Our Nurse of the Week is Darren Moon, a staff nurse in the Loma Linda University Medical Center emergency department, who recently received the 500th Healing Hands Award for his lifesaving care. When patient David Colwell was admitted after experiencing symptoms of a heart attack, Moon stepped in and took the necessary steps to ensure that Colwell received the lifesaving medical care he needed.
Moon was reunited with the patient whose life he saved after Colwell nominated him for the Loma Linda University Health Healing Hands Program. Surrounded by emergency department colleagues, Moon was recognized for his actions as the 500th Healing Hands Grateful Patient Program recipient.
According to News.LLU.edu, Colwell addressed Moon at the awards presentation with the following: “Thank you for your expertise and quick action to address my situation. I understand you were also part of the team in the cardiac cath lab who attended to me. I’m glad you are part of the Loma Linda family.” The nomination came as a surprise to Moon, but he was honored to receive the 500th Healing Hands pin.
The Loma Linda University Health Healing Hands Program provides patients a way to recognize staff members who have provided exceptional care, according to their website. The program allows patients and their families to give a gift of any amount, and direct it to supporting the campus in any way they choose along with a note to the caregiver.
Connie Cunningham, executive director of emergency services at Loma Linda University Health, praised Darren with kind words: “Darren is an amazing nurse, skilled and well-rounded. When David arrived in the emergency department, Darren was focused and calm as he sifted through all of the symptoms.”
Time is of the essence with patients like David who exhibit cardiac-related indicators, and thanks to Moon’s lifesaving care, Colwell is now in good health. To learn more about Moon and Colwell’s nurse-patient relationship, visit here.
Our Nurse of the Week is Lauren Wirwille, bride-to-be, who was driving to her own bridal shower with her mom in the front seat when she noticed a minivan stopped in front of her. She decided to honk, prompting the car to start moving again, but after Wirwille turned at the intersection her mom saw the van veer off the road. Realizing that the man had looked slumped over, Wirwille pulled over and ran toward the man’s car where she found him unconscious.
As an emergency room nurse for St. Joseph Mercy Hospital in Green Oak Township, MI, Wirwille knew exactly what to do to help the man who had gone blue in the face. She was already running late to her bridal shower but couldn’t help pulling over to help a stranger, and she quickly realized it was a good thing she had followed her instincts.
After instructing her mother to call 911, Wirwille began trying to find the man’s pulse. At the same time, another driver pulled over and offered to help get the man out of his vehicle. Then Wirwille immediately started CPR. She recalled the event to ABCNews.go.com, explaining that, “Not a lot of people know how to do chest compressions. After a little while, you do get tired, and you need to not be tired, so I had my mom start chest compressions. She did great. I was so proud of her.”
Shortly after starting CPR, Fire Chief Kevin Gentry arrived on the scene and assisted in performing chest compressions. The EMS crew was able to revive the man and transport him to Providence Hospital where they believe the man was recovering but weren’t able to retrieve any details.
Wirwille ended up being an hour late to her bridal shower, but she was welcomed with open arms and applauded for her heroic actions. She didn’t regret being late to her shower; she was simply humbled by the experience and happy she was able to help somebody through an emergency situation.
Earlier this month, the Texas A&M Health and Science Center held an event called Disaster Day, a mass casualty simulation to help prepare nursing students and other health science students for their future careers. The simulation was held in a gymnasium filled with approximately 400 volunteer victims affected by a tornado that touched down near Houston.
Matt Ward, a student leader for Disaster Day, tells TheBatt.com, “We have the largest simulation in the nation for running a disaster day. We have college of nursing, medicine, pharmacy, veterinary staff and biomedical sciences all here today. It’s important to get all of those communities together, because we have over 300 students on staff to help the patients that are here.”
As approximately 300 students entered the gymnasium, they were instructed to mark victims with green (not critical), yellow (need care), red (critical), or black (deceased) triage tags to determine their necessary level of care. The students were faced with a number of simulated emergencies from birthing mothers and mentally ill victims to lacerations, broken bones, and tree branches lodged in bodies. Simulation conditions included that all nearby hospitals were at full capacity so all medical work had to be completed on site.
College of Nursing Assistant Professor Alison Pittman tells TheBatt.com, “There are two nurses assigned to each row in the disaster and there is one provider assigned to each row. So they gave to triage their patients and decide who needs to be treated first, second, third.” The simulation provided an opportunity for students to experience a fast-paced emergency situation to prepare for potential catastrophes they might experience in their medical career.
To learn more about Texas A&M’s Disaster Day mass casualty simulation training, visit here.
Below, I interview Erin Sullivan, BSN, RN, CEN, about her experiences in critical care. She recently switched her specialty from the emergency nursing to intensive care, and shares her reflections, challenges, and some advice.
What is your background in nursing?
I graduated as a second degree nursing student from George Washington University in 2014. I was a new graduate nurse in the emergency department (ED) for about two years before I switched to the MICU (medical intensive care unit) in March 2016.
When did you decide to change specialty, and why?
I decided to switch to the ICU about 18 months into working in the ED. At the time, I was considering applying to some graduate school programs that required ICU experience as a prerequisite, so I made the switch to broaden my experience and learn a new skill set.
What do you do now and what is your job/where?
I’m working in the MICU at Northwestern Memorial Hospital in Chicago. I also still work per diem in an ED.
What was challenging about the transition to the ICU?
The biggest challenge I had in transitioning from emergency nursing to the ICU was learning how to think like an ICU nurse. There are jokes in nursing that the two types of nurses are “wired differently.” In the ED, the goal is to quickly assess, diagnose, and stabilize patients, and then to move them out to an appropriate level of care as soon as possible. In the ICU, the goals for the patient are more long term, and you have to consider a bigger picture and a larger scope than I would in the ED. It’s a completely different way of thinking, organizing, and prioritizing patient care.
What do you miss most from ER nursing?
The thing I miss most about the ED is the teamwork. I don’t know that I can quite explain the team aspect of ER nursing to someone who’s never experienced it, but there is a special camaraderie that forms between all of your coworkers. Whether it’s one of the best shifts or the worst shift ever, your fellow coworkers join together to make sure we all come out on the other side. I also miss the organized chaos that is the ED, and the anticipation of never knowing what is coming through the door next.
What do you enjoy most about the ICU?
Being in the ICU, I really enjoy being able to watch a patient progress from being critically ill to becoming well enough to leave the unit. Unlike the ED, many times you have a patient three or four shifts in a row, so you can get to know the patients in a way I never got to in the ED.
What do you want to do with your nursing career moving forward?
I’m not sure what the next step is in my career. One of the reasons I chose nursing was because there are so many different options in what you can do. For now, I’m enjoying working in the MICU and picking up in the ED every now and again to get my adrenaline fix. I’m fairly certain though that I’ll find myself back in school pursuing a graduate degree in nursing at some point.
What tips or advice do you have for someone who wants to change their specialty?
My biggest advice for anyone considering switching their specialty is just to do it. As nurses we learn new things everyday, and we shouldn’t be intimidated or scared of the challenges that come with switching specialties!
That said, do your research. Can you handle the stress of a new job right now? Are you adaptable and a quick learner? Do you get along well with new people? These are all considerations before jumping into a new specialty. For me, I was still within the broader scope of critical care. If you’re completely changing specialties, from adults to pediatrics, or from med-surg to labor and delivery, make sure you talk to people who are in that field and that it seems like the right fit for you. But remember, you can always go back!
“Are you crazy?” This was the response—replete with an equally stunned face—I got when telling people that I was thinking of taking a new graduate emergency department nurse residency. “Um, I guess so,” was my pathetic shy response. Inevitably, second guessing ensued.
Nothing about the ER is easy. Now, I would venture to say nothing about any kind of department or nursing is easy. I remember watching the TV show ER as a kid. I always kind of imagined the TV show…“ER.” Cue theme music. Cue fast screens of each actor looking serious, looking concerned, looking medical-ly. Wait. Where is sexy George Clooney with medication on hand, and that stethoscope placed precariously, but oh so perfectly around his neck? Nope. Not here. I’ve looked. No Clooney, no Noah Wyle.
I can remember it vividly. The moment I decided to tackle nursing. I had been sitting next to an elderly blind woman. I was a volunteer in the ED, the lowest on the food chain, and unbearably shy and awkward. I was asked to help feed this woman her meal. I approached the curtain, and with a feeble, “hello?” I walked in with trepidation. The woman was as sweet as she could be, with a southern accent and manners to match. She asked, “Well, hello there…Do ya have my Jello?” With this I felt at ease, and with a smile I sat down next to her and proceeded to have a long conversation about Jello, Southern food, and the smooth moves of James Brown.
I would not change my choice for the world, and working in the emergency department has been the most rewarding, challenging, and enlightening experience of my life. And, without a doubt, I have learned some of the most about nursing and myself during trying times and harrowing situations.
This brings me to Room 20.
We have all heard it. The stories, those patients that stay with you the rest of your career. The ones you never forget…you can be anywhere, doing anything, and BAM! An immediate recollection of the event. It is like a memory frozen in time that is destined to stay with you the rest of your life. I must admit I had not had mine yet. As a busy, task-oriented new graduate nurse with spankin’ new scrubs on (and a shiny pen light to boot) I was unaware of the fateful day I would encounter my moment. But then again, who is really ready when that moment strikes?
I was on top of things this day, I had my rooms prepped, my monitors ready for whatever may befall me. I looked over to the charge nurse desk, and saw a patient on a stretcher. Oh lord, I thought to myself, this one looks like a challenge. He was talking, more mumbling, and at first glance anyone could have mistaken him for just another guy who had had too good a time out on the town. Boy, was I wrong. “Put him in that room, room 20.” They were pointing to my assigned room. My breath quickened, I picked up my pace, and I steadied myself for my new patient.
“He’s responding, but just barely.” I looked at him; he looked like someone in crisis, not at all as he first appeared by the charge nurse desk. And I knew then we had to work quickly before he deteriorated even more. “I’m starting IV access.” My hands fumbling, shaking, I tried to keep his hand steady. I missed. The other nurse missed. Another nurse and a nursing assistant were getting the patient on the monitor and performing all other duties. I called for the code cart. “We need IV access…And quick.”
“I know,” I exclaimed, attempting to keep my calm despite a steady surge of butterflies and terror creeping up on me.
“Hey,” the other nurse looked me squarely in the eye and said one of the most haunting things I have ever heard. It was not so much what he said, but the way in which he said it that really struck home. “This guy is going to die.” I swallowed hard. This stirred in me more fight than anything. The attending physician and respiratory therapy were at bedside as we furiously wheeled him into the trauma bay. Multiple rounds of epinephrine, a failed pericardiocentesis, a chest tube, you name it. We couldn’t save him. In the end, we all settled on a brain bleed. The ultimate diagnosis: fatal and sudden bursting bilateral cerebral aneurysms.
Despite knowing we did everything we could—we worked as a team, we poured sweat and tears into this case—it was not enough. Perhaps his fate was sealed before he entered our ER. But, I still recall staring at his lifeless hands, hands that one time held coffee, high-fived a friend. He was in his 20s. I cried all the way home. Like a baby. The stress of the whole day just releasing into my steering wheel.
As a new graduate nurse in such a demanding environment, with equally demanding patients and tasks, I learned I can never get used to seeing a dead body. But I also learned I never want to get used to it. I try and treat every patient with as much respect and dignity as possible, and more often than not I choose to not know the backstory unless necessary. Death in an emergent setting can be harrowing, but there can also be moments of calm sadness, if not even serenity.
What Can a New Grad Do?
1. Breathe. My biggest advice: BREATHE. Really, you would be amazed at what an inhale and exhale can do for one’s nerves and clarity of thought. In retrospect, I know that as a new graduate nurse just the simple task of breathing in such stressful situations is immeasurably beneficial.
2. Decompress. Does nursing school prepare you for all of this? No. I say a silent prayer for each zipping of a body bag. It is hard to tell others of such morbidity, and to this end, self-care and decompression at the end of the day is both healthy and necessary.
3. Reflect. I think back to that situation often, and realize, more than anything, the worth of reflection in clinical practice—for improvement, for your own sanity. I personally like fitness or long walks, but it should be something fulfilling for both your body and soul.
4. Forgive Yourself. Fast, critical thinking is needed, split-second task performance, and impeccable teamwork. Will this always happen? Hopefully so, but honestly and unfortunately, it isn’t always possible. If this is the case, then learn to forgive yourself, and know that all your heart, effort, and knowledge were put into the case. After all, nursing is both an art and a science. And taking care of others is one of the most beautiful of arts.
And still, at the end of the day, I make sure to always try and reflect on two pivotal questions: Am I happy? Am I a good person? What are your answers? I know that as a nurse I am happy, and I know that I strive every day to be the best person I can be—for my patients, for their families, for my coworkers. As for the art that keeps on giving? Maybe it can be said that nurses are medicine’s Monets.
Below, I interview Lt. Meg Whelpley, a nurse practitioner (NP) with the National Heart, Lung, and Blood Institute (NHLBI) on the Cardiology Consult Service at the National Institutes of Health (NIH). She tells us about her career as a bedside nurse, a travel nurse, an NP, and now as an officer in the Commissioned Corps of the US Public Health Service.
Tell me about your background.
I got my bachelor of science in nursing in 2005 from Johns Hopkins University. My first degree, however, was in information technology, and I worked for the federal government before deciding that I needed to go into nursing. I have worked in both adult and pediatric emergency departments (ED), the intensive care unit (ICU), and I now work in cardiology.
What was your first nursing job?
My first job as a nurse was in the ED at Inova Fairfax Hospital, a level-one trauma center in Fairfax, Virginia. It was wild and fun, and the teamwork was outstanding. It was an amazing introduction to nursing and medicine, and I am grateful each day that I started my career there. The challenges of that environment were innumerable, and the lessons I learned continue to impact my daily life, both personally and professionally.
What did you do next?
As can frequently happen in an ED, there was a mass staff exodus when I had been at Inova Fairfax for almost two years. Travel nurses were hired to fill open nursing positions. The new travelers told me about the glory of the travel nurse life, and I was single and ready for a change.
Where was your first travel assignment?
My first stop was a tiny rural hospital on the Eastern Shore of Maryland. They had fewer beds in their entire hospital than we had in the ED at Fairfax! It was a huge eye opener. In only my second week there, I was made charge nurse of the ED four nights a week. The manager told me I had more experience than any of her night nurses despite having less time actually at the bedside.
Being a charge nurse must have been a great leadership experience for you. Where did you go for your next assignments?
My next adventure was to was Denver, in a pediatric ED. I was nervous about taking care of kids, but I had a great time and loved the work. I was there for nine months before heading to Chicago. There, I was in the ED of a level-one trauma center, and again was part of a great team, but the work was tough. Inner city Chicago was very different from suburban northern Virginia. I was there for the last six months of 2008 when the financial markets crashed. The effect was definitely felt in travel nursing. I was thrilled to be asked to come back to Denver and returned there for a three-month contract in January of 2009. I was then offered a position there as a staff nurse, and I took it while I worked on taking the next steps to pursue my master’s degree.
What led you back to school for your advanced practice degree?
I really liked the idea of participating in patient care at a higher level. As a bedside nurse in the ED, most of the physicians I worked with appreciated my assessments, and they challenged me to think further about possible differential diagnoses. They were wonderful teachers. I wanted to focus more on diagnosing and treating patients, and I really believe in both the art and science of nursing, so becoming an NP was the clear choice for me.
Where did you start working after you were a CRNP (certified registered nurse practitioner)?
My first job was in the ICU at Inova Fairfax. I loved the work, but the schedule was really challenging. We rotated days and nights, and I even worked a few 24-hour shifts as needed. It was harder than any schedule I had as a nurse in the previous seven years! I quickly found a new position with the cardiology service at MedStar Washington Hospital Center in the District of Columbia, and I stayed there for two years. It was a great place to learn, and we had a great team of NPs. It was a very autonomous NP service, which was professionally satisfying. I had the opportunity to return to federal service with a position at NIH in 2013, and I jumped at the chance!
Do you remember when you first heard about the United States Public Health Service (PHS)? What drew you to this organization?
My first encounter with the PHS Commissioned Corps was at a job fair at Hopkins during my nursing undergrad. I was reintroduced to the service when I took my position at NIH—many of the people that work here are Commissioned Corps officers. I had always been interested in serving. You could say it’s in my blood: My brother was in the Marine Corps, my father spent his entire career as a civil servant, and my mother worked as a priest and social worker. Of course, my husband’s service in the fire department was also a big influence on my decision to serve. We hope to instill the value of service in our son, as well.
The idea of being a part of a group dedicated to “protecting, promoting and advancing the health and safety of the nation” was very appealing to me. I had looked at other branches of service a few times through my years of education, but the fit with the PHS was definitely right for me.
What did it take for you to become a lieutenant in the PHS?
There is a multi-step application process (detailed at www.usphs.gov) that requires that you obtain employment in a federally qualified position prior to commissioning. My position with the NIH qualified, but many other positions are available throughout the federal government, and you can begin the PHS application process before securing a qualified position. We work in the Bureau of Prisons, the Indian Health Service, the Centers for Disease Control, and the Federal Drug Administration, to name a few agencies. Once you receive your call to active duty, there is a required two-week Officer Basic Course as a part of the commissioning process, and then it’s time to get to work.
Where do you work? What is your role? What is a “day in the life” like for you in your current position?
I am currently an NP with the National Heart, Lung, and Blood Institute on the Cardiology Consult Service at NIH. I work with a team to evaluate patients enrolled in any number of research protocols there. We see patients before, during, and after their participation in research, depending on their cardiac history and needs. I get to spend a lot of time educating and learning, with both my patients and the students that round with us. It is a very rewarding job. I wear my uniform every day with pride.
What responsibilities do you have with the PHS?
As an officer in the Commissioned Corps, I have added responsibilities with the PHS, which include working with the Capital Area Provider (CAP) team in support of the Office of the Attending. My CAP team duties also include local deployments to act as medical support for mass gatherings throughout the District of Columbia. Additionally, I volunteer with the MobileMed-NIH Heart Clinic, which is an organization that provides cardiac evaluations for underserved citizens of Montgomery County, Maryland.
What is most challenging about your job?
Understanding the complex diagnoses of my patients in addition to the proposed treatments and their cardiac implications is a challenge every day! We see some amazing things at NIH, and almost none of it is straightforward. I have been here three years and not a day has gone by that I haven’t learned something new.
What type of person would be good in this role?
I think that my success in this job has come from my strong foundation and training in the art and science of nursing. Caring is an art form, and it is essential in developing relationships with patients and the teams with which we consult. Science requires focusing on details and critical thinking about patients to ensure the best outcomes possible. The type of nurse that would be good in this role needs to be a caring, detail-oriented, critical thinker—oh, and I write patient reports constantly, so good written communication is a must!
What is most rewarding about your work?
Patients here are very appreciative of their care. Because they are participating in research, there is no charge for the care they receive, which makes people really grateful. Grateful patients are refreshing for me, as that was not always the case in the other places I have worked. I also get to take my time with patients. I can really help them better understand their own hearts and how to best care for themselves. Education is an amazing gift to give to patients, and empowering them in their own care is very rewarding.