Recently, a patient underwent an exploratory laparotomy with a colon resection. The surgery was uneventful, as was emergence from anesthesia. The patient was transported to PACU. Shortly after arrival in the PACU, Paula Thomas, RN noted that something was not the way it should be. After this type of surgery, most patients are somewhat hypotensive. Although this patient was also hypotensive, Paula noticed subtle differences in the vital signs and how they responded to standard treatment protocols in the PACU. Paula notified the anesthesiologist and the surgeon involved with the patient's care. A decision was quickly made to return this patient to the OR for re-exploration at which time a mesenteric vessel bleed was found and corrected. The patient did well and recovered from the procedure. If not for Paula's attention to subtleties, this patient would have had a different outcome. Paula's excellent care of this patient is representative of her attention to detail and superb nursing care of all her patients. A job well-done!