Three weeks ago there was a 2 1/2 year old girl on my service who had very significant adenopathy. Because of other clinical issues there was concern about Kawasaki Disease. With that diagnosis it is very important to get an echo. One was attempted in the Emergency Department, but the little girl was completely uncooperative. Up on the floor the house staff requested another echo, but this time wanted to try some sedation.

Nadine Schultz then approached me and indicated that because of the adenopathy she was worried that the patient's airway might not be maintained if she was sedated. She also told me that the echo tech that was available for the study was very good with children, and that she felt it would be best to try to do it without medication. I agreed, and she was right; the tech was excellent, and the study was completed. It was normal.

By the next day, the patient was transferred to the PICU due to concerns about her airway. Ultimately, she only required observation, was soon back out on the floor, and a few days later was discharged home in good condition. But, by not sedating the patient for the echo, we may have avoided a significant clinical problem. I feel that Nadine is an excellent nurse, and I very much appreciate her not only her wonderful bedside manner and rapport with patients and families, but also her clinical judgement, technical abilities and assertiveness. I'm glad she's on our team.