On an early summer’s afternoon in Seville, Raimundo Caro checked his mailbox and was surprised to find a postcard. “This was something I wasn’t expecting,” he says. “But when I turned it over to see where it came from, who had sent it, and what they had written on it, I was overcome with emotion from all the joy this little postcard brought me.”
The postcard carried the signatures of stroke nurses Joaquín García, Sergio González, Marta Ángel, Juan Manuel López, and two members of the Angels team in Spain – Susana Granados and team leader Alicia Arjona. It had been popped into a red post box on the Angels booth at ESOC 2025 in Helsinki, and from there found its way to the south of Spain.
At around the same time, postcards landed in the mailbox of Paloma Caro in Málaga, and on the desk of Aida Gómez.
All the postcards carried QR codes that linked the recipients to a story about Spain on the Angels website. The QR code on Raimundo’s postcard took him to the story of Almería, which late in 2024 became the first Angels Region in Europe. He says, “I knew the story behind the Hospital of Torrecárdenas firsthand, where quality monitoring was lead by Joaquín. But the involvement of all the hospitals in the region, together with the EMS, and the implementation of the FAST Heroes campaign in so many schools to spread the importance of early detection in stroke, I think it’s an amazing story.”
The nurses at both ends of the postcard exchange are all members of the Andalusian Nurses Steering Committee (GENVA) that was formed in 2022 with the goal of standardizing stroke nursing care in the region, and which has in addition become an influential platform for knowledge and experience sharing. All 12 stroke units in Anadalusia are represented in the group, which means their influence is felt throughout the region – but it also impacts practice in their own hospitals. All four GENVA nurses who’d traveled to Helsinki were there to collect double diamond awards on behalf of their hospitals. Three GENVA nurses – Joaquin, Raimundo and Sergio – are also past nominees for the ESO Angels Spirit of Excellence Award, which honours individuals who embody excellence in stroke care.
Raimundo was nominated in 2023 in recognition of his role as an advocate of scientific research in neurovascular nursing care, and as founder of the stroke unit at Hospital Universitario Virgen Del Rocío in Seville, and of the Spanish Society of Neurological Nursing (SEDENE). He is now retired but participates in GENVA activities as an ‘emeritus’ member.
Sergio was also a 2023 nominee together with his colleagues Almudena Fernández and Álvaro López at the Regional University Hospital of Málaga where they’d developed Proyecto Flecha, a visual “checklist” that standardises post-acute care in the stroke unit. And in 2024, Joaquín García, chief nurse in the stroke unit at Almería’s University Hospital Torrecárdenas, became only the second nurse in Europe to receive the Spirit of Excellence Award in recognition of his leadership in standardising stroke nursing care and his advocacy for quality monitoring. Joaquín is part of the GENVA leadership structure, together with Sergio, Paloma Caro, and Lidia Ruiz of Hospital Virgen de Macarena in Seville.
We had some questions for the GENVA nurses – both those who attended ESOC, and for their colleagues who later found postcards in the mail.
Joaquín García, Hospital Torrecárdenas, Almería
What did you enjoy most about ESOC 2025?
Without a doubt, the best was getting to see my colleages and enjoy the congress together.
How important is a unified, cooperative structure like GENVA for speeding up change?
It’s not just important but essential. It’s the base where we can build and secure knowledge, and share experiences.
After three years, has GENVA met or exceeded its goals?
We have already accomplished so much, but honestly, this is only the beginning. A very important beginning, indeed, but there is still a lot to do, and I am sure we can achieve everything we set out to do!
Juan Manuel López, Hospital Virgen de las Nieves, Granada
What are the stand-out things you learnt at this year’s ESOC?
It was an amazing experience. You get to see all the technological advances, the most innovative research works, get to know very interesting people and network with them… And the best is we bring home all these new possibilities to our stroke units.
Honoring your colleagues by sharing a postcard from Helsinki was such a good idea. How did it come about?
Susana showed us the postcards and told us we could send them to anyone we want. We were definitely missing some of our GENVA members there, so we thought it would be great to remind them how much we would have liked to share the experience with them as well.
How has GENVA impacted stroke care improvement at your hospital?
GENVA was a before and after for us at the hospital, a turning point. Being part of it means we can share knowledge, concerns, questions, protocols, projects, and support each other through good and rough times.
Marta Ángel, Hospital Virgen del Rocío, Seville
What is your stand-out moment from ESOC 2025?
Definitely the ESO Angels awards ceremony. Not just receiving the recognition but also getting on stage with my colleagues while watching on the screen all the Spanish hospitals that had been awarded double diamonds, was truly an unforgettable moment.
Which story did your group select to send to your colleagues back in Andalusia?
The story of Almería, of course. The achievement of Almería becoming the first Angels region in Europe is a huge honor for us.
How does being part of GENVA impact your work at your hospital?
It's an opportunity to motivate and encourage my teammates, not only by spreading the word about the projects we are working on, but also by letting them know about the amazing group of nurses who are fighting together for a common goal, which is to improve stroke care.
Sergio González, Hospital Regional de Málaga
What was your goal in sending a postcard to your fellow GENVA members?
We could not stop thinking about our colleagues who’d been there in previous years, but couldn’t this year, because they’d changed departments, retired, or had to decline the invitation for personal reasons. GENVA is more than a working group. The friendships, the support for each other and the good atmosphere we have created, make GENVA a unique group, and that is why it is growing so strongly.
After three years, what is the impact of GENVA on stroke care in Andalusia?
Nurses from stroke units in Andalusia are united and working together. Thanks to this, we are part of the Andalusian Stroke Plan, the program which organizes and leads all new initiatives in stroke care in our community. Any patient who enters an Andalusian stroke unit will receive the same nursing stroke care protocols, based on the latest scientific evidence. We are also leading some multicentric research projects to try to give GENVA a wider visibility in the health and scientific community.
What was your highlight of ESOC 2025?
Being part of a scientific event like this one and being exposed to multiple studies and new possibilities. I feel blessed to keep learning and sharing in this environment.
Raimundo Caro, Hospital Universitario Virden Del Rocío (retired)
You received a postcard from ESOC! Who sent it to you and what did they write on it?
It was sent by my GENVA colleagues who were at ESOC, Marta, Joaquín, Juanma, and Sergio, as well as Ana Raquel from Tenerife, and our Angels, Alicia and Susana. It said that they miss me and that they always remember me as a reference in stroke care.
What would you say are GENVA’s main accomplishments to date?
The main accomplishments may be the standardization of stroke care in all stroke units when it comes to nursing protocols, together with the implementation of the Arrow Project, not only in Spain, but internationally. It is a reality that many stroke units around the world are now sharing this protocol which was born in Málaga, Andalusia.
Who would you send an Angels postcard to if you could?
I would send a postcard to all the GENVA members, to thank them for helping me achieve everything I fought for, in 38 years of working in neurology. In the beginning, the idea that all the stroke units in Andalucía would share the same stroke care, was unimaginable. I would also send a postcard to all those hospitals who don’t yet belong to the Angels community to make them aware of everything we are achieving together, improving treatment and stroke care around the world.
Aida Gómez, Hospital Universitario Virgen de la Victoria (Málaga)
You received a postcard from ESOC! Who sent it to you?
My GENVA colleagues sent me the postcard, Marta, Joaquín, Juanma, and Sergio, and my favorite Angels, Alicia and Susanita.
What was your first reaction when you recognized what it was?
I was really really happy to see that my colleagues were thinking about me during ESOC, as much as I was thinking about them.
The GENVA group of nurses are really making an impact on stroke care in Andalusia. What would you say are its main accomplishments?
I would say the biggest so far is being part of the Andalusian Stroke Plan. This is a very important recognition for us. Besides that, that we have formed a very amazing and solid working group which I really admire.
If you could send an Angels postcard to anyone in the stroke community, who would it be?
Our colleague Yolanda Rodríguez from the Hospital Virgen de las Nieves in Granada. She is a very important part of the group, someone we all admire deeply.
