Stroke is one of the leading causes of death similar to STEMI’s and Sepsis. I have never analyzed the thought of recurring stroke however as I think back to all the patients I have cared for there are multiple causes of stroke-like symptoms after the initial stroke. I gathered information from a prospective cohort study that found recurring stroke has a higher mortality rate. The associated risk factors with second stroke were hypertension, chronic infarcts, and age. An astonishing 35.7% of the 1872 patients died during the follow-up of this study (Khanevski, at.al., 2019). The organization I work for has recently became a stroke center and I receive data on all the patients our department activates a hyper-acute stroke protocol on. For 2021, the department activated approximately 54 potential stroke patients and of the 54, three were diagnosed with stroke. The challenging portion is educating patients and families to call 911 if stroke-like symptoms occur as time is brain. Patient and families decline to use ‘911’ and decide to drive themselves to clinics, their primary care offices and to the department I work in, Advanced Urgent Care. Patients tend to report they don’t want to “wait” in the ED. Nurses and providers continue to educate the population in our area that there is no wait when it comes to stroke-like symptoms. I look forward to hearing about your progress with the DPI project. Khanevski AN, Bjerkreim AT, Novotny V, Naess H, Thomassen L, Logallo N, Kvistad CE; NOR-STROKE study group. Recurrent ischemic stroke: Incidence, predictors, and impact on mortality. Acta Neurol Scand. 2019 Jul;140(1):3-8. doi: 10.1111/ane.13093. Epub 2019 Apr 11. PMID: 30929256; PMCID: PMC6594196.