When I think about a DAISY Nurse, I think about going above and beyond to make sure that the patient is well taken care of even if that means thinking outside of the box. Sherri Crouch, RN is the best example of that. She is a fierce advocate for her patients and is never afraid to speak up. The story below is just one example of how I have witnessed her leadership and her experience lead to better patient outcomes.

In September 2021, ASU was assigned a patient to administer IV antibiotics for 13 weeks as that patient had recently been hospitalized for sepsis related to a foot wound. During that hospitalization, that patient required an amputation and the surgeon gave this patient a choice: either her forefoot would be amputated or a below-the-knee amputation. The patient has limited mobility at baseline due to an autoimmune disease and wished to save her foot to preserve future mobility, she choose to have a forefoot amputation. The wound was left open to pack wet to dry daily. There was confusion about who was going to complete wound care (Home Health versus family) and how often. Sherri contacted the surgeon's office and the home health agency several times over many days to coordinate care. Sherri has an extensive background including Home Health and knew that Medicaid regulations would limit how much care the Home Health agency would be allowed to provide while the patient was receiving IV antibiotics at the hospital. She discussed with the patient the option of family changing the dressing and they decided it would be better changed by an RN at the hospital. Sherri also has experience with different types of dressings. The original order for dressing changes was minimal and did not show much improvement over the first week. Sherri suggested to the surgeon to use an Aquacel dressing with Dakin's cleanses to decrease the frequency of dressing changes to three times a week versus daily. After several days of calls, it was decided the patient would continue to come to the hospital daily for IV antibiotics with dressing changes to be done three times a week. ASU does not regularly perform dressing changes and did not have the suggested dressing in stock. Sherri worked with our ANM to get the correct dressing ordered. She also taught each nurse on the unit how to perform the dressing change so everyone would be able to change it for the patient. When we started doing dressing changes for this patient, the wound did not look healthy. It was pale, and yellow, with minimal granulation and lots of sloughing tissue. The wound was the entire width of the foot and deep. There was no shape of the foot. We were fearful that the patient would still lose her foot despite our best efforts. Thanks to great wound care, the wound is mostly closed with healthy-looking tissue as of March 2022. The patient has followed up with us on several occasions and says her foot is 100% healed and she is ready for "dancing with the stars". If not for Sherri's persistence, experience, and leadership we would be having a completely different conversation regarding our patient's foot.

Personally, I have learned a tremendous amount from Sherri on how I can better help my patients care for themselves at home and how to become a better advocate for my patients. The patient thinks so highly of Sherri as well. She has said many times that if not for Sherri she would have lost her foot.