You did well to assess the pros and cons in transferring this resident to the hospital. I understand she was scared from contracting COVID-19 and disliked having to isolate after 14 days of getting back but she needed urgent care considering that the MD wouldn’t attend till 4 days time. You made a good choice in detraining that the pros outweighed the cons and went ahead to send her to the hospital. In the hospital, pain medications and advanced interventions (if needed) would be provided. With 10/10 pain rating, pain management interventions were seriously needed. Good job!