Jackie demonstrated exceptional care for a client and family that presented a unique and complicated challenge to the unit milieu and our healthcare system. The young lady we received suffered severely from autism that went untreated for most of her 15 years of life. The family had opportunities to receive professional assistance, but preferred to care for their daughter in the privacy of their own home with limited outside help. This family's belief was reinforced by a recent trauma experience within the school system where the child was physically assaulted by care providers. Since this traumatic experience the family justifiably resisted all outside help; however, the child was becoming too aggressive for the family to manage at home, which led to the family desperately seeking assistance from a system they didn't trust. Early in the family's experience of our hospital system they felt as if their fears were correct as their daughter spent nearly 5-hours in mechanical restraints within the emergency department. These restraints were a response to the child's aggressive behaviors that left visible reminders to all of the fierceness of the attacks; both mom and dad were left bruised, scratched, and defeated.

Fast forward to the admission to our inpatient unit . . . nursing staff received the routine report of the patient, her challenges and the barriers the family presented to treatment. Rather than accepting the barriers Jackie reassessed the family, their beliefs, limitations, and the educational needs of the family. Jackie was instrumental in advocating for the family's 24-hour, 7-day stay in our structured and safe environment where learning could be promoted. Recognizing the importance of synergy Jackie also worked closely with N to develop a family plan that was introduced in our inpatient environment and could be carried forward to the home upon discharge. Jackie also assigned techs with autistic experience to be the main supports for the family. Jackie spent tireless hours one-to-one at the bedside with the family and patient ensuring safety and working through each crisis as it evolved. During the 7-day length of stay behavioral crisis continued to occur; however, Jackie and the staff masterfully managed these episodes in a trauma-informed manner ensuring safety of the family, child, and staff without the need of mechanical restraints or seclusion.

Let me reiterate, the same child that needed nearly 5-hours of mechanical restraints pre-admission, was not mechanically restrained or secluded during her 7-day stay under Jackie's care and clinical leadership. Jackie's efforts changed the mindset of the team to accept the value system of the family and to creatively think about interventions that would not compete against the family's belief system. Jackie also built trust of the family who accepted outside assistance from autistic specialists for the first time in years. This clinical success story could have ended much differently if we didn't have compassionate nurses like Jackie Lewis who instills faith and hope in patients and family by exceeding expectations and anticipating needs. Jackie is truly a remarkable nurse.