The unimaginable happens. Ambulances wail through the streets toward the scene of the accident. It’s worse than they thought. Immediate advanced medical care is needed, and every minute matters.

That’s where Sarah Larson and her team come in. As chief transport nurse for Med Flight and Children’s Hospital Emergency Transport Ambulance, known as CHETA, at UW Hospital and Clinics, Larson knows that when she steps off that helicopter and onto the scene of an accident, her one and only job—the one she’s done for 30 years—is to take care of her patient.

“Usually these patients are critical and require rapid transport with advanced providers to an appropriate hospital,” Larson says.

Every flight is different, so Larson needs to be prepared to deal with any possible medical emergency within the confines of a three-seat cabin packed with medical equipment in an aircraft that travels at 150 miles per hour. It’s loud in the cramped space, and sometimes the patient is scared, or worse, on the brink of death.

“You have to be able to focus, using your experience and training and knowledge and compassion,” she says. “What you do can make a big difference in a patient’s life.”

This job is not for everyone. But it is for Larson. “I thrive on it. You are actually part of a very intimate experience of life and death.”

She’s a leader—you can see it in the way she carries herself. As she walks along the cherry-red aircraft on the sunny eighth-floor helipad of the hospital, her confident strides are often punctuated by a power stance, knuckles curled against the crook of her hips. At age 57, standing at 5’3”, she’s been a flight nurse at UW Hospital and Clinics for almost as long as the UW’s Med Flight program has been in existence (it started in 1985), and she’s been the chief flight nurse for seven years. The Med Flight program has 24-hour coverage, seven days a week. One aircraft is based in Madison and one is based in Iowa County. The program is busy, completing about 1,200 flights a year. Her influence has been felt in Iowa County—an area that needed quicker medical service.

“She was instrumental in the transition to our new base at the Iowa County airport as well as our national accreditation, which we received in 2016,” writes her Top Nurses nominator, Med Flight nurse Kimberly Maerz.

Larson—who also hires and handles orientation of staff and is the facilitator of day-to-day operations—helped build and implement an education program for this accreditation. The program is personalized based on the skill requirements of each team member, Maerz writes. It’s “very comprehensive, allowing the flight nurses and children’s transport team the ability to learn and [remain proficient in] skills that save lives,” writes Maerz.

In this capacity, Larson passes along knowledge gained in her long career. But she also does what so many great leaders do—she leads by example. She still completes flights, and that’s where Larson says she feels most at home—in the helicopter, inches away from her patient. The passion she has for her job escapes with every sentence, every story about starting her flight career as a 27-year-old nurse and about flights she completed while nine months pregnant—with all three of her pregnancies.

“I knew that I wanted to be a nurse since second grade,” she says. “I knew that I wanted to take care of people.”