This paper presents three research case studies of children who have had surgery for a cardiac condition and discusses the experiences of the children and their families through their responses to the Heart Beads programme, as well as the insights gained by staff. The Children's Hospital at Westmead has a significant population of children with cardiac conditions. For many of these, diagnosis signals the beginning of a long, arduous journey with multiple procedures and admissions. The hospital has a family-centred care focus, and the cardiac ward undertook a project to implement and progress changes consistent with this approach. Staff developed the Heart Beads programme to enhance the care of children being treated for cardiac conditions. The programme involves children receiving distinct beads specific to each cardiac procedure, treatment, or event in recognition of their experience. A total of 7 staff members and 11 families were interviewed and particular stories were noted by staff. The case studies presented illustrated how nursing staff were able to recognize potential improvements to care and acknowledge the experiences of patients and families. Assumptions questioned as a result of the programme related to the complexity of the child's condition and gender. The death of a child and the acknowledgement of the child's life is also considered. Heart Beads allowed staff to reflect on the positive aspects of the care they provided.