Talking to patients came easily for nurse Josephine Twilley, but recording their stories became serious business for her as director of patient services.

Only a few years from retirement, she took on the newly created job of Patient Representative. Before, she always tried to avoid conflict, but it became part of her job as ombudsman.

"Usually it was just a misunderstanding, a miscommunication," she remembers. "We had so many people from out of town, we had people who couldn't even get on an elevator and know what button to push."

Thanks to her, they had a voice. She made sure that patients' emotional needs were understood as carefully as their medical ones."One of the big things we did was track down false teeth. It's a small thing, but before you know it, people would say we didn't care enough to help them find their teeth."

"I didn't want these patients to fall through the cracks," she says. "I wanted them to be heard."

Sometimes, it was lost clothing, watches or jewelry. Other times, if a patient needed attention, she found an attendant. "There were a lot of little things that we did," she says. "We were busy - it was 'Johnny-on-the-spot.' "

Soon, she was helping people prepare their living wills with the pastoral staff. She also supported doctors when they asked the family of a dying patient to donate organs.

She learned that kindness is often a patient's most critical need. Her gift for easing tension - "major diplomacy," she calls it - earned her the Pitt Memorial Foundation's Award in 1985. "You had to be a good listener, that was the secret," she says. Her fledgling efforts ensured the development of the Patient Representative Program at PCMH.

Josephine Twilley