Karen was taking care of a laboring patient who had failure to progress and required a c-section. The patient had an epidural but was unable to lay flat in the bed because lying flat made it difficult for her to breathe. Karen identified the problem and contacted anesthesia to come up with a plan that was best for mom and baby. After discussing the situation with Karen, and her patient, a decision was made to perform an awake fiberoptic intubation in the OR. Awake intubation is time-consuming and requires coordination between nursing, anesthesia, neonatology, and obstetrics. Karen displayed leadership and compassion to bring all the teams together in a well-coordinated effort. The intubation went well, all the components for success were present. Exemplary team effort and great proactive insight by Karen.