Ashley is a true leader on the unit; she has precepted more than half of the nurses who have come to the unit in the past 10 years. When she is not officially precepting, she is still the most sought-after resource on the unit. Every single shift she works many jobs: the charge nurse, the rapid response nurse, the IV team, and the sounding board for countless questions from her peers. She is always willing to help when coworkers are drowning and bears the brunt of the most challenging patients on the unit. When the night shift is designing the assignment around a difficult patient there are frequent cries of "give them to Ashley, she can handle it." 

As much valued by her unit as Ashley is, she is even more appreciated by her patients. She is frequently found at the bedside of a patient who is struggling, providing treatment and reassurance. Her patients remember her kind touch and long curly hair. They are comforted by her unflappable attitude and knowledgeable care. She has an uncanny ability to know when patients are circling the drain which comes from years of experience and her nurse's intuition. I was inspired to share two of Ashley's particularly impressive stories in the last month alone: 

First, there was a patient experiencing ongoing atypical chest pain. Cardiology was at the bedside and asking us to administer Nitro to this generally stable patient. While I went to retrieve the medication, I saw Ashley wheeling a bedside cardiac monitor to the room. Since this is not necessarily the standard of practice for a med-surg floor, I inquired about her decision. She shrugged and said that she had a bad feeling and wanted to be extra careful. Her concern proved to be a lifesaving instinct as the man shortly after went into cardiac arrest. Because the bedside monitor was hooked up, we were able to recognize the dysrhythmia within seconds. We provided CPR, a shock, and achieved ROSC in under 2 minutes. Because of Ashley's concern, we were able to prevent a delay in the response to the patient's emergency and he was awake and talking before the CCU team even arrived on the floor. This is one of many examples of Ashley's intuition, but one of the most striking. That is something that new nurses don't have, and you can't teach in school. She just KNEW.

Second, she was doing a bedside report with the night shift, and she knew from the moment she walked into the room that her patient was in severe respiratory distress. She alerted the doctors to her concerns and escalated care appropriately. While this was just another day in the life of Ashley, I was especially struck by her commitment to this patient. She kept him calm while performing interventions and educated his family members when they arrived to see him. She was everything that I would hope a nurse would be when taking care of my sick father. It took about 10 hours for her to eventually transfer him to the ICU due to staffing. During this time she cared for this patient as an ICU nurse on the floor. Her coworkers and I helped fill in the gaps with her patients as we knew she would do for us. The doctor was profusely thanking her for maintaining the BiPAP, drawing labs, and administering medications all while coordinating the patient's transfer. Ashley has taught me what exactly needs to be done in an emergency, and she has instilled in our unit the necessity of working as a team. We have received compliments from doctors and other teams responding to our unit on how much we have already done before the critical care team is even at the bedside. This is especially important for our floor because we maintain the second code cart and respond to incidents throughout the MOC.

I have watched Ashley provide new ostomy teaching and resources via video chat during COVID when family members couldn't visit, use an interpreter for hours to ensure that a deaf patient could make his needs known, and teach a restless stroke patient to play catch with his unaffected arm. There are so many examples of her excellence, that I cannot include them all. She is what makes our unit extraordinary, and a common joke is that if Ashley ever leaves, we will all follow her. She is truly deserving of recognition for all of her efforts and accomplishments, and I respectfully request that you consider her for this award.