I am a Project Manager overseeing the replacement of the Nurse Call System at a large cancer hospital in California. Due to the hospital’s high patient census, installation had to be completed in phases, with only two to three patient rooms under construction at any given time. This phasing required careful sequencing to ensure that the existing nurse call system remained operational in “Head of Line” rooms while “End of Line” rooms were brought online with the new system. The replacement also extended to all support areas, operating rooms, and imaging rooms. Given the hospital’s size, the construction effort spanned several years. I met David Rivera in July 2021, prior to the installation phase. As expected, performing construction work in an active hospital presented significant challenges, including maintaining operations, achieving timely HCAI (formerly OSHPD) approvals, and coordinating staff training. David played a key role in providing the resources and coordination necessary to address and resolve these challenges effectively.