Alfredo Valle is an experienced ICU Nurse who has recently joined the MICU team at the Western NC VA Health Care System. I assisted in orienting Alfredo during his day-shift rotation. During one shift, I was in charge and our assigned patient required transport to Duke. The transport was scheduled for 0800, so we knew we had a lot of documentation to complete before the veteran left with EMS. We reviewed the required documents needed to facilitate transport from both nursing and medicine staff; and communicated with the transfer coordinator about EMS arrival times and report contact information. We gave a report to the receiving nurse at Duke, as well as the EMS team. While I assisted EMS with transitioning the veteran and his drips from the bed to the stretcher, Alfredo went to help another RN with her patient, or so I thought.

When I came out of our patient's room, it was quiet, (yes, I said the "Q" word) and I couldn't see anyone in either direction. I asked our ward clerk, "Where did everyone go?". She informed me another nurse experienced an emergency and was taken to the emergency room by another nurse. I peeked in to check on the first patient of the nurse who had gone to the ER, then went to check on the second. When I checked on the second patient, Alfredo was already in the patient's room; and had been. After about 20 minutes of just talking with the patient, Alfredo came out of the patient's room and told me that since our coworker had told him she needed to go to the ER, he just took a super quick report on her patient so he could assume care and she could get to the ER. Not only was I impressed by Alfredo's flexibility this morning, but I was also impressed by his initiative to take on immediate additional assignments without being asked to do so. He prioritizes not only the health of our veterans but the health of his coworkers as well.

Soon after receiving the report, one of the patients we assumed care of experienced cardiac arrhythmias and required the support of the code team. While we were all providing critical care interventions, Alfredo was also providing critical patient information to the code team and physicians as needed as if he had known the patient for days. He gained the majority of the patient's critical information just from the talk that he had had with the patient immediately after assuming care. Alfredo's initiative on this day played a vital role in the lives of many people; his coworker's, as well as the veteran he was caring for. He continues to exemplify his knowledge, professionalism, and compassion in his nursing care each and every shift. His patients trust him and have verbalized to me that they feel safe while in his care. Alfredo is a wonderful addition to our MICU team, and we are truly grateful to have him!