

Even though the patient has transferred to another ward, Elaine keeps in contact with the patient and still plans to make him some homemade clam chowder. As nurses we can easily get caught up in the ever growing piles of seemingly unimportant healthcare administrative minutia, and forget our patients. Elaine McMullen did not forget and proceeded to go WAY outside the box to reach out and connect with her patient. Her attention to detail and flowering nursing innovation brings great credit to her, James A Haley VAMC and the profession of nursing.