To summarized the nursing experience of a patient with wet beriberi and multiple organ dysfunction caused by thiamine deficiency due to chronic alcoholism. For the patient with atypical clinical manifestations，sudden onset of refractory shock，and multi-organ failure，a multidimensional assessment strategy was adopted to rapidly and accurately identify wet beriberi. A step-down vitamin B1 protocol was formulated to ensure safe supplementation of thiamine. Precision volume management was implemented to correct congestive heart failure，individualized ventilation and rehabilitation strategy was applied to promote lung pulmonary recovery. Renal replacement therapy was early initiated to correct acidosis and improve renal injury. Health education was guided by dyadic coping theory and information-motivation-behavioral model. Through timely treatment and meticulous care，the patient was transferred to a general ward after 7 days，discharged on day 13，and showed good recovery at 3-month follow-up.