Mary Aileen has always been a compassionate and caring nurse. Tonight, however, is more exceptional because during her assessment of this 94-year-old female patient, only 4’7 weighing 74 lbs. she noticed protrusion to her right forearm. No bruising was noted. The patient was nonverbal, but Mary Aileen noticed that the patient was guarding that extremity. Mary immediately informed the doctor and got an order for an x-ray of that right forearm. Results of the x-ray indicated dislocation but non-acute fracture of the proximal 3rd of the ulna. Suspect a chronic dislocation of the radial head. What struck me is how this patient has been admitted for some time and there was no documentation of any kind regarding the protrusion or bump to her arm. The patient grimaced when she was moved. This tiny elderly patient was in agony and nobody noticed until tonight. This is because of the caring attitude of Mary Aileen. That caring and compassionate attitude went further when she called ER and got an arm splint for the patient.