The triage nurse line was contacted by the patient to notify the doctor that she was having elevated blood pressure. Steven astutely recognized this as a major concern as the patient has Scleroderma. He notified the provider promptly. Steven then facilitated her getting labs which were quite complicated as she lived far away. He then paged the provider to notify him with the labs were back so that they could be reviewed promptly. It turns out that the patient had a Scleroderma renal crisis which is a true rheumatologic emergency. The providers were able to catch it early and get her into the hospital where she is currently stable, and her blood pressure is under control. Without Steven's quick actions, it is possible that the patient would have ended up on dialysis or lost her kidneys.