DAISY Award—Annie Tat, MSN, RN, RN-BC

Annie Tat, MSN, RN, RN-BC
Tower 8 Transplant/Metabolic

Nomination #1

Growing up, we have been conditioned to think of heroes as the people in capes who swoop in and save lives. In 2020, the year of the nurse, this global pandemic has highlighted how nurses act as heroes every day, putting themselves on the frontlines to save complete strangers. In a profession where saving others is the main goal, anything short of that may feel inadequate. Embracing loss of life takes an incredible amount of strength, as it fundamentally opposes what we have set out to do as nurses.

Patient A. became well known on Tower 8 during her several-month-long hospital stay. She had been fighting against her pulmonary hypertension diagnosis for years. When she learned that she would have to gain a substantial amount of weight to qualify for a lung transplant, she began guzzling burn shakes and weighing herself multiple times a day. When Physical Therapy didn’t feel safe walking her with oxygen saturations at 70%, Patient A. insisted that they were worrying over nothing. Patient A. was determined to make it home, even as her oxygen requirements went up, and even when she reached the highest setting on her high flow nasal cannula.

On Thursday, Patient A. and her husband, were celebrating their wedding anniversary in the hospital when they learned there was nothing more they could do to save her life. They agreed that hospice was the only option left, though Patient A. refused to allow anyone to use the word “hospice”. She was scared to stop fighting because being a fighter was so strongly embedded into who she was.

Friday morning, Annie came onto shift and cared for Patient A., a patient she had cared for many times. Annie had spent the last few months trekking across the hospital to the Burn ICU to make Patient A.’s favorite flavor of burn shakes (it was a tie between chocolate banana and vanilla pineapple). Annie brought in the scale anytime Patient A. wanted to check her weight, celebrating every fraction of a kilogram up and arguing with the scale when it went down. Annie spent countless hours coordinating with Physical Therapy, the Pulmonary Team, the primary doctors, and Respiratory Therapists to ensure the entire interdisciplinary team was following Patient A.’s care, seeing her as an individual with the goal to get off high flow and go home, not just another statistic in a debilitating disease.

Annie was surprised to see this huge transition for Patient A. and recognized the prevailing fear that was meant to stay hidden beneath the fighter. Annie sat with Patient A., held her hand, and listened to what she wanted. Patient A. wanted to stay on tube feeds because she wasn’t ready to give up feeling full or the hope of gaining a few more kilograms. When Patient A. became too nauseous to tolerate the feedings, Annie gave her Zofran and simply attuned to Patient A.’s wishes. She didn’t impose her own thoughts, nor did she offer solutions; she was there to support Patient A. in any decisions she wanted to make. Annie validated Patient A.’s feelings and gave her autonomy in an uncontrollable situation.

On Saturday morning, Annie came back to work and immediately went back to Patient A.’s room to stay by her side. It was clear that things were changing when Patient A. stopped making her usual sarcastic quips. Patient A. could no longer make decisions for herself, and her husband had only had a day to prepare for this moment. Annie held him as he cried and listened to what he wanted for Patient A.. Annie shared tears with him and let him know how deeply Patient A. was loved, not just by him and his loved ones, but by her Tower 8 family as well. Over the months that Annie cared for Patient A., she had established a strong sense of trust because she had infused love into every action she had taken for Patient A. and her family. Because of this compassion, her husband trusted that Annie would advocate for Patient A.’s best interests, even when it felt like there was no “best” left. He trusted that Annie would give her all to the love of his life even beyond the very end.

Annie started the morphine drip and was unafraid to increase it when it was clear that Patient A. was uncomfortable. When the morphine reached the max range, Annie called the doctor and negotiated for more medicine. She knew what Patient A. would want and was ready to continue to fight in Patient A.’s stead. Annie only left Patient A.’s side to call the team and to check for new orders. When Patient A. passed peacefully, Annie was there, holding her and her husband in their greatest moment of need. And when her husband was ready, Annie walked him to his car, making sure he knew that he would always have a family on Tower 8.

A hero is someone who can recognize that saving a life is not the only measure of strength. It’s the intentional decision to actively listen to the needs of others, the love that is infused into even the simplest actions, and the humility that comes with loss. To Annie, nursing is not just a profession; it’s a daily decision to hold a stranger and to love them through the hardest of times. She gives all of herself to her patients, their families, her co-workers, and members in the community each and every day. Regardless if she is saving a life or navigating a loss, Annie radiates warmth, empathy, love, and openness: qualities that embody a true hero.

Nomination #2

The cornerstone of Annie's nursing care is promoting patient engagement, relationship-based care, and working with her colleagues in the unit as well as other members of the interdisciplinary team. Annie never misses the opportunity to connect with her patients and their family. Her patient care involves not only what brought the patient here to the hospital. She goes beyond to make sure they are successful as they transition to home. She is hardworking, listens openly, and communicates respectfully. Annie is humble and would be the first one to say she is only doing her job! Her energy and care extends beyond the walls of Tower 8 as she is fully involved with her many advocacies in the promotion of Relationship- Based Care as one of the facilitators of See Me As a Person; representing us as a board member of ANA/C supporting the advancement of our nursing practice, and her volunteer work in the Sacramento County to promote social justice and racial equality. Most recently, a transplant recipient patient informed this writer that she is most appreciative of Annie because of a special accommodation she made prior to receiving her transplant. The patient was a direct recipient of a kidney donor from her friend who unexpectedly passed away from a brain bleed. The donor patient was being sustained on life support at a Bay Area hospital until the donation can be facilitated to our recipient patient here at UC Davis. The patient verbalized that her own family and the donor's family and children were overwhelmed with the enormous mixed of emotions of losing a loved one so suddenly and the decision and opportunity for the kidney transplant. She said that in the midst of grieving for the loss, exciting yet uncertain opportunity for a transplant Annie made the effort to take her to a private room, facilitated and made sure she (patient) had a chance to connect via video call to the family members who were with the donor before initiation of the organ procurement from the other hospital. The patient was touched by Annie's kindness and understanding of her need to say goodbye to her donor friend and reassuring his children and family that he will continue to live on. The kidney transplant was a success! Thank you, Annie for all you do each and every day!