I was working with Jess on the maternity unit when she admitted a med/surg patient from the ED. The patient was a vibrant 82-year-old woman who came in with gallstones and abdominal pain. Although the patient was laughing and chatting with us, Jess quickly recognized that the patient was deteriorating. Without hesitation, Jess got the patient on oxygen and communicated her concerns with the rest of the healthcare team. While waiting for further direction, Jess monitored the patient's heart rate with the tools at hand- the electronic fetal monitor in the room. Watching the patient's heart rate on the monitor, Jess noted an unusual pattern and promptly investigated further. An EKG suggested the patient was in and out of second-degree heart block- a surprising finding that necessitated further monitoring with telemetry. In a stressful situation, Jess thought quickly and critically about how to care for her patient. Using what she had, she caught a heart rhythm that could have potentially escalated to a fatal dysrhythmia. She worked efficiently with healthcare team members outside of her unit and promptly developed a plan to care for her patient- all at 3 am! As nurses, we sometimes get siloed in our particular roles and departments in the hospital, but Jess showed us how being a nurse is about listening to your instincts, putting the care of the patient first, think creatively, and communicating- even if it feels uncomfortable.