Recently, an older female patient presented to the ER with a complaint of back pain after falling over a phone cord while getting out of bed. The patient was on blood thinners and had a small (baseball size) bruise to her back. The patient was otherwise in good spirits. She was joking with the staff about her love of the music group BTS (which she says is way better than The Beatles that she grew up with) and her blood pressure was actually a little high, but she otherwise had normal vital signs. The patient was sent for CT scan and while awaiting the results, Jaycee came in to reassess her patient. The patient just couldn’t get comfortable. She stated that her back was hurting worse and Jaycee noticed that although the patient’s blood pressure was now normal, it was a SIGNIFICANT drop from where she started. Jaycee asked the patient to let her examine her back again, and that is when she noticed that the baseball size bruising had grown to nearly half the patient’s back. She checked the CT scan result which showed “active arterial bleeding,” and immediately notified the physician. She alerted the ER team and charge nurse that this patient was at risk to decompensate quickly, and additional labs and emergent blood were started on the patient. The patient did begin to deteriorate shortly after Jaycee’s assessment, both in mental status and in vital signs. However, because Jaycee was one step ahead, we were able to intervene quickly. The patient was emergently transferred to Midtown where it was discovered that she had not 1, but 2 arterial bleeds (thoracic and gastric arteries), which required a procedure in IR. Time was of the essence for this patient, and had the internal bleeding not been caught by Jaycee’s thorough assessment, this patient most likely would have had a very poor outcome. I am extremely proud of Jaycee, and she would definitely be one of my top picks to take care of my family should we ever need to come to the ER.