I would like to nominate Payton Salsgiver for the DAISY Award in recognition of her extraordinary compassion, clinical insight, and unwavering advocacy for one of our most vulnerable patients who had been with us for over eight months enduring an incredibly complex and difficult hospital course. She experienced respiratory failure requiring prolonged ventilator support, multiple ICU transfers, the initiation of dialysis, and numerous in-depth discussions about her code status with family members spread across several states. Despite our team’s best efforts, her condition remained fragile, and the emotional toll became evident. In recent weeks, as the patient gained more mental clarity, she began mouthing the words that she was ready to stop. That she was done. Her tears spoke volumes when words could not. Payton played a pivotal role in making sure the patient’s voice was truly heard. During a night shift handoff conversation with another nurse, it became clear that the patient needed a strong advocate, someone who would not just listen, but act. Payton, who was simultaneously completing a rotation with the Palliative Care team as part of her nurse practitioner studies, recognized how crucial this moment was. Drawing on her experience and education, Payton collaborated with respiratory therapy to place the patient on a trach collar and a speaking valve, despite the known limitations of the patient’s condition. Although the patient could only tolerate the valve for five short minutes, those five minutes changed everything. In that fleeting window, the patient was able to speak her wishes aloud. She was tearful, emotional, and adamantly expressed her desire to discontinue life-prolonging treatment. It was a powerful and heartbreaking moment, one that may never have happened without Payton’s thoughtfulness and clinical intuition. This small, but deeply significant act opened the door for real, compassionate conversations between the patient, her care team, the Palliative Care providers, and her POA. Payton helped initiate the process that ultimately honored the patient’s final wishes; to be free of machines, tubes, and pain and to pass peacefully and with dignity. Patients with long hospital stays are sometimes unintentionally overlooked, seen as simply still here, but this patient was never just here to Payton. She saw her as a whole person with a voice, values, and the right to make decisions about her own care. Payton could have continued to provide excellent clinical care without every suggesting a speaking valve. Instead, she chose to go further. She chose to advocate. She chose to listen in a way that truly mattered. Thank you, Payton, for your humanity, your courage, and for ensuring that this patient had the chance to speak for herself. Your actions made a lasting difference and embodied the very heart of nursing.