May 18, 2026
Following in mother’s footsteps: Nurse practitioner leaves lasting impression on patients
By TJ Banes, IU Health Senior Journalist, tfender1@iuhealth.org
All Smyrna Rivera ever wanted to do was practice nursing like her mother. A native of Gary, IN, Rivera graduated from Purdue Calumet in 2002 and started her career working with her mother at Methodist Hospital in Gary. She worked in the ICU; her mother was an oncology nurse.
When her mother passed in 2016, of metastatic ovarian cancer, Rivera was determined to carry on her legacy. Three years later she received her doctorate from Marian University and has worked in transplant surgery with IU Health since 2022 as a nurse practitioner.
“My mom’s impact was profound and has always been very meaningful to me. It continues to influence the way I care for my patients,” said Rivera, the mother of three boys. The oldest is 22 and studying environmental science at IUPUI. The younger two are 14-year-old twins.
As youngsters, Rivera’s sons received monarch caterpillars from her mom for their birthday. That dramatic metamorphosis of watching the caterpillars turn into butterflies is something Rivera brought into her role as a compassionate caregiver.
When a young nursing student from Little Rock, AR drove nearly 600 miles for a multi-organ transplant, Rivera played a notable role in the patient’s recovery. Kelly Baker received a stomach, small intestine, large intestine, and pancreas on Aug. 13, 2025. She remained hospitalized through Halloween, Thanksgiving, and Christmas. One of the most difficult days was her 21st birthday in September.
It was Rivera who turned that day into a special celebration. Again, following in her mother’s footsteps, Rivera gifted her patient with monarch caterpillars.
“I turned 21 two weeks after transplant and Smyrna brought me the caterpillars in a big glass jar so I could watch them and look forward to seeing them hatch,” said Baker. When the day came to release the butterflies, Rivera pushed Baker’s wheelchair outside in the greenspace near Riley Hospital. It was a moment that her patient will treasure forever. In a card to Rivera, Baker wrote: “Due to my illness and complications I’ve missed many milestones and my 21st birthday could have been just another day, but because of you, it wasn’t. During one of the hardest parts of my recovery, you got me outside for the first time in nine months and it felt like I was getting back a piece of my normal life.”
Rivera said the gift and release of the butterflies reflected her job in transplant.
“As a transplant nurse practitioner, I see how transformative transplantation can be for those individuals with organ failure. To me, organ transplantation parallels the life cycle of the monarch butterfly,” said Rivera. “Patients with organ failure enter a period of uncertainty and vulnerability, much like the monarch as it transitions through various stages: larvae, caterpillar, chrysalis and ultimately a butterfly. Transplantation offers patients a second chance at life where, like the monarch, they emerge stronger, with a renewed sense of hope and the ability to ‘take flight.’”
While many people celebrate the holidays and their birthday dining with friends and family, Rivera knew that patients with intestinal failure can’t savor the same experiences. Part of her role as a nurse is being in tune with the specific needs of her patients. “Creating core memories is extremely rewarding for patients that spend so much time in the hospital,” said Rivera. For her dedication, Rivera was recognized as “IU Health’s Rising Star Advanced Practice Provider.” The award celebrates her meaningful impact to her role with IU Health’s transplant program.
“I try to support patients not just medically but emotionally as well,” said Rivera. “Transplant recovery is a long and difficult process, and small moments of hope can help make a difference.
In the past months, Rivera has been thinking about ways to share more monarchs with patients and staff. She loves to garden and spend time outdoors and has considered developing a butterfly garden near the hospital grounds.