Kara Bortone pays close attention. Not just to her patients’ symptoms, but to what makes them smile. 

Bortone came to the neurology department at the Lahey Hospital & Medical Center in Burlington, Mass., after working as a travel nurse. Her New England ties were too strong to keep her away, and now she rotates day and night shifts in the neurosciences critical care unit at Lahey.

“The brain is so much of a gray zone, there’s so much happening and so much change,” Bortone says. “It really keeps you on your toes.” She has a lot to look out for. Neurology requires a very detail-oriented mindset, as similar diagnoses can present differently across patients.

Her typical day consists of neurological exams and assessments, testing patients’ brains, and monitoring. Looking out for any changes that require intervention is key, too.

“There’s nuances to each person and each day,” Bortone says. But she doesn’t get lost in the minutiae. Patient-centered care is the biggest part of her work ethic and philosophy, and fostering that human connection is how she helps them through incredibly challenging moments. “Even a very small change in demeanor can end up being something that needs to be acted on and addressed,” Bortone says. “It can be a challenge when you haven’t seen that person before, or only met them for the first time a couple hours ago.”

Checking into neurology as a patient often means there are neurological symptoms to be examined and evaluated — often presenting in confusing ways, so Bortone involves her patients in as many decisions on their care as possible.

“I’m advocating for them, but really they’re advocating for themselves,” she says. “I just try to bring a smile to their face, make a lighthearted joke if it’s applicable in the moment, just to bring a smile and some levity to really difficult, uncomfortable times in their lives.”

Bortone knows the little things can make a difference. It’s not just spotting a slight change in behavior, but also using that detail-oriented mindset to make her patients’ days a little better. When her pet-loving patients are going through a difficult time, Bortone has photos of her own cats on hand. It’s an emotional pick-me-up that doesn’t require a prescription.

“We’re all really the same,” Bortone says. “We all have a pet or a hobby or a loved one, anything that brings us joy and makes us feel good. That’s the thing that can help my patients feel like they’re having a normal conversation, not just about the thing that’s making them sick.”

And for Bortone, seeing those human moments with her patients can be one of the most rewarding parts of her job. She’s seen her patients walk, talk, and eat again after being unable to for periods of time.

“If we can get them outside, seeing them close their eyes and look up at the sun for the first time, or when they smell the fresh air or feel the breeze, those smiles are priceless,” Bortone says. “They’re always so grateful, and it’s a beautiful thing to see. That’s what we do it for, those smiles and making people happy and better.”

“They’re always so grateful, and it’s a beautiful thing to see. That’s what we do it for, those smiles and making people happy and better.”

– Kara Bortone

Kara’s nomination letter:

I am writing to nominate an extraordinary nurse, Kara, who works in the Neurology ICU at Lahey Hospital & Medical Center, for recognition during the Salute to Nurses.

I was admitted after suffering a stroke — one of the most frightening experiences of my life. As a mother of three young children (and a very loved cat), I was overwhelmed with fear, uncertainty, and the ache of being away from my family. In the midst of that fear, Kara became a steady light.

From the moment she walked into my room, she had a smile on her face that felt genuine and grounding. She didn’t just treat my medical condition — she treated me. She understood that I was scared and took the time to explain everything that was happening in terms I could understand. She never rushed my questions. She never made me feel like just another patient in a busy ICU. She made me feel seen.

What truly sets Kara apart is the compassion she carries beyond her clinical skill. Knowing how much I missed my children and my cat, she went home after one of her shifts and did a lighthearted photo shoot with her own cat. On her next shift, she showed me the pictures to make me smile. In a time when I felt vulnerable and afraid, she intentionally created a moment of joy for me.

Those small, thoughtful gestures meant more than I can fully express. They reminded me that I was still myself — still a mom, still someone who laughed — even while facing something life-altering.

Kara represents the very best of nursing: clinical excellence, empathy, humanity, and heart. I will never forget the way she cared for me during one of the most difficult moments of my life.

-Katie Warnock