"A PATIENT WROTE YOU a nice note," my nurse-manager Bonnie called to tell me. "Take a look at it when you come in." I immediately began to think about the standout patients I'd recently cared for.

Mr. B, for example, had been dying from cancer. I spent a lot of time talking with his family and making sure he was comfortable. Maybe his family had written the note.

I also thought about Mrs. C, newly diagnosed with diabetes. She was a willing learner, but seemed to know a lot of people who'd developed diabetic complications, making her fearful about the disease. I spent hours teaching her about diabetes and easing her concerns. Possibly she'd written to thank me.

Then I thought of Mrs. G, a postoperative patient. Her vital signs were stable, but she was lethargic and complaining of generalized muscle weakness. I informed Mrs. G's surgeon and he ordered lab work, which revealed hypokalemia. Mrs. G was treated and discharged without further complications. She'd thanked me for following up on her symptoms. Maybe she'd written the note.

But when I went to work the next day, Bonnie surprised me by saying it had come from Mr. S. Mr. S? Who was Mr. S? I wondered.

Even after reading the note, a brief expression of gratitude for my nursing care, I couldn't recall this patient. I worked that day with the mysterious Mr. S at the back of my mind, embarrassed that I'd made a difference to someone and I couldn't even remember who he was.

Driving home that night, it clicked. Mr. S had undergone a hip replacement and was 3 days postoperative when I cared for him. I thought about how busy that day had been and how I hadn't spent as much time with any of my patients as I'd wanted. All I did for Mr. S was to help him walk to the bathroom with his walker and give him pain medication-in other words, routine nursing care.

Then it occurred to me that I'd provided routine nursing care for all of the standout patients I'd recalled. Each of the standout patients had provided me with a unique learning experience, but so did the patient I forgot. I'd served as an advocate, collaborator, teacher, care provider, and professional-as any nurse would have done.

I learned a valuable lesson that day-every patient has an impact on my growth as a nurse, and even routine care makes a difference in the lives of the patients we care for.