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Infective endocarditis secondary to Serratia marcescens is very rare, noted in patients with severe immunosuppresion. The disease is associated with high mortality. Therefore early diagnosis and aggressive treatment is recommended.The Saudi government is currently facing multiple challenges in achieving "The Gold Standard" in nursing practice. This is not limited to educational challenges, staffing shortage, paucity of international and national benchmark evidence, absence of clear and defined scope of nursing practice, and lack of appro