Paige is an excellent clinical nurse, who occasionally works in the charge nurse role. This past Sunday as charge nurse, she did an amazing job. She was challenged with a difficult shift, during which she remained calm, professional, and courteous to all team members, patients, and their families. 

At 07:45, we realized we had a no-call, no-show nurse and Paige took the assignment. She apologized to the night shift nurses. The assignment consisted of two patients, one a covid + patient with multiple bowel movements and nausea episodes. Her second patient had cancer and was on two vasopressors with multiple family members visiting throughout the day. 

While providing excellent care to these patients, Paige went to help with the unit's first admission. This patient required an emergent line due to hypotension and remained unstable throughout the day, hovering close to intubation. 

Although a nurse was requested from Supplemental staffing after the no-call, no-show, they only were able to send a progressive care nurse. Staffing was called again with a request for an ICU-capable nurse at 3 pm, due to unit acuity and as they had a nurse who was scheduled to leave at that time. 

Paige then met with some upset family members and successfully de-escalated the situation. 

At this point, Paige went back to her assignment and replaced an infiltrated PIV and then worked through a plan of care for her patient with the providers. 

Then, on the unit, a comfort care patient passed away. Paige facilitated post-mortem care and paperwork. 
Returning to her assignment, her patient experienced a hypotensive episode. She called the physicians to the bedside, gave a fluid bolus, and obtained labs. Next, she rounded on the team, ensuring everyone was doing all right and taking lunches. During this time, she helped turn patients, administer medications, and obtain labs. 
There were several acute situations, in which Paige provided support, including an emergent chest tube placement, an end-of-life scenario, and two patients with respiratory instability.  Paige checked on these nurses frequently and advocated for closer monitoring. 
Paige then worked with bed management to find patients that were appropriate for discharge to the floor.

At 3 pm, there was another no-call, no-show nurse who answered her phone. Paige was very professional and told the nurse to drive safely but to please come in. In the meantime, she asked the CICU float nurse to stay a little later and adjusted API. She then came to help cover the assignment.  

Another family member became upset who wanted to visit with a patient (the policy for this rule out is one visitor per day and mom was already at the bedside). Paige had to escalate this to the clinical administrator for support. She then advocated for needing more MRICU staff for the night shift and was assigned a 12-hour night nurse and a care partner. After finishing the assignment board, a patient’s isolation was de-escalated, which meant the patient had to be assigned and moved to a new room for cleaning purposes.
During this incredibly busy day, Paige was very helpful and professional and she showed leadership skills by making sure the unit functioned smoothly, set the night shift up for success, the team received the necessary support, and that all the patients remained safe while all patient or family concerns were met. As a member of the team that day, I can say we were all thankful for her ability to guide us through the day and make it a “good” day for everyone. Thank you, Paige!