Michelle was the charge nurse for the outpatient Oncology Clinic when a child was admitted to the inpatient ICS that was receiving a highly reactive medication that day. We give this medication with some frequency in the outpatient clinic, and Michelle and I have had to quickly prepare and administer reaction medications to our clinic patients with some regularity.

Michelle and I offered to help during this inpatient infusion even though we were both scheduled for the outpatient clinic. Michelle remained cool and calm and offered her expertise when the child began to react, and we had to treat him immediately. The child received a few medications to assist in treating the medication reaction and was having blood pressure issues when Michelle spoke up to the physician and suggested other treatment options. The physician preferred to utilize an NS bolus at this time because he had concerns about dropping the blood pressure further.

The patient was still extremely uncomfortable and clearly not feeling well. Michelle professionally escalated her concerns to some of the physicians/LIPs in the clinic, and the patient received additional treatment with their guidance. Michelle then sat down with the bedside physician to discuss his rationale and how things could have gone smoother. He agreed with Michelle and was grateful for her feedback. Michelle went above and beyond to advocate for this patient using multiple safety tools (ARCC, clarifying questions). Michelle is an incredible nurse and always puts the care and concern for the patient first.

Michelle was able to have a calm and professional debrief with the bedside physician and provided excellent treatment options and rationale for using them for any infusion-related reactions he may treat in the future. She has vast knowledge and expertise and is willing to share and help educate all members of the interdisciplinary medical team. She puts the safety and care of her patients first and she is an excellent member of the Oncology medical team!