Julie had been ready to assist in admitting someone to the towers and she reports that she felt that the patient complaining of coughing up blood was more. Before getting ready to admit the patient she had convinced the MD to order a chest xray, even though one had been ordered a few days ago without significant findings. The chest xray report was abnormal and a CT of chest was abnormal. This patient needed a lifesaving intervention that could not be done at Driscoll, and instead of admitting to the floor,. The patient was transferred to Texas Children’s uneventfully. I am convinced that had Julie not been so perseverant, this child’s life may have changed dramatically. Instead without significant event, this patient was safely transferred, and given the opportunity to make a quick recovery and return home.