The patient was my husband (double amputee and kidney transplant recipient) and he was on the unit recovering from a heart attack. He was coherent and in good spirits when he emerged from the Cath Lab. By that evening, he was beginning to become disoriented and delirious. He was agitated and unable to sleep. By the time Rachel came on duty the next morning, he was psychotic, severely agitated, and totally unable to do anything for himself. Not even feed himself or use a tissue. He was grabbing at his tubes and IV lines. He required seemingly continuous nursing care. He was trying to get out of the bed, was incontinent in the bed, was causing sores on his arms to bleed, injured his IV site, and had episodes of vomiting. He required an EKG and had to be transported for a CT scan. I could do nothing to orient him or to calm him. Rachel was on the frontline of his care for 12 hours. She was trying to reason with him, explain things to him, changing his bed linens, reconnecting an external catheter numerous times, bandaging his arms, and replacing his IV line. Once while trying to turn him to clean his soiled pads, he unexpectedly projectile vomited on her.

Throughout ALL of this, Rachel was unfailingly professional and polite each time she was called to do one more difficult caretaking task for this hard-to-maneuver, unreasonable man. I was so impressed with all the effort she displayed and how she kept her composure the entire time. She looked exhausted but was still compassionate toward him and did everything in her power to help him. She then had to take the difficult step of putting him in restraints. While doing all these tasks, Rachel was simultaneously trying to figure out what was going on medically. She kept looking at labs, asking me questions about his premorbid functioning, checking his vision, working with me to get previous labs from the transplant clinic, and was communicating with the treatment team.

I have been greatly impressed with the high level of competence and devotion I am seeing in ALL the nurses on this unit. If anyone was tested to the max, however, it was Rachel. She is an extraordinary professional and I am forever indebted to her. (My husband will be as well when he is able to comprehend what she did for him.)