In the middle of report one morning, one of the CNAs on my unit came rushing in and said, “Clara, I can’t wake up one of your patients and he doesn’t look good.” I had learned over the years that when this particular aide said “you’d better get in there”, that was a guaranteed transfer to the ICU, or in the case of DNR patients, a death by the end of the shift. I quickly recalled as many details about Mr. R as I made my way to the bedside. Yesterday, he was alert, oriented and sitting up in a chair. I knew he had metastatic prostate cancer, but this admission he was in for unrelated problems and was certainly expected to survive the hospitalization. He had cardiac history and diabetes. I was his primary nurse and had been caring for him all week. Before I had gotten to his bedside, I thought, “It’s Father’s Day.” I dreaded having to deliver any kind of unexpected bad news to his family on Father’s Day…..