Gayle was nominated by her manager, who shared a self-reflection that was part of her annual evaluation:

While caring for a younger patient with a chronic condition (cystic fibrosis), I had the opportunity to have a positive interaction with her boyfriend. The two have not been in the relationship long, and this was the first time that he had been with her through an exacerbation. He was very distressed, watching her go through the process. Around 11pm, he asked me for a cup of coffee. I brought it to him, and within a very short amount of time, he asked me for a second cup. The patient then spoke up and said to her boyfriend "are you going to pull an all nighter?", to which the boyfriend responded "if I have to, yes."

I heard this and encouraged him to elaborate, to explain the reasons that he felt he had to stay awake. He explained that he was worried, and that he wanted to stay awake to watch the patient. I sat down then, and had a conversation with both of them about their concerns. I invited the patient to explain what an exacerbation is usually like for her, so that the boyfriend could hear from her what to expect. She did, and the two of them had a conversation about her illness. I then explained caregiver fatigue, including sleep deprivation leading to lowered immune response, making him more susceptible to illness, and in turn possibly putting the patient at increased risk. The patient also strongly supported this idea. The three of us then discussed the steps being taken to monitor the patient, including alarms (pulse ox, Bipap), and frequent checks by staff members. The patient also reassured her boyfriend, explaining that she would use her call light if she started to have any problems or concerns. I educated both of them about the RRT system, and also informed them that I was in close contact with her doctor. We all agreed that there was a good plan in place. I then asked the boyfriend if he would like the second cup of coffee. He shook his head and asked for water. He fell asleep within the hour. Once he was calm, the patient's respiratory status actually improved, her heart rate went down, and she was able to fall asleep as well.

Another time I recognized that my patient was feeling isolated and having aggressive feelings as an ineffective coping mechanism. Instead of just offering a medicine, I asked about what provides comfort and help. He responded views of natural spaces provides relief, so I worked to be able to get coverage for a break and took the time to bring this patient over to Kohler viewpoint. He was amazed this was here and it really helped to alleviate anxiety without requiring medications. He got clearance and went back several times during his treatment here.