College Begins Recognition of DAISY Honorees

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Sage Williams (left), Dean Patty Ravert, and Julie Valentine.

The BYU College of Nursing has partnered with the DAISY Foundation to begin a new tradition and recognize an extraordinary nursing faculty and student each semester. Last October we were pleased to recognize assistant professor Dr. Julie Valentine with the first DAISY Faculty Award and Sage Williams as the DAISY In Training Award recipient.

The DAISY Foundation (an acronym for Diseases Attacking the Immune System) was established in 1999 by the family of Patrick Barnes, as a way to honor him after he died of complications of the auto-immune disease ITP. Pat’s family created the DAISY Award for Extraordinary Nurses to honor registered nurses who make a difference in the lives of patients and families experiences in healthcare (some of our alumni have received this distinction).

The DAISY Faculty Award provides national recognition and appreciation to nursing faculty for their commitment and inspirational influence on their students. The DAISY Student In Training Award is designed to remind students, even on their toughest days in nursing school, why they want to be a nurse.

Each January and September, the College of Nursing will accept nominations at nursing.byu.edu of a nursing professor or student that reflects compassion and exemplifies the Healer’s art. Recognition occurs at the college’s professionalism conference in February and the scholarly works and contribution to the discipline conference in October.

DAISY Faculty Award

CMH01731-1Julie Valentine is an assistant professor and also a certified adult/adolescent sexual assault nurse. Dr. Valentine focuses on multidisciplinary, collaborative research studies uniting disciplines in sexual assault case reform to benefit victims and case processing. In 2015 she was the primary author of two grants totaling $3.2 million for the testing of previously untested sexual assault kits and the resulting investigation and prosecution of these rape cases in Utah.

She is engaged in a collaborative research project with the Utah state crime laboratory exploring the impact of new DNA testing methods in sexual assault cases, and a collaborative law enforcement study on trauma-informed victim interviewing in sexual assault cases. From 2014 to 2017, she served on the Sexual Assault Forensic Evidence Reporting committee with the National Institute of Justice developing national best practice policies in sexual assault cases.

In 2016 Dr. Valentine served on the BYU Advisory Council on Campus Response to Sexual Misconduct which investigated Title IX implementation and recommended substantial policy and structural changes. As a mother of eight children and two grandchildren, Julie is an influential teacher wherever she goes. Whether at the lectern, hospital, courtroom, legislative floor, church or home, she shows love, compassion, and a kind listening ear with everyone.

Of interest, her favorite holiday is Valentine’s day, when her family sends our Valentine cards and enjoys making dozens of yummy treats to share with neighbors, friends, and co-workers.

DAISY In Training Award

CMH01733-2Sage Williams (BS ’17) became a research assistant at the end of nursing semester one, working with faculty members Dr. Julie Valentine, Dr. Linda Mabey, and Dr. Leslie Miles on multiple research studies on sexual assault victims throughout Utah. Her passion for caring for underserved and vulnerable individuals expands beyond the research arena to immersing herself in volunteer work.

She takes a monthly 48-hour call as a victim’s advocate in Utah County for sexual assault victims with Center for Women and Children in Crisis, volunteers at the University of Utah Health Burn Camp program for children, and worked this past summer in a family refugee camp in Greece for children and families fleeing Syria. Of note, she left the camp to join faculty members in Dublin, Ireland to present at the International Sigma Theta Tau conference. While there, Sage only had sandals to wear because she had given her shoes to those more in need at the refugee camp.

Her plans include obtaining a DNP as a psychiatric mental health nurse. She is truly an exceptional nursing student who emulates the Healer’s art and will make a difference in the world, especially with those who have been traumatized.

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Who Comforts Nurses?

Note: See our Facebook page (https://www.facebook.com/BYUNursing/) for this article’s accompanying video

Who comforts nurses?

It’s a question that may feel odd to ask, given that nurses care for and comfort others. People sometimes forget that nurses are human too.

So who is the designated person for nurses to turn to when their workload seems to be overwhelming them?

“Unfortunately sometimes nobody,” explains assistant teaching professor Stacie Hunsaker. Hunsaker studies two phenomenon that occur frequently in the nursing profession—burnout and empathy fatigue.

Burnout, she explains, is “exhaustion from the demands of work” and can happen in any job. Empathy fatigue is a condition that is a bit more specific to healthcare and has reaching consequences.

“That is when a healthcare provider feels too tired to care,” Hunsaker explains. “Maybe they’ve had a lot of emotional patients, a lot of emotional cases, a lot of things that cause almost PTSD. They didn’t experience the event that caused the stress, but by caring for others and having that empathy for them, it hurts them. People often build up a hard shell to prevent more hurt, so they stop caring.”

When a nurse experiences empathy fatigue, it can deeply affect the way he or she treats patients.

“Most of us decide to enter nursing because we love people and we care for people, and if you build up a wall, you can’t make that connection with a patient,” Hunsaker says. “It really can negatively impact the patient’s care. A lot of research has shown that it can negatively impact even a patient’s recovery.”

How common is empathy fatigue? According to Hunsaker, it’s fairly prevalent.

“There are a lot of studies and a lot of research that it’s most often recognized and probably the biggest problem in those areas that have more exposure to death or dying or psychologically exhausting patients,” she says. These areas include intensive care units, emergency departments, and oncology.

Luckily, research has also shown ways to combat empathy fatigue. Some are basic, such as getting enough sleep, exercising, and eating well. Hunsaker recommends that new nurses avoid picking up too many overtime shifts and take sufficient time to focus on themselves and their relationships with others outside of work. Positivity is also an important tool.

“The number one thing that’s easy to do that I would suggest for nurses is every night before you go to bed write down three good things that happened to you,” she says.

Additionally, nurses need to find someone who they can turn to for help. Research has shown that those who comfort in turn need someone to comfort them.

“I teach and try to tell my students and new nurses to talk to somebody that you know gets it or understands,” Hunsaker says.

One of these sources can be Heavenly Father.

“I can’t imagine practicing nursing without prayer and without praying before a shift, without praying before a difficult case or after,” Hunsaker says.

Singing the Healer’s Art

Singing the Healer’s Art

By Dr. Sheri Palmer, Teaching Professor

Although I have taken students many years to Ecuador, a few experiences will always be in my memory.

A few years ago, I had the opportunity to take one of the first groups of nursing students from the United States to the only welfare psychiatric hospital in Ecuador. After visiting the psychiatric hospital for the first time, my feelings were mixed with sadness and emotion.  The complex of buildings was old and vast. Cement walls and chain link were prominent features throughout the facility.

We were shown where the younger male patients were, and it was indicated that“over here” were the “forgotten” patients, those who had been left at the hospital many years ago by their families. Patients were everywhere in their tattered, drab clothing; however, they were clean.  Most had no shoes, but of course I had to remind myself we are at the equator.  A large part of their living occurs outside as the weather is temperate most of the year.  I didn’t worry for their physical well-being (after all it was dinner time, and the workers were busy setting up the long tables for the meal, a soup with a big plate of rice).

We passed through ward after ward of patients sitting or standing around the premises.  Sometimes we were led on one side of the chain link fence to see the patients on the other side, and other times we were led inside the wards where we were surrounded by patients.

As we were a large group of North Americans, we drew much attention.  I had the uneasy feeling of being on display, yet ironically, I felt that the patients might also feel like they were on display.  Many times some of the patients would come up to us for a handshake or a hug.  Students were caught off guard by this and many were reticent to touch.  As I hugged and shook hands with as many patients as I could, many students also felt more at ease in saying hello and giving of themselves to the patients. Our tour complete, we passed through the gate to the other side and piled in our van.  The mood was somber and quiet.  Everyone was lost in thought.  Here we were in Ecuador with such high hopes of helping all the sick and infirm, yet we were overwhelmed with feelings of despair.  I felt the Spirit tell me that in this circumstance we could heal with singing, and not just any songs; they needed to be songs of faith and love about Christ and His mission to earth.

The students agreed readily with the idea. Permission to visit the hospital the next Sunday was granted.  We spent the week singing and practicing heartily in the van wherever we went.  Favorite songs were chosen, parts were practiced, and we were ready. The next Sunday afternoon we came again to the psychiatric hospital ready to sing!

We sang two or three hymns in each building. The long drab cement walls provided excellent acoustics. The students’ voices blended beautifully and the hymns seemed even more beautiful in Spanish.  Many patients came over and sat on the ground in front of us, some came to stand by us and sing, and some even knelt with hands together in prayer.  We felt like angels.  The Spirit was strong.  The sweet nuns who guided us around were amazed at many of the songs we sang. Upon leaving each ward, hugs and handshakes were freely given by the students.  We all felt love in our hearts for these patients.

The last ward we visited was the “Children’s Ward.”  We didn’t have the chance to visit this one previously, so I was hoping this would not be a shock for the students.  After walking amongst various bed-ridden children, who were obviously not only mentally handicapped but very physically handicapped, my heart was breaking. I was wishing we had something more to give. We stood in our little semi-circle and started to sing “I am a Child of God.”

One of the patients, a teenager, started getting really excited and swinging her arms, hopping up and down, and screaming.  My first thought was that this was a mental patient who was excited.  But after the nuns helped calm her down, it was apparent the girl was also crying and saying, “I know this song, I know this song!” Two of the students brought the girl into our little choir circle and we all sang the song together. Many of us had tears flowing down our cheeks. We had found a child of faith within these cement walls of the psychiatric hospital! We finished our little repertoire of hymns, and had to tear ourselves away from our new-found friend.

Again, upon passing through the gate and piling in our van, the mood was somber, but reflective. The spirit had helped us touch and heal others in a place where we weren’t sure how it could be possible. We were able to “Sing the Healer’s Art” in Ecuador.

 

 

 

A Veteran Relies on His Heavenly Friend

BYU College of Nursing sponsors a Utah Honor Flight experience each spring for local veterans. Participants travel to Washington, D.C. for three days to visit war memorials built to honor their service in World War II or the Korean War. Nursing students join the trip to practice the knowledge they have learned in clinical practicums regarding veteran support and care.

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Russell Hansen and Jeff Peery

I had the privilege to accompany my neighbor last year as his guardian. Russell Payzant was 96 years-old and served in WWII as a mechanic in the United States Navy. He worked at the Alameda Naval Air Station in California until discharged. His total time in the military was 3 years, 3 months, and 3 days.

As his guardian, I was responsible for his well-being and looked after his healthcare and medical needs. The first night we were together, he could not find the medicine for his glaucoma prevention. We searched every inch of his suitcase twice but could not find it. When asked if the drops were needed, he told me, yes, or he’d go blind.

Now the panic began (I did not want to be the first Honor Flight guardian to harm their veteran).

I called the flight medic for our group to ask her opinion. Apparently, the drops were needed. Since it was a prescription, we would not be able to get a replacement that night, and we must find them.

I turned to Russ for guidance. Ironically, I was one of his church leaders at the time, yet I felt no inspiration for the situation. The thing that impressed me most about him was his faith in God. Without hesitation, he said he’d ask his heavenly friend for help.

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Russ spent several minutes in prayer, on his knees, pleading with the Lord to allow him to find the eyedrops. I did the same, but he had a true connection to heaven. Moments later he got up, went to his suitcase and looked again. In a “secret” pocket was his medicine, placed there securely by his loving wife (who didn’t want it to get lost).

I looked repeatedly, but he had searched—searched for support from his Father.

Our time together was amazing! The rest of the weekend went well and we learned a lot about each other. I grew to appreciate him in so many ways.

Before our trip, he considered himself ‘only a mechanic in the war.’ However, after being greeted by cheering crowds in airports, at war memorials, and during a welcome home gathering with the National Guard, Russ considered himself a war hero. And for the next nine months, he had many stories to share with family and friends about his travels.

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Russ giving President Franklin D. Roosevelt some advice!

My friend passed away February 19, 2017; I am fortunate to have known this man.

Nursing: Doing the Lord’s Work on the Lord’s Day

As we begin the month of December, one theme we often hear is just how busy and commercialized the holiday season is getting. Whether we’re hunting for Black Friday deals, booking plane flights, buying Christmas presents, putting up decorations, or planning holiday get-togethers; it’s really easy to forget the true meaning of the Holiday season – to gather together with friends and family to commemorate the birth of our Savior.

For members of The Church of Jesus Christ of Latter-Day Saints, gathering to remember the Savior is something they’ve been encouraged to do every week. Each Sunday, members are encouraged to gather in chapels across the world to learn about Jesus Christ and to strengthen one another. Members are also encouraged to refrain from activities like working or making purchases on Sundays. It’s part of their effort to “keep the Sabbath Day holy”. But for some members of the church, “keeping the Sabbath Day holy” isn’t that simple.

“The first thing that comes to mind when I think of the Sabbath is that it’s a day of rest,” shares associate professor Bret Lyman. “Although, in my career, it certainly hasn’t always been a restful day.”

Senior woman is visited by her doctor or caregiver

Ever since he was a teenager, Lyman has worked as a certified nursing assistant in hospitals and nursing homes. Like many medical professionals, Lyman has often spent his Sundays changing catheters, applying bandages, and helping patients get to the bathroom. But Lyman says that working on Sundays never stopped him from trying to keep the Sabbath day holy.

“When I worked on Sundays, the Sabbath was a day when I was little bit more mindful about why I was it was necessary for me to work that day. I thought a lot more about how what I was doing related to the things that the Savior would do.”

For Lyman, it wasn’t hard to find connections between what he was doing and what the Savior would do.

“One thing that I was always impressed with was the story of Savior washing the disciples feet. If you think about it, that’s kind of gross. I mean the disciples walk around in sandals all day, the roads were made of dirt, and they worked hard, so they probably sweat a lot. Their feet must have been just gross! So for the Savior of the world to wash somebody’s feet; that’s a real act of humility!”

“When you’re doing nursing care, a lot of it is kind of “dirty-work”. You’re taking care of people’s most basic needs (taking them to the bathroom, cleaning them up, dealing with blood and body fluids, etc.). If you think about it, you are providing basic service; the same way that Christ was doing that basic service of washing the disciples’ feet. You are doing what the Savior would do.”

Er Nurse HIspanic Patient

Lyman says that in some ways it was easier to serve people as the Savior would when he worked on Sundays, compared to other days of the week.

“One of the delightful things about working on the Sabbath was the lighter atmosphere. On Sundays, there aren’t as many tests and procedures going on. Patients generally have a lot more family members come to visit, so there are more people to interact with. That means there are more people I can support and more opportunities for me to spend time with my patients and take better care of them.”

“When I think of the Savior, I think of how he was always providing service to his fellow-men,” associate teaching professor Ron Ulberg adds. “As nurses, that’s what we do 7 days a week, 365 days a year, 24 hours a day.”

Ulberg spent 25 years of his career working in an intensive care unit (ICU) the Veterans Affairs Hospital in Salt Lake City. Work in the ICU is one of the most demanding and stressful careers in the nursing profession. But Ulberg says when it comes to Sabbath day observance, the small and simple things are often what matters most.

“I think a lot of it has to do with your attitude and the way we interact with people; just being a kind, caring individual. Any opportunity that you have to lift somebody (it doesn’t have to be a major thing), to make their lives a little happier and their smiles a little bit bigger can make a huge difference.”

 

 

 

The Healer’s Art

As a part of the 50th anniversary of the BYU College of Nursing, a book was compiled called “The Healer’s Art: 50 stories for 50 years.” It has been 15 years since this book was first published and these stories were shared. We plan to regularly post selections from this book to help each of us remember and cherish the experiences of nursing and learning the Healer’s art. 

 Healer’s Art

Maile Wilson

As I entered the hospital for my second ICU clinical, I was expecting a normal, uneventful day. My patient, who was in a coma took little care, so I helped my nurse with her other patient, a 25 year old male. He had been in a car accident and was now a quadriplegic.

I was not sure what to expect from this patient because I had never taken care of a quadriplegic before. The nurses had been talking about how quadriplegics were the worst patients, especially when they learned how to “click” their teeth to draw attention. When we went in for our morning assessment, I was amazed at how young this patient looked. I realized he was only a few years older than I and would be paralyzed for the rest of his life. He would have to have someone take care of him his whole life. He was single, and now would probably never marry. My heart was saddened with the thoughts of his future and I admired his will to live.

I helped with his care throughout the morning. After the nurse and I were almost caught up and finally sat down, he started to click. My nurse started to grumble and complain about how he did not need anything, and that he was so demanding. Since I was not doing anything, I volunteered to go check on him. Through some careful lip reading, I found out he was hot (he had a fever all day) and wanted some cold water on his head. My heart swelled with sympathy as I realized he couldn’t even scratch his nose or put a washcloth on his head by himself. His request was small, but I wanted to make him comfortable, so for about 20 minutes, I sponged his head with cool water, washed his face, and dampened his hair. His eyes rolled back as he enjoyed the cooling sensation of the water. I talked as I worked and it was amazing the information I learned about him, even though he had a tracheotomy.

The more I served him, the more I loved him and wanted to help him. When other people would do treatments for him, I made sure I was there and they were careful and gentle. There was a connection between us, I as the nurse, and he as the patient, because I spent the extra 20 minutes with him.

It turned out to be a wonderful, yet hard and challenging day. I learned a lot about myself and about true nursing. When I started the day, nursing was just a matter of giving a bed bath, administering medications, and assessing. But as I left, nursing was caring. Caring to spend an extra minute to straighten the sheets, so he would not have to lie on a wrinkle; caring to make sure he was comfortable before I left the room; and caring to make a difference, however small in this man’s life.

As I look back on my nursing experiences, it is the time where I connected with patients and cared for their needs that I remember. I don’t remember when I placed my first catheter, or started my first IV, but I remember those with whom I spent time, nursing their physical and spiritual health. As nurses become busier, I hope I will still be able to feel that connection with patients and be what everyone imagines a nurse to be: caring.

 

Critical Care at 33,000 Feet

As a part of the 50th anniversary of the BYU College of Nursing, a book was compiled called “The Healer’s Art: 50 stories for 50 years.” It has been 15 years since this book was first published and these stories were shared. We plan to regularly post selections from this book to help each of us remember and cherish the experiences of nursing and learning the Healer’s art. 

Critical Care at 33,000 Feet

Elaine Bond

On a return flight home from the Middle East, our plane was somewhere over the Atlantic. My fellow passengers were a varied ethnic group, mostly Arab, many East Indian, some Europeans, and a few Americans. Most of us had been on board for over nine hours, from our Amman, Jordan embarkation site and were tired and somewhat crotchety. Other passengers joined us during a refueling stop in Shannon, Ireland. We were about two hours out of Shannon when an overhead announcement asked if there was a doctor or a nurse aboard. I could tell by the tone of voice this was no ordinary request.

With my Critical Care senses kicking in, I pushed my call light, stood up, and started toward the front of the plane. A flight attendant hurriedly escorted me to the bulkhead, where a row of portable cribs hung, filled with babies, in front of their mothers’ seats. Another flight attendant handed me a large seven month old baby, Mohammed, who was in obvious distress. My senses were reeling, as I performed my initial assessment. Even as I noted he was seizing and not breathing, the smell of diarrhea and vomit assailed me, and the feel of hot, soiled clothing met my touch. Luckily, I could see his heart was still beating, as his pulse pounded in his throat.

As I stood in the aisle, surrounded by the baby’s young mother, Amal, and other concerned passengers, I tried to block out the confusion so I could function. “Baby, baby, are you all right?” I mechanically asked, extending his neck to assure an adequate airway. When he began to gasp for air, I quickly took stock of the surroundings and determined how to eliminate some of the confusion and get enough space in which to work. Since the plane was not full, I asked the flight attendants to move the other mothers and their babies to new seats. Amal hovered over me, worrying about her son, frantically asking questions in Arabic which I could not answer. Another nurse (Mary Peterson) arrived, saw someone was in charge, and began to return to her seat. Since my background is with adults, and though she was not a pediatric nurse either, I asked her to stay, knowing two heads were better than one, since we needed at least two pairs of hands and someone to communicate.

Mohammed drifted in and out of consciousness, sometimes able to focus on my face, alternating between no respirations and rapid respirations around 50 breaths per minute, with a heart rate of 160 to 180 beats per minute, sometimes seizing and sometimes lying limp. We unbundled him from his blankets and outer clothing. Now at least, we could see more easily whether he was breathing. He was clammy to the touch, leaving me wondering about his underlying problem. I knew he must be dehydrated due to the vomiting and diarrhea. Was he also hyperthermic? Did he have an infection? It was difficult to tell. My limited Arabic, “Marhaba, Kaef Halak? (hello: how are you?) was inadequate for the occasion.

One flight attendant served as a translator and brought the aircraft’s small first aid kit to us. Oh, for my emergency supplies and sterile gloves locked carefully away in the hold below! The first aid kit had a fever scan thermometer inside and we quickly checked Mohammed’s temperature. It was somewhere around 39 degrees, but we did not know whether it was accurate. A nearby grandmother handed us a rectal thermometer, which gave us a more precise reading of 41.2 degrees. We quickly asked for and received a container of ice, which we placed in strategic locations around Mohammed’s body, as we were getting his history from his mother.

She had taken him to see a doctor the day before the flight, when he would not nurse as usual, following several bouts of vomiting and diarrhea. The doctor had given her some acetaminophen suppositories to control his fever and Pedialyte to provide fluid, calories and electrolytes. Mohammed had not resumed nursing, would not drink the Pedialyte from a bottle, and Amal had not known what to do with the suppositories.

Since she had the Pedialyte and suppositories with her, we administered a suppository and mixed Pedialyte in a bottle to try to give him, should he become conscious enough to try to suck. We continued to cool him with cold wet cloths filled with ice. Because he was so dehydrated, his veins were so small. I could not have started an IV, even if I had the equipment and fluids.

Sometime during the confusion, the airplane’s co-pilot came to ask us what we needed to do. I said, “We have two choices: return to Shannon, Ireland or land at the first available airport in North America. This baby will not live until we reach JFK airport in New York.” After conferring with the captain and radioing for additional instructions, the co-pilot returned and reported we had passed the point-of-no-return and must continue forward.

The next two hours were a blur as we sped over the Atlantic to our new destination, racing against time. We continued to cool Mohammed, worrying that we would cool him too rapidly, or that we couldn’t cool him enough. His temperature slowly dropped; down to 39.9 degrees, then 39.4, on to 38.9, down to 38, then into the 37s. We removed the ice and wet cloths and placed him in a clean dry blanket.

The flight attendant brought us a small, partially full oxygen cylinder with an adult face mask. We had to estimate the flow of oxygen and I had to help others understand we couldn’t place the mask completely over Mohammed’s face; we didn’t know how much flow we had and we incurred the risk of having him rebreathe his own carbon dioxide. He soon regained some color in his face and his capillary refill time returned to normal.

He seemed to be awake and we tried to give him the Pedialyte, but he was too weak to swallow. His dark eyes were huge as he tried to fathom what was going on around him. We gave him to his mother to hold, hoping it would provide some comfort and a sense of security for both of them. She was very frightened– on her way to a foreign land to meet her husband, unable to speak the local language, and not knowing whether her baby would be dead or alive in the next minute.

I didn’t pay attention to how hot it was in the plane: I thought I was hot because I was working so fast and because of the stress of the moment. However, the heat came back to haunt us later.

The pilot, co-pilot, and chief flight attendant gave regular updates to the passengers about our diversion to Gander, New Foundland, and about Mohammed’s condition. From what I could hear and see, the passengers were understanding and quiet. The mothers and grandmothers in our vicinity gave words of encouragement to Amal and to us, which the flight attendant translated for us. I suggested some Muslim, Hindu, and Christian prayers might be in order as well! The pilot was able to locate Mohammed’s father in New York and get him on a plane to Gander to meet us.

At last, we landed in Gander, where there was an ambulance waiting for us. We hustled Mohammed into the ambulance where they could get an IV started, get some fluid into him, and give him the correct amount of oxygen.

While I was helping with paperwork, both for the ambulance and the emigration officials, one of the flight attendants came to me reporting an elderly male patient was not responding well and asked if I would look at him. When I got to the man, he was slumped in his seat, grey, totally unresponsive, chin on his chest and not breathing! As I lifted his head, I thought, “Oh no! This cannot happen twice on the same plane!” He began breathing and his color began to improve. His initial blood pressure was 60/40 mm Hg and his pulse was 30 beats a minute. I tried to analyze whether his rate was really that slow or whether he was in bigeminy or trigeminy. I could only feel a pulse every second or third beat.

Getting an adult into Trendelenburg in a cramped airplane is no small task! However, Nurse Peterson was creative in getting people out of enough center seats so she could get space for him to lie down. Once again, we needed an interpreter and a spokesman for the gentleman, who was East Indian. We discovered he had taken his Beta Blocker (Atenolol) shortly before the problem arose for Mohammed. Our analysis told us the heat in the plane and the excitement of the emergency landing had exacerbated his normal response; he vasodilated and bradied down.

His blood pressure slowly equalized and his heart rate returned to normal. As he became more alert, he was able to converse with us. He refused to get off the plane and said his daughter could take him to a doctor when we got to New York. Nurse Peterson stayed with him as I finished the paperwork for Mohammed so the ambulance could leave. We periodically checked on the gentleman during our flight to JFK and he experienced no further difficulty.

As I walked off  the plane, five hours late, I thought, “This is just like any routine day in ICU. When the shift starts, you have no idea what care you will need to provide. When a trauma patient arrives, you stabilize, assess, stabilize more, assess more, send the patient off to surgery, deal with psychosocial concerns, get an interpreter for families, save lives, then walk out the door. No one out there can possibly understand the drama behind the work we do. You smile when your significant other asks how your day went, and you answer, ‘It was just a routine critical care day.’ ”