Holly was caring for a teenage patient who was seeking care in our peds oncology department for cancer treatment. All other therapies have failed this very sick patient, but the family remained hopeful. The patient would be receiving a new protocol for treatment that would require him to receive chemotherapy Monday through Friday for several hours each day in our center. One nurse cared for him on Monday and Tuesday, but would be off in subsequent days. Holly collaborated with the Monday and Tuesday nurse to get to know the patient, familiarize herself with the care and protocol, and met the family. Holly took over the patient's care on Wednesday.

By Friday, Holly recognized the patient looked progressively sicker, evidenced by worsening vital signs. He and his parents were quite anxious. Holly appropriately escalated concerns regarding the patient's and parents' discomfort and concerns for what our next steps for intervention would be for the patient if he continued to worsen. With support from nursing leadership, a multidisciplinary meeting was quickly held that included bedside nursing, the patient's care coordinator, who had an established relationship with him, the physician, nursing leadership, and respiratory therapy. A mitigation plan was made. Holly's advocacy made all the difference for the patient and the rest of the staff on the unit. At the end of the day, Holly speaking up got a consult to palliative care at his bedside and the medication needed to relieve the patient's suffering. The patient was able to be sent home that evening with his family.