To Sandra:
I appreciate your hard work and diligence in caring for my patient. Your work exemplifies the importance of teamwork and how each person is valuable, not to mention doing due diligence to your position and not merely following doctor's orders. I am impressed that after the decision was made to keep baby another day to work on feeding, you examined and observed the baby. You noticed the baby was breathing fast. You called me at the clinic to tell me the baby was breathing fast and you thought you heard a murmur, but were not sure. You said you would go back to examine baby after he was finished with lactation. You could have looked at my exam note and convinced yourself that you did not hear a murmur since no one else heard a murmur. The baby's vitals were fine earlier and I examined the baby twice and detected no murmur.

You waited for baby to calm down and reevaluated. You called me back to confirm murmur, fast breathing, and increased work of breathing. I was shocked because this was a clear change from the quiet, sleeping baby I saw early that morning. I don't know if the increase work of feeding helped make his change in status more apparent, but you heard the murmur and I did not. You also documented several vitals which led to baby's aortic stenosis being discovered and likely was a contributing factor to baby's difficult feeding.

Baby had a successful procedure and is doing well. Family is grateful beyond belief.