Equity & Accountability/Advocacy: 
One experience that required this nurse to courageously uphold the nursing code of ethics took place when the nominee’s patient, who was a member of a minority group, lay in the hospital dying of cancer. She was a mother who would not live long enough to see her daughter graduate from high school. The patient’s family said she was the glue that held their family together. Every single family member stated the family would fall apart when then this woman passed. She needed hospice but was in an unfunded financial situation with no charity hospice resources available. This nurse upheld the nursing code of ethics provision number three by “promoting and advocating for and protecting the rights, health, and safety of the patient.” Though the patient could not afford hospice and there was no opportunity for charity hospice, this nominee found creative ways to provide alternative, high-quality, end-of-life care.

Compassion and Collaboration:
Hospice would have allowed the patient to be surrounded by family at home, knowing this, the NP took it upon herself to become the patient’s family coordinator so that she could say goodbye to everyone and carry out her dying wishes. This NP also served as this patient’s hospice nurse, by coordinating care of the chaplain and interprofessional team, bringing the physicians, and nursing staff together to adjust the patient’s pain medications so that she/he could be coherent when family was present and have less pain when she was alone. This nominee had limited resources and realized that if she was at a private institution where patients have insurance and have every medical intervention at their disposal, this patient would have had hospice, spiritual care, family support, etc. She filled in the gaps to provide as close to a hospice experience as possible in the hospital setting. 

Compassion and Respect:
The patient’s goal of care was to stay alive and alert until she had seen all of her family members. This nominee ensured the patient was surrounded by family, as was her dying wish. The patient hung on for a week to accomplish this, while the NP and care team completed comfort measures. The nominee and the patient lovingly adopted the nickname for each other of “Cabrona”, as both identified with being strong Hispanic women who held provisional, roles in their families. In the patient’s final days, this nominee worked with the chaplain to bring a priest to the patient’s bedside at her request. Another wish was to amend her relationship with her parents and then die alone after she had seen all of her family, and at that point, she wanted to be as pain-free as possible while passing. This nominee made all of these things possible. In these acts, she courageously upheld nursing code of ethics provision number one, “to practice with compassion and respect for the inherent dignity, worth, and unique attributes of every person”; provision number two, “the nurse’s primary obligation is to the patient, whether an individual, group, community, or population”; and provision number four, “making decisions and taking action consistent with the obligation to provide optimal patient care”.

Integrity & Equity:
This nominee honored the patient’s wishes and creatively coordinated care among the interprofessional team. Overarchingly, she upheld provision number eight by “collaborating with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities”; and number nine to, “articulate nursing values, maintain the integrity of the profession, and integrate issues of social justice into nursing and health policy.”

The nursing ethics lessons she/he learned at the bedside have followed her into the world of research to address social inequities and disparities as a nurse scientist and impact not only patients but also the community.