Commitment to Excellence -- Ryan Igros was the nurse assigned to my husband in the Emergency Department last Saturday.  I was immediately struck by his role model leadership in demonstrating commitment to Mayo Clinic’s value of excellence.   While he asked the typical assessment questions, background and symptom history, and what occurred that brought us in -- what I was immediately struck and impressed by, however, was his intentional, proactive approach to the ED visit, assessment, and care planning.   As an example, immediately after taking vitals and getting history, he walked us through what he anticipated that the provider was going to order to gain additional information/data, i.e., possible fluids, so he started the IV, blood needed to be ordered and because he was anticipating care plans, took blood while starting the IV (one less poke). Again, this forward-thinking stance was a testament to the needs of the patient first, as well as the nursing environment, which empowers the staff to do the right thing!   He came in several times early on to share information and educate on hypertension, blood pressure, etc. Not in an “I know it all” attitude but instead from the patient/health education lens. In addition, because of his approach, it accelerated the ED assessment/care planning process/time, as the physician came in and ordered exactly what Ryan indicated might have occurred earlier.   The time to receive results and determine a treatment plan was accelerated because of his proactive approach.   It also gave us the confidence that we were in good hands, given my husband’s initial BP of 60/40.   In my 20 years of being an employee and patient at Mayo Clinic and experiencing the terrific care for my family, friends, and ancillary patients, I have had the opportunity to interact with and observe many, many nursing care team members.   However, I have to say I can’t recall a nurse who had such outstanding clinical expertise, clinical judgment, and nursing excellence.   It was impressive to observe and be a part of -- not to mention how proud and prideful I felt with the quality of nursing colleagues you all have recruited and onboarded at Mayo Clinic. I know workforce shortages and post-COVID pandemic burnout have impacted your staffing levels.   What a gift to have experienced the nursing care of Ryan!   And we know that clinical nursing expertise contributes to better quality outcomes.   

Mutual Respect and Compassion -- Ryan’s interpersonal style and skills include strong mutual respect, actively listening to our story, our concerns, health challenges, etc. He never left the room without asking, “What else do you need?" or "Can I get you anything?”  We know how busy the ED is and the seriousness and complexity of the patient population, and yet, we never felt that we were “another patient, another bed, another number.”  In addition, I had knee surgery a few days before we came to the ED, still had stitches, bandaging, and had limped down the ED hallway.   Ryan and the team ensured I had access to a walker and asked if I needed a wheelchair, as the ED space is large, and the hallway/walk is long.   While caring for the patient, he also demonstrated care and compassion for me (as the family member) which I did not expect or anticipate.   And there were other care team members who walked right by, ignored, or did not want to intervene due to privacy; yet Ryan was helping to ensure that I was comfortable too, given the amount of time we would be in the ED.  It was much appreciated, not expected.    I just need to say that his commitment to the needs of the patient come first was clear and evident, and the needs of the family were above and beyond.  

Communication -- Ryan’s communication, which you can guess, was superb!   He repeatedly let us know that he/the team were watching K’s vitals from the unit/desk (outside the patient rooms), tried to manage and monitor the frequent machine bells that kept going off.  He was responsive to checking regularly with unstable pressures and made us feel that he had a lens on K’s vitals – even when he was not in the room.   This demonstration and verbal acknowledgement were a huge source of comfort, given it took several hours to get BP to 99.  

Collaboration -- We observed Ryan collaborating with other multi-disciplinary team members, including the physician, resident, lab, other ED colleagues, etc.   He kept a watch out for the Cardiology service so he could be available for them if they needed anything, to be able to act on their orders, etc.  Again, such a disciplined, professional, intentional care team approach to taking care of the patient!   Often, we hear, “We will wait for the doctor/service to do rounds, with the nurse walking in later to ask us, “Did the provider come in yet?”  This is understandable given the business of the hospital, yet Ryan’s approach was, “I will keep an eye out for them and ensure that I am here to listen, help, etc."   

In Summary -- We have talked about and thought about this young nurse several times since K’s ED visit, transition to the observation unit for several days, and eventual discharge.    He so impacted our lives with hope, goodness for future generations, caring for Mayo Clinic patients, and we would like to do something special for him.