Our ICU Team is one of a kind with a lot of excellent staff within. One registered nurse who stands out from the rest is Ayesha Pacheco. She is one of our expert nurses who has served the clientele of WKBH since its opening in 2011. She comes with years of critical care experience. Her critical skills and knowledge can guarantee you that every patient she takes care of receives the best attention.

She is quick at identifying any subtle change in their status. As proof of this, she immediately noted a patient having a myocardial infarction the moment that patient arrived in the ICU on a stretcher very diaphoretic without complaints of chest pain. Because of her assessment skills, the patient was immediately transferred to BHM for cardiac catheterization, thus saving that patient's life.

These qualities also made her one of our preceptors and resource nurses in our team. During the pandemic, Ayesha was not exempt from all the unit challenges we faced. I saw how scared she was as we all struggled to provide care to all our patients. She expressed her concern about not being able to work an extra full shift for the team just like some of our nurses. However, she found other ways to compensate for that to make the team feel more appreciated by bringing in breakfast on weekends and buying pizza or lunch whenever the team was extremely busy. Very importantly, she still does this even if our census has gone down and was doing it even before the pandemic hit us. This is her way of showing how much she cares for our team.

In addition, Ayesha brought the spirit of Christmas to the unit last December 2020 by bringing in a Christmas tree to the unit. Due to COVID 19 restrictions, we placed the tree and decorated it in the ICU Family Waiting Lounge. She also purchased other door decors to make the unit appear more festive. Today, Ayesha further displayed her kindness and gentleness to our team by graciously donating a beautiful Pandora bracelet which will be raffled for the Heart Walk.

What sets her apart from the rest is the amount of care and compassion she has for her patients and family members. She has towering patience towards confused patients, even in the process of ventilator weaning. You can just imagine how difficult it is to extubate and go through weaning process in patients who do not fully understand simple instructions. But our Ayesha never turns her back to these kinds of patients. She patiently stays at the bedside to support the patient throughout the process while giving simple instructions. Within an hour or two, magically, that confused patient gets off the ventilator. This is just one of the reasons why Ayesha has received multiple DAISY nominations in the past from her patients and family members.

Apart from these, she also has her eyes on timely patient discharge or transfers to the right level of care. As soon as she begins her shift, she works on status downgrade of patients when they met the criteria. On patients with transfer plans to LTACH/SNF/Rehab units, Ayesha never fails to facilitate the process. Her patients will surely leave during her shift. On top of this, she makes sure that the family is involved in the patient's care and that the plan of care is communicated to them timely. She treats every family call, no matter how busy she is, with utmost importance. This is one example of how family-focused is Ayesha in her care.

She is a consistent team player and never shies herself away from an admission even if it means it will be her third patient. When the unit is challenged with having to triple a nurse, Ayesha does not hesitate to volunteer to be that nurse. For being such a commendable employee, she was our Fineapple of the Month in September of this year and she continues to deliver excellent service to date. Ayesha also has eyes on our ICU outcomes. She is very dedicated and committed to providing excellent care. She never forgets the basics of nursing. Patient turning is one of her favorites. When some others document that it is difficult to turn a patient because of hemodynamic instability, that is not the case with Ayesha. She prioritizes her patient's stability and makes it a point that her patient gets turned to prevent the development of pressure ulcers in her patients. This is how she ends up finding skin breakdowns which trigger all other interventions.

In terms of leadership, I commend Ayesha for stepping up as the resource nurse multiple times in the ICU these past few weeks without hesitation or expression of being stressed for assuming the role, when some other nurses avoid it. She gracefully took on the role with open arms without a hint of stress. In addition, she proactively promotes the discontinuation of central lines and indwelling urinary catheters to avoid CLABSI and CAUTI.

To top it all, Ayesha is the only RN who voluntarily comes as early as 4 am during scheduled EOC-CRR rounds and Joint Commission visits to help prepare the unit as she excitedly looks forward to 100% compliance. Even days before the scheduled visits, she has already begun to collaborate with the ICU leadership. These are qualities of competence and professionalism. For her excellence at the bedside, skills, and knowledge, competence and professionalism, kindness and gentleness, caring and compassion, family focus, in addition to her commitment and dedication to her patients, family members, co-workers, team, and for the general ICU outcomes, I strongly believe Ayesha Pacheco is a true DAISY Nurse.