Helen was caring for a patient who had come in for an iron infusion. Normally, for our iron infusion patients, we do not routinely check laboratory work after obtaining their baseline levels. We typically repeat their labs three months after completing their iron infusions.

However, after assessing this patient, Helen recognized that something else was going on. The patient reported being hypotensive at home, experiencing bloody stools, and having vision problems. Although her vital signs were normal during her clinic visit and her blood pressure was not low enough to prompt immediate concern, Helen saw more than just the numbers.

Following our standard practice, she reported the patient's symptoms to the provider, as we always notify our physicians of any symptoms patients are experiencing, whether they appear related to their treatment or not. Initially, the plan was to refer the patient to a gastroenterologist for further evaluation since she appeared clinically stable.

Helen advocated for her patient. She recommended obtaining a CBC based on the patient's reported symptoms before sending her home. The provider agreed, and a CBC was drawn while we proceeded with the iron infusion.

When the laboratory results returned, the patient's hemoglobin was 4.4 g/dL, requiring multiple units of blood transfusions and hospital admission. She was immediately sent to the Emergency Department for further evaluation and treatment.

If Helen had not spoken up, this patient could have gone home with a critically low hemoglobin level and experienced life-threatening complications. Her careful assessment, critical thinking, and willingness to advocate for her patient likely prevented devastating consequences, including hypovolemic shock or death.

Helen's vigilance, clinical judgment, and unwavering commitment to patient safety exemplify extraordinary nursing care and make her truly deserving of DAISY Award recognition.