Trinity Health Grand Rapids Hospital, 3 Lacks is a 32 all private bed acute care unit that serves patients that are 65 & older. A high acuity adaptable unit; regularly have patients who are on telemetry, cardiac drips, high-flow oxygen; bi-pap; etc. Older adult can deteriorate quickly, so this unit requires a high level of assessment skills, comfortability with advocating for whatever the older adult patient may need. Our unit is considered a high acuity unit (because older adults require a lot of extra time and TLC) which makes 3L a very fast-paced unit. For this reason, we provide nurse directed care. Trinity Health Grand Rapids Hospital is a NICHE (Nurses Improving Care Health System Elders) exemplar organization (exemplar is the highest designation a hospital system can achieve). This designation is achieved primarily through the outcomes demonstrated on our Senior Adult Unit (3 Lacks) and through the partnerships we have with our Geriatricians (22 of them) and our Long-Term Care facilities. Magnet designated facility with active shared decision making councils. We continuously strive to improve outcomes and provide exceptional experiences for our patients, staff, and community.