C is a 4-year-old boy like any other who loves to run and play. He spends the majority of his time in an imaginary world where he is constantly on an adventure or as he often puts it: “exploring.” He is extremely perceptive, unbelievably intelligent, and bursting at the seams with love for people and life.

Insert a recent viral illness and ensuing Kawasaki Disease. C was unable to move his swollen legs and cried out in pain whenever he had to be picked up. His body was completely masked behind a dark red and all-consuming rash. His eyes were bloodshot, he wasn’t eating or drinking, and cycling Tylenol and Motrin only served to bring his fever down to a manageable 101 degrees. By the time C met Beth he had been sick for days, had been through the ER where he had been sent home and was subsequently admitted directly to the Bronson Children’s Hospital.

Beth walked into the room in the morning on the second of C's five-day stay. Mom (who is a nurse) was on her way home, Dad was coming on shift and C was there to stay. This was the morning that C would be diagnosed with KD and begin IVIG treatment. Beth had already empathized with the family, demonstrated her willingness to confront a tidal wave of questions, provided expert explanations of what was occurring, conveyed the treatment strategy to the patient and family and the day had only just begun.

Before IVIG treatment began and despite the reality that Beth hardly left the room at all that day, she wanted to make sure that the family was educated and informed. Beth educated Dad on what the adverse reactions to treatment might look like just in case symptoms had an abrupt change during one of the few 15-minute increments where she was unable to monitor C directly. And it is a good thing that she did because what she wanted a contingency plan for is exactly what happened. C was a little over an hour into treatment, he was stable, protocol was to press on increasing transfusion to the max rate. After following that protocol and monitoring C in the immediate aftermath, Beth left the room to attend to the continuously increasing list of tasks that had to be accomplished in addition to providing direct patient care. After all, she was the link between C and the staff of physicians painstakingly navigating the turbulent waters of treating C’s condition as well as her two other patients that day and they needed timely information.

It just so happened to bin in this short window where C’s body would become overwhelmed and harshly reject the IVIG treatment. Beth couldn’t have been out of the room for more than 10 minutes when his red rash turned to purple, his fever climbed from 100 to 104.3, his heart rate peaked at 190 and what started as a light shivering became shaking as his small body lay clenched in the fetal position where he was somewhere between awake and asleep.

To us, this is where Beth distinguished herself as the best of the best in the world of nursing. Beth had and would continue to build a deep relationship with the patient and his family, garnered respect, demonstrated expert knowledge and conveyed what she knew to the family. She was providing every convenience and comfort imaginable, taking seriously the input of C’s parents and consciously involving them in the care plan while continuously engaging the rest of the healthcare team to address mounting concerns.

C’s body was not going to withstand the rate of transfusion outlined in the protocol. Beth contacted the physician immediately upon entering the room and was confronted with the stringent, statistically driven, two-dimensional nature that has to be the foundation of objective care. Protocol said to maintain max rate; Beth wasn’t willing to accept this outcome for her patient.

Beth hesitated on the phone, considered her options and with great tact she took action: Beth persisted in advocating a three-dimensional picture for the physician on the other end of the phone and stressed the correlation of C’s worsening symptoms with adverse reactions to IVIG treatment. The order was issued and transfusion was slowed to half. Shortly thereafter, transfusion would be decreased to one-quarter and was ultimately ceased to allow his body to reset. The diagnosis was correct, the treatment effective, the symptoms not yet critical but Beth knew that something needed to change quickly and she orchestrated that change.

Beth would continue to care for C through countless other challenges that would arise in the next 2 days. Ultimately, she would see him through the majority of his challenges in his hospital experience. She brought him gifts when she discovered his love of dinosaurs, took extra vitals for the sake of precaution, skipped lunch, hardly sat down for 3 days and, in the final hour of her last shift with C, would become the target of his enema-induced bowel purging.

Not only did Beth go “above and beyond” in caring for C but she stayed there for 3 days and that is no small feat. To convey the heartfelt appreciation C’s family has for her is difficult to put in writing but perhaps this detail will provide that perspective: C and Beth took a picture together the afternoon of her last shift with him (the day his symptoms and side effects became totally resolved before he would be discharged the next day) that picture was hastily printed and framed as a gift to Beth and another copy will be incorporated as a permanent addition to C’s bedroom beside the shadow-box from the day he was born. We will forever be grateful for everyone in the Bronson Children’s Hospital who helped care for him and we are humbled to have been surrounded by such a fantastic team of medical professionals whom we owe our entire world; Beth made herself the spearhead of C’s care team.