Neil arrived on the unit to take report from the night shift. He went in to assess a patient the night shift had concerns about and noticed the Blood Pressure was low-considerably low on a patient who had had a mastectomy the previous day. He re-assessed the patient and using good critical thinking skills, and maybe a gut feeling, recognized a problem and he asked for help from his Charge Nurse and Unit Director. He called the appropriate team and was able to get them to respond to the unit immediately.

Upon further assessment and review of the patient's chart, the patient's H&GH had gone from 11/35 prior to surgery, to 7/23 during the night to 5/16 on a stat ABG. (The patient asked why her fingernails were so white. They looked like they had nail polish on them!). The patient would need at least 4 units of blood!

Neil, with the help of the 9A team, took the appropriate nursing measures - preparing the patient for transfer to the ICU and then to the OR for an emergent mastotomy with an incision and drainage. The family was called by the NP to notify them of the transfer so they would not be concerned if they arrived un-expectantly on the unit.

Neil was outwardly calm and reassuring during the whole time. He had an excellent rapport with the physician team. He dealt with the patient as a person, not a patient or a room number. It came from the heart.