It is 2:00 a.m., and Arabey El Sayed has been transported from a village 5km away to the emergency department of Qena General Hospital with severe chest pain. He is a 75 year old farmer, and is married with five grown children. Dr. Ahmad, the physician on duty, is assisted by Abeer and Shimaa, two nurses trained through the Improving Performance of Nurses (IPN) Project. They work together quickly to provide the patient with the necessary emergency care. A nurse administers the ECG, and the patient is diagnosed with myocardial infarction and moved to the Cardiac Care Unit.