Many nurses can’t wait to experience the urgency and pace of a trauma unit, but what is it really like to work on one? Marissa Kesse (Nu ’23), a BSN student at the University of Pennsylvania School of Nursing, shares her clinicals experience.
I was so excited to have been placed on the trauma unit: emergent gunshot wounds, groups of nurses on top of a patient performing CPR, code reds, blues, and greens. To me, trauma held the glitz and glam of nursing.
The first day, however, was quite underwhelming. It consisted of us students feeling as though we were hounding our nurses searching for something to see, but the nurses telling us there just didn’t happen to be much happening on that day.
“Granted, my expectations did stem from shows like Grey’s Anatomy—which should have been my first red flag….”
We, the nursing students, sat soberly as a group working on our 20-page care plans for our patients, feeling sad and what we thought was boredom. We were surprised when nurses would come to join us by the computer to work on their own charting, and they would express their thankfulness for an unusually nice, slow day.
Some of my fellow classmates began to agree, but I knew exactly what I had planned to see on the trauma unit and that’s what I was still waiting on. Granted, my expectations did stem from shows like Grey’s Anatomy—which should have been my first red flag….
The next week I certainly found what I thought I was looking for. The first patient I saw was a young boy involved in a gang-related shooting, having received multiple gunshots to the chest.
Before we entered my nurse gave me a warning that the patient was young, to make sure I was prepared- with which I quickly brushed her off and asserted I was ready. In my mind, this was exactly what I had been waiting for; indeed, the patient was a bit young but I reassured myself this would soon be an everyday thing.
When we entered, the patient had two chest tubes with multiple extended suture sites from the many surgeries he underwent. We were going in for our morning rounds which meant we would be checking the chest tube drainage and sites underneath the bandages, and performing some wound care.
“It felt as though every time the nurse adjusted the tube in his chest, there was a 32 Fr tube going through my own chest…”
As I saw the young boy churn from pain while trying to keep a brave face while we tried to perform care, it took everything within me to not cry. It felt as though every time the nurse adjusted the tube in his chest, there was a 32 Fr tube going through my own chest and, it was the sadness of the entire situation that made it the most unbearable feeling.
I love to volunteer my time at the local West Philly elementary schools and high schools. Looking at the young 16-year-old boy, I could imagine how easily that could have been any of my students. And, more times than not it would not even be their fault.
As I walk through the local schools that feel and look almost like a prison, I see how much more funding these schools need in order to provide their bright students with what they deserve.
I work in the school libraries with a team from Penn, as the School District of Philadelphia had to fire their entire librarian staff years ago due to a lack in funding. I can see how easy at times it may be to fall right through the cracks as young, impressionable boys and girls; how easy at times it may be to cling to an “out” in a hard life.
“My view of trauma has changed quite a bit.”
My view of trauma has changed quite a bit. I find trauma to be a sad place as many of the patients there were going about their day when someone else made a mistake that completely turned their life over.
My second patient, a hardy construction worker, was involved in a massive car accident that left him in a coma for weeks and now can barely stand during physical therapy without his heart rate, blood pressure, and respiratory rate skyrocketing.
Despite this, I was still so impressed with how much optimism and hope the man had. He was so engaged with his care, sharing how he watched all his surgical operations on YouTube to understand what had been done. The patient always had a hearty spirit with the medical team and continued to push himself to do his very best during physical therapy sessions.
As I shared my reflection, a seasoned nurse reminded me that these new feelings I was experiencing are normal and natural. These feelings were what would make me “a good nurse.”
My short time on the trauma unit has taught me more about how to maneuver being a nurse than any nursing semester I have ever had, and I am so thankful for it.
I look forward to seeing what my clinical journey will continue to show me about myself. Next stop… the cardiac unit.
(If you are a University of Pennsylvania nursing student, you can submit your own story here.)
“Since I was in, I think, about 4th or 5th grade I knew I wanted to be a nurse,” says Brittany Wilborn, RN. It took the mother of five nearly a decade, but Wilborn, our Nurse of the Week, knows how to persevere and how to pace herself. She has cleared the many obstacles in her path, developed an arsenal of leadership skills, and is steadily amassing a collection of nursing credentials. Over the past 10 years, she progressed from a CNA to an LPN, then an ADN RN. Before the ink had dried on her RN, she had gone on to enroll in a BSN program. And after that? She plans to become an FNP.
Wilborn’s nursing aspirations were born early in life. As a child in Galesburg, Illinois, when Brittany went to see her pediatrician, it was not the doctor, but the nurse who attracted the little girl’s rapt admiration. The APRN-to-be recalls, “I thought she was so pretty, and she was professional. The way she approached me and treated me, made me feel better about myself and the situation. That’s when I knew that I wanted to be a nurse.”
But she had a lot of living to experience first. After Wilborn graduated from high school in 2010, she enrolled at Carl Sandberg College to begin her studies and earn her CNA credentials. However, life had other plans for her. Brittany became pregnant and soon dropped out to give birth to twin boys. (Twin boys have a talent for stopping all sorts of things). For the next few years, she focused on mothering the boys through their Terrible Twos and had two more children. Looking back, Wilborn thinks she needed to do some growing up herself first. “Now I feel like it [dropping out of college] was an excuse that I was making,” she said, and added, “And I think it’s one that a lot of us, as parents, make. ‘Oh, the kids, oh the kids!” After giving birth to child number four, though, she decided it was time to move fully into independent adulthood and pursue that nursing career: “2014 is when my journey really began to take off. I became a CNA, started working, got an apartment, and moved out of my mom’s house….”
After earning her CNA, Brittany went on to complete Sandburg’s Licensed Practical Nursing program in 2018. However, as a woman of color she had been subject to so many non-criminal law enforcement encounters that the NCLEX-PN criminal background check was deeply intimidating. Anxious and overwhelmed, she went no further until Covid and an insightful instructor pushed her forward. While Wilborn was working as a CNA at the height of the pandemic, the nurse she was assisting told her, “I don’t know why you won’t be a nurse. Why won’t you take your boards?’ Then, Stacy Bainter, MSN, a Sandburg nursing faculty member, also urged her to go ahead. “I realized that [your history] doesn’t define who you are and what you’re capable of,” Wilborn says. And, with a conscientiousness typical of good nurses, she thought, “If (Bainter) believed in me and Sandburg believed in me to give me this degree, I owe it to them to at least apply for my nursing license and put it to use.” She also began to flex her leadership skills (valuable not only for nurses but to any mother of twin boys). Brittany joined Sandburg’s Black Student Association, became a student trustee for Sandburg’s Board of Trustees, and was selected as chairperson for the Illinois Community College Board’s Student Advisory Committee.
Today, Wilborn has five kids and a growing collection of degrees and certifications. She is now an RN with an associate’s degree (ADN), but that is just the beginning. Wilborn is pursuing her BSN now at a joint Sandburg/Chamberlain College program, and after that plans to enroll in the FNP program at Chamberlain College. If there are more obstacles ahead, Wilborn will find her way around them: “It’s necessary for me to keep going because I know that I can. It’s necessary because I feel like I shouldn’t limit myself. For some people, the ceiling, that’s their limit. And for others, the ceiling is your bottom.”
For more on Brittany Wilborn, RN, see her interview with local TV station KWQC.
It is not unusual for nursing and other healthcare professions to run in the family, but sometimes the connections that lead a new generation into nursing can be almost eerie.
Tara Wood, DNP, CRNP, NNP-BC was a NICU nurse when she gave birth to twins Jade and Taylor England. Her newborns weighed less than two pounds and spent their first 87 days in a NICU. At some point, it seems to have been written that at least one daughter was destined to return one day.
“We had central lines,” says Jade England, who is completing her BSN degree at the University of Alabama Birmingham School of Nursing. Both sisters have a permanent souvenir of the constant care they needed from birth: “We still have that scar from where they were placed. It’s just crazy to see that we have actual proof of what we’ve been through.”
That scar is the only physical reminder of their journey. England knows how lucky they are to not have any complications from being born prematurely. Growing up, she saw the pictures of their tiny bodies covered in sensors and tubes. When she decided to become a nurse, she knew she had to return to where her story started—the NICU.
“You have to have compassion for those babies. You just have to be called to do that,” England said. “I want to be able to be that nurse to let the parents know that I was in their child’s place. I just want to provide the best care possible and hopefully sharing my story will make a difference in their stay in the NICU. I don’t want to give them false hope, but I also want them to know that miracles happen.”
“She literally walked me around the entire unit and was telling everybody, ‘this is my baby, I took care of her and her sister.’”
Jade England graduated in April and now works at UAB Hospital in the Regional Neonatal Intensive Care Unit. Her mother, Tara Wood – who is a member of the faculty at UABSON hopes her daughter will be able to give families the comfort she remembered needing.
“They’re going to be told all the bad, but when you can see a living example of success, I think it’s going to be amazing. I can’t wait to see what she does,” Wood said.
England will be working with one of the nurse practitioners who cared for her at the hospital where she was born. During her clinical at UAB, they made the connection.
“She literally walked me around the entire unit and was telling everybody, ‘this is my baby, I took care of her and her sister,’” England said.
“I think I found healing by helping others.”
Wood remembers not being able to hold her children for months. During that time, her lifeline to her girls was the nurses and nurse practitioners.
“My world was rocked,” Wood said. “My babies were really sick. Both of the girls were on the ventilator for weeks. Their organs were premature, and you’re faced with all the things that can go wrong. Just knowing that every minute mattered, it really put you in a constant state of terror and panic, of not really knowing how your babies are going to survive, much less thrive.”
She had planned on becoming a teacher, but the twins’ experience in the hospital changed her life. She realized she wanted to be a nurse so she could care for other families.
After working as a NICU nurse, Wood earned her Master of Science (MSN) in Nursing and Doctor of Nursing Practice (DNP) from the UAB School of Nursing. The journey came full circle for her as well. She’s now an Assistant Professor at the School and the Coordinator for the Neonatal Nurse Practitioner Specialty Track, teaching and preparing nurses to care for infants and families.
“Being a NICU mom 22 years ago we didn’t really talk about post-traumatic stress disorder and things like that that really lingered. I think I found healing by helping others,” Wood said.
Taylor England, Jade’s twin sister, also graduated from UAB this spring with a major in psychology with a minor in legal affairs and a certificate in mental health.
Jade wants to follow in her mother’s footsteps and plans to return to school next year to start the Post-BSN to DNP Nurse Practitioner Pathway to earn her Doctor of Nursing Practice degree. One day, she hopes to teach alongside her mom.
“I’m a proud mom and I want to share them with the world because I think that they were born to do great things,” their mother says. “They have servants’ hearts, and they want to help and do good.”
Flight nurse Morgan Hand, BS, RN is never in the same place for too long.
Her employer is Sanford AirMed, and she calls Fargo, North Dakota home, but when Hand clocks in each day, she never knows where her shift will take her.
“One of my very first flights, we actually had to fly all the way out to the Montana border, and then fly that patient all the way to Rochester. It was basically a really big triangle. I want to say maybe seven, eight hours.
“With (Sanford) AirMed, we could transfer anywhere within the United States. We even do transports to Canada if it’s necessary. We can go pretty much anywhere,” Hand explained.
And she’s gone pretty much anywhere, even escaping the wind-cutting-right-through-ya Midwest winters for a much more temperate climate.
Empowering other nurses across the globe
Hand returned from a working trip to Costa Rica on Feb. 19. It was part of Sanford World Clinic’s newly launched Global Nurse Mentor Program, aimed at impacting health care across the globe.
In this program, which was launched at the beginning of 2022, providers like Hand share their skills and experiences with international providers.
“Really what it’s designed to do is to take nurses within the Sanford system and mentor nurses throughout our different partnerships throughout the world,” Hand said.
Hand was sent to Hospital Metropolitano, a hospital in San José, Costa Rica.
“With my World Clinic mentor, my person who I work with directly in the World Clinics, we decided pretty early on that trying to empower nurses and looking at the culture was going to involve me going there right away,” she said.
Always looking to get better
Hand spoke highly of the already existing care at Hospital Metropolitano, saying, “their foundation is already there.”
She added the providers at Hospital Metropolitano keep their egos at the door and only focus on what’s best for the patient.
“A lot of the workers, whether it’s physicians or the nurses, they want to grow. They want Sanford’s help. So, that was really enlightening to see that they wanted me there. Even if you are the best health care in the world, you could still grow and learn,” she said.
Hand said it’s humbling that Hospital Metropolitano asked to partner with Sanford Health.
“A couple of their physicians have worked here in the United States. Their chief medical officer trained in the Twin Cities. So, he had known about Sanford. They saw that Sanford had grown and has done all these things with quality and safety, really helping them be one of the best. They saw that and said, ‘We want to take that in and be just like them,’” she said.
Hand will participate in the mentor program for the rest of 2022.
Reaching beyond Costa Rica
Initially, Hand was excited about growing health care in Costa Rica. Once she was there, she realized just how much of a reach Hospital Metropolitano has.
“There’s actually a lot of different patients that they serve from around the world. There was a patient there from Argentina. I got to talk to a family that was from Canada that actually had to have a procedure done while they were there.
“So, it’s not only impacting Costa Rica, but it’s truly impacting multiple countries around the world,” she said.
Hand said she considers the Global Nurse Mentorship Program a once-in-a-lifetime opportunity.
“I love that Sanford’s doing this. It’s a really good partnership. I think we all went into health care to help people get better. To do that on a global scale is something that honestly, I can’t really put into words.”
A common reason people return to college is to advance their education and their careers. It was the main reason for Jason Herman, BSN, RN, too. But he didn’t just advance in his career. He reached new heights — literally.
In 2018, Herman graduated from Edson College’s RN to BSN program. He was already a registered nurse, but in order to work at his desired hospital, he needed to earn a Bachelor of Science in nursing.
“After graduating from Edson College, I worked as a staff nurse in the emergency department at Augusta University Medical Center (AUMC), a Level I trauma center,” Herman said.
He continued pursuing his education, this time enrolling in a master’s degree program. It was during his time at AUMC that he learned they’d planned to start a helicopter emergency medical service program. He applied, and in 2021 was offered a position on the inaugural flight crew.
He’s since graduated with a Master of Science in nursing and had the opportunity to compete in a clinical challenge at the Air Medical Transport Conference.
“It’s a clinical-based interaction where teams of two respond to challenging situations that test clinical knowledge, critical thinking skills, teamwork, communication and situational awareness. We competed in the scene flight track against 25 other teams. My coworker and I placed first in the competition and were invited back this year to defend our title,” he said.
Herman recently spoke of his BSN journey, the impact it has had on him, and the importance of going after your dreams.
On the value of completing an RN to BSN degree program:
” [It] helped me achieve my current job by serving as a stepping stone in the path to further education. Without a BSN, I would not have qualified to work at Augusta University Medical Center, due to their pursuit to obtain magnet status, which requires nurses to be bachelor-prepared. My position at AUMC gave me the opportunity to become a flight nurse with the AirCare program.” [Aspiring flight nurses should check the Board of Certification for Emergency Nursing Certified Flight RN details].
A faculty member with experience as a military flight nurse helped Jason set his course:
In a history of nursing class, “My instructor was a flight nurse in the military during her active-duty career. She shared photos of flights she had taken and her work environment. This solidified my dream to become a flight nurse.”
On working full-time while enrolled in an RN to BSN program:
While it can be “difficult to work full time while being a full-time student,” Herman says, “the completion of the RN to BSN program will open doors for you that you never thought were possible.” One of the biggest challenges he faced was pursuing his BSN while his wife was in medical school. Herman recalls, “I was working full time as an emergency department staff nurse and going to school full time. Trying to provide for my family emotionally and financially while pursuing a bachelor’s degree was no easy task.” Fortunately, “ASU allowed me to obtain my degree while still having a manageable work-life balance.”
When Ingrid Johnson, DNP, MPP, RN, FAAN was an undergraduate, she wasn’t really sure if she was on the right path. At the time, she was pursuing a Bachelor of Science in nursing.
“I was ambivalent as a BSN student and early on questioned my decision to be a nurse as I wasn’t sure I really fit in the box of what a nurse was supposed to be,” Johnson said.
Pursuing a DNP presented Johnson with the usual stresses and challenges: she continued to work a full-time job throughout and juggled job, parenting, and school duties. She recalls, “One day, my youngest approached me and said, ‘Mom, we never see your eyes anymore. You are always studying or working.’ It knocked me off my feet and I realized I needed to figure out some different habits so I wouldn’t miss my kids’ lives.” But the experience was also a game-changer: “Now I have a job that didn’t even exist when I first became a nurse. More education is never bad. I am so pleased I didn’t stop learning.”
Johnson, who is the president and CEO of the Colorado Center for Nursing Excellence, continued to work full-time at the center (though in a different role) during her time in the DNP Innovation Leadership program.
Her DNP project was focused on growing programs for advanced practice registered nurses in rural areas. Johnson’s passion for that work carried over to her day job after graduation. “I continued to work on that and brought in several million dollars of funding to support building APRNs in rural and underserved communities across Colorado,” she said. The United Health Foundation read my initial article on the project in Nursing Administration Quarterly and we have now expanded the project from an FNP focus to add PMHNPs.”
Even as she was promoted, Johnson remained committed to the program, and in 2021, she was inducted into the American Academy of Nursing on the power of that work.
Johnson has always understood the importance of lifelong learning for a nurse and sounds almost like a Greek philosopher when she says, “The real reason I sought a doctorate was that I knew education teaches us to think differently and ask different questions. One of the hardest realities for me was identifying that the more I learn, the more aware I am of how much more there is to learn.” Her DNP, she adds, “reminds me of that as I continue to learn new things from my staff and the world around me on a daily basis. It has been humbling and very gratifying.”
“We were not only permitted to think outside the box, we were also expected to do so and seek the evidence to support it.”
For herself, Johnson’s DNP journey helped her find her place as a nurse innovator. In her very first DNP course, “[Faculty members] Kathy Malloch and Tim Porter-O’Grady… pulled no punches and told us to think bigger, more creatively, and get out of our own way. I realized that in my whole career as a nurse and life as a student, we were told to follow the evidence and only do what we were told to do. Nurses follow evidence-based practice, so there was never the space to think outside the box. Now, we were in an innovation leadership program and we were not only permitted to think outside the box, but we were also expected to do so and seek the evidence to support it.”
To Johnson’s mind, “It was scary because over the years, I had been slapped down for not fitting the mold or for thinking of alternative ideas. When they told us that our job was to stop being a linear thinker and to find evidence around other less obvious solutions, it was incredibly freeing. I think we are born creative, and in an effort to learn evidence-based care and practice, we lose that, and often we are not permitted to find that side of ourselves again.”
The learning experience behind her DNP, Johnson remarks, also has made her a more perceptive nurse leader. Her doctoral work “opened my heart to look outside my own ideas and better listen and learn from those around me so we can innovate to support… I didn’t have the tools to really do that prior to this degree, but now I often have the right tools, and if I don’t have the right tools, I have the resources to figure out what tools I need and how to get them.”
What advice does she have for current and future DNP students? “Enjoy the process and embrace the reality that for the rest of your life, you will have more questions than answers … and that is OK. Stay curious. Remember that when you get feedback that doesn’t feel warranted, listen for what is true in the feedback. It can be your greatest gift. Even if only 2% of the negative feedback is correct, it may be exactly what you need. If you knew everything and did everything perfectly the first time out, you wouldn’t need to be there!”
Hand returned from a working trip to Costa Rica on Feb. 19. It was part of 
