Cindy Perdomo always knew she wanted to be a nurse because she wanted to make a difference and knew that, as a nurse, she could. She started at Encino-Tarzana Regional Medical Center as a new nursing graduate more than 18 years ago, but still feels she is learning and improving her clinical skills.

"I have a standard of nursing I try to apply to all my patients, and that is that their comfort is first. I am thorough and empathetic. I feel like you have to be. I'm with the patient for 12 hours, while the doctor may spend five or 10 minutes. It is really up to me as the nurse to relay all the information-sometimes critical information-and to make judgments."

Perdomo has developed excellent working relationships with physicians, and many of them seek out her opinions. She credits her clinical expertise mainly to her years of experience, to seeing and remembering things, and to learning to pick up critical signs.

"I feel I take the time to really talk to patients, not just about their physical well-being but also what is going on in their head, how they are handling the hospital stay and how they'll handle it when they go home. That can be a huge adjustment, and Ithe primary person communicating between all the parties about what they will need and so forth."

She doesn't see her skills as anything extraordinary; what she does is simply what any nurse would do. But she does think that her practice of listening to patients-not brushing off anything they tell her-enables her to pick up on things that others might not.

"It is like figuring out a puzzle. Sometimes, you can prevent things from happening. But it takes time, and nurses don't have too much of that these days."

Although she was instructed in nursing school never to sit on the bed of a patient, Perdomo does so anyway. Getting on the patient's level that way makes it easier to talk and to listen.

"It makes it more one-to-one. Then I'm not an authority figure standing over them, but someone who is there to listen. Throughout my shifts, I just try to make patients comfortable and make things better for them."

Perdomo enjoys mentoring new nurses because she can watch them go from having little confidence to feeling as though they know how to do anything. She strives to help them learn to be organized and to budget their time well in order to provide the care patients expect and to provide it in a caring manner.

"Even though we're always rushed," she said, "it is important not to appear that way."

She often brings homemade treats to work, for both staff and patients, because it boosts morale. Anything that helps the staff become closer helps them work better together, she said, which, in turn, results in better care for the patients.