Our team on Davis 12 would like to nominate Morgan Whitmore for a DAISY Award. She exemplified the value of Primary nursing by emphasizing continuity of care, responsibility, acceptance, care coordination, and relationship/rapport building. A patient was admitted to Davis 12 Surgical Specialties unit into Morgan’s care. This young man had a complex social/emotional history leading to medical and surgical conditions. He was admitted to our floor for a psychiatric crisis. Unfortunately, because this patient had a colostomy, he was unable to be appropriately placed in a facility. A plan was constructed to do a takedown of the colostomy so that placement could occur. During the period before surgery and the postoperative period, the patient reported voices that produced suicidal and homicidal thoughts. He asked the nursing staff and Mental Health workers to restrain him for his and our safety. When out of restraints, he would self-harm and throw things. The patient would also have verbally abusive outbursts, which startled staff. As the patient became deconditioned from prolonged restraints, bed rest, and post-operative complications, we were challenged with an uphill battle of safely recovering the patient and transitioning his care. Morgan was eager in the pursuit to help this patient with his goals.

Morgan attended the monthly interdisciplinary team meetings and assisted with the planning of daily and then weekly ECT appointments. Morgan was instrumental in gaining support from the different interdisciplinary teams to progress the patient's care and get the patient to participate in the progressive efforts. Morgan worked closely with the BEST team and psychiatric nurse practitioner to safely transition the patient out of restraints. When the patient was in Morgan’s care, she worked tirelessly with physical and occupational therapists to promote mobility. The patient went from bedbound to ambulating in the halls. Morgan was the only nurse who felt safe enough to shower the patient. She committed to bathing him twice a week on a gurney because of his need to remain restrained. This effort took a great amount of time and often left her drenched as well. She bought him special bathing items to help him feel more human and eventually taught him to care for himself again.

Due to the patient’s challenging behaviors, many nurses were intimidated and did not want to be assigned to his care. The patient was rotated among staff to prevent nursing burnout. Thus, care continuity was challenging but critical to progressing the patient’s recovery. Morgan voluntarily remained his primary nurse. However, Morgan noticed that the patient would regress when she would be off for a few days. To promote care continuity, she authored a written Care Plan that defined a scheduled routine for the patient and actions to take should the patient escalate. Nurses referred to a care plan prior to caring for the patient. The plan allowed nurses to anticipate the specific needs and behaviors of the patient and facilitated therapeutic goal-oriented care for the patient. Specifically, the care plan helped restore the patient’s independence in his ADLs. When Morgan returned to work, she took the time to review and update the care plan. She was also vocal in sharing the care plan with all members of the care team and her peers during our safety huddles.

On the day of discharge, almost six months later, Morgan voluntarily swapped her shift just to be present for his discharge. Having worked with the patient, she anticipated the discharge would not happen without challenges. Unsurprisingly, the discharge was a complex circus act. Morgan’s presence that day helped resolve many things that could have jeopardized his discharge. She effectively communicated the patient's progress and instilled confidence in the board and care that the patient was ready to transition out of the hospital. When the patient finally left the unit, he glumly smiled at Morgan. He would never admit his admiration for Morgan’s service, but you could tell he was grateful. She gave him a new chance at a successful recovery from his psychological disease and to receive the directed therapy he was prescribed. Her relentless dedication as his primary nurse is inspiring and touching. Morgan went above and beyond the call of duty to restore this patient’s independence and dignity. Morgan took actions to compassionately care for a young man that many were afraid of and felt had no purpose.