During a routine check-in process for cardiac rehab, a patient was not feeling well and did not present as he normally did for exercises. Upon monitoring, the patient's heart rate was up and down and he was lightheaded and dizzy. Lisa called the patient's cardiologist, but before she received a return call, she decided to send the patient to the emergency department. Later that day, the patient had a permanent pacemaker inserted. This was directly related to Lisa's keen nursing skills and recognition that the patient was declining. The patient called back into the hospital after discharge to thank her for her quick actions and for the kindness and compassion. The patient feels blessed to be alive following his previous cardiac event and then this second one. Lisa is very caring to her patients always answering their questions and offering sound advice during their visits.