By Janice Petrella Lynch, MSN, RN
As 2015 comes to a close, we are grateful to the nurses who shared their beautiful stories of volunteerism and service with us. Celebrating nurse volunteers was this past year’s cover theme, and in every issue, we featured RNs who gave of their time and expertise in helping those in need across the globe and in their own communities. When you read their stories online at Nurse.com, we hope you were inspired by what they have accomplished and how they have touched the lives of so many.
You learned about the nurse who joined the fight against Ebola in West Africa, finding creative ways to bring a sense of childhood to her pediatric patients who had seen more death than most will see in a lifetime. You read about the RN who established the St. Agnes Nurses Center in 1999, which is the only parish-run primary care clinic in the Archdiocese of Philadelphia, and the retired nurse who created an organization that now provides food for more than 7,000 people a month in Arizona. You read about RNs who traveled by ship or plane to care for children and families in Haiti, Uganda and Madagascar, while other RNs helped families closer to home. We know these RNs represent all nurses throughout the U.S. who give selflessly to help others in need, and we thank them and you for helping to make our world a better place.
Hero in training
A nurse volunteer with New Jersey Task Force One Urban Search and Rescue Team prepares for disaster alongside firefighters
By Kathe M. Conlon, BSN, RN, CEM, MSHS
As an RN and community educator for The Burn Center at Saint Barnabas in Livingston, N.J., some of my professional responsibilities include training and educating firefighter and emergency medical services. In 1996, the New Jersey Office of Emergency Management was putting together a new urban search and rescue team that I was asked to join. I was honored and excited, but I didn’t see how I could possibly make much of a contribution. After all, I worked in a hospital setting, not on a rubble pile. I could care for patients, but I knew nothing about search and rescue efforts.
Modeled after national USAR teams, New Jersey Task Force One’s mission is to search for and rescue victims injured in a disaster. When buildings collapse, when flood waters wash out communities or when people find themselves stranded and in need of rescue, NJ-TF1 is there to help.
More than 200 members — mostly firefighters with expertise in structural collapse, confined space, trench or high-angle rope rescue, hazardous materials, canine and technical search — volunteer their time. The team has several components, each one based upon specific areas of expertise such as planning, logistics or communications. The health and welfare of team members and victims are the responsibility of the medical component, where I serve as senior nurse logistics, coordinating the medical and pharmaceutical cache.
Disaster often strikes without warning so team members are required to keep bags packed and ready to deploy at a moment’s notice. We must be self-sufficient. In addition to bringing any specialized equipment needed to locate and remove victims, we travel with our own food, water, housing (including tents, cots and showers) and medical supplies that should last for at least 72 hours.
Because of the complex and dangerous nature of search and rescue, NJ-TF1 continually trains and training must always be executed as if it were the real thing. The team uses a training field designed to replicate, as much as possible, many of the real world situations we are likely to encounter. A rubble pile soars several feet high, complete with tunnels and confined spaces. It is filled with sharp objects and broken concrete and debris, simulating a building collapse. A train car is tilted at a 45-degree angle as if it had just derailed, and plane fuselage and other hazards are scattered about. Training exercises include set-up and breakdown of a base camp, including a field hospital. Despite the precarious nature of this work, safety is always a priority, especially for the medical group.
Members are activated by pager, with up to two hours to respond from anywhere in the state. Upon arrival at our home base, medical specialists prescreen everyone, checking vital signs to establish a base line and evaluate overall health. Since this is a training exercise, the team deploys to our training field and simulates intelligence briefings, identifies potential hazards to consider where victims might be trapped, develops a course of action and begins operations. Once located, prestaged victims have to be stabilized and removed by rescue personnel, all under the watchful eyes of medical specialists. The team usually operates on two 12-hour shifts, with the first shift going to work upon arrival at an incident, while the second shift establishes a base of operations and gets some rest in preparation for the next shift.
One unique characteristic of NJ-TF1 is that medical and rescue teams train together. Unlike other teams, medical personnel actually accompany rescue squads into collapse zones. They work side by side to begin treatment, and then figure out the best way to remove victims from highly unstable environments without causing more injury. Sometimes the quickest way to get someone out may not be the best way medically. For example, lifting a piece of heavy concrete quickly frees a trapped victim; however, it simultaneously puts them at risk for crush injury, where a build-up of toxins floods the bloodstream once the weight is lifted. Even without these concerns, sometimes simply removing victims presents other challenges. The team must take into account intravenous lines, splints, cervical stabilization and oxygen therapy when pulling someone out of a small void. In addition to a strong clinical skill set, medical specialists must learn how to operate rescue tools and work while wearing self-contained breathing apparatus in compliance with federal requirements to enter and function in such hazardous environments.
When I first joined the task force, I was the only woman and nurse. Today, more than a third of the team is female, and there are several nurses who, along with physicians and paramedics, make up the 20-member medical component.
Often, I am asked why I volunteer and leave my family and my work on a moment’s notice, sleep in a tent and operate in austere environments under extremely precarious conditions to care for disaster victims. The answer is simple: It is an honor and a privilege to work with the courageous men and women of NJ-TF1, and to be able to make even the smallest difference in someone’s life at a time when they are most vulnerable and in need of help.
Kathe M. Conlon, BSN, RN, CEM, MSHS is director of Burn Programs at The Burn Center at Saint Barnabas in Livingston, N.J. She is a charter member of New Jersey Task Force One, serving as senior nurse logistics of the medical component.
More on New Jersey Task Force One:
Modeled after national USAR teams, the mission of the NJ-TF1 to provide advanced technical search and rescue capabilities to victims trapped or entombed in structurally collapsed buildings or injured in a disaster. NJ-TF1 members pledge to provide efficient and effective rescue technologies in a planned and measured response system that mirrors the Federal Emergency Management Agency’s guidelines on urban search and rescue and the appropriate National Fire Protection Association standards. The members of NJ-TF1 maintain their skills and abilities in technical rescue training that require deployments to natural or manmade disasters, hurricanes, floods, conflagrations, explosions, earthquakes or incidents involving weapons of mass destruction that are beyond the capability of local emergency services.
It’s a calling: Faith community nurses continue to serve after retirement
By Karen Long
At the end of her military nursing career, Irene Rich, PhD, MSN, RN, was going through a difficult time in her life. Her in-laws were receiving hospice care and living with her family. But that emotional experience was made easier by her church congregation’s caring overtures, such as cooking meals for the family or having a pastor come over to sit with them.“For the lowest part in our family’s lives, the church walked around us like angels,” she said.
That experience motivated Rich to become a Faith Community Nurse and give back at Messiah United Methodist Church. She’s one of five FCNs at the Springfield, Va., church where they perform weekly blood pressure clinics, health consultations, blood drives and cardiopulmonary resuscitation training. They even gave out bicycle helmets to promote safety. “It’s not all flu shots,” Rich said. “We reach out to the community in a lot of ways.”
The FCNs are drawn by the ability to bring their nursing into a church setting, to pray with patients and to form relationships with patients that are different than those of more traditional settings, Rich said.
Mary Keil, whose career in nursing was mostly in home healthcare, started the FCN program at Messiah in 2000 after being approached by the church’s senior pastor. Though Keil was unable to continue her volunteer duties after a stroke in 2004, the church now has five FCNs who have taken the two-week FCN training, plus another nurse Lois Blum, BSN, RN, who is a member of the health ministry nurses team.
They have nursing experience in various specialties including pediatrics, post-operative recovery, drug rehabilitation, orthopedics and public health. The diverse backgrounds allow the nurses to call on each other to support the congregation, said Patti O’Neill, BSN, RN. During her professional career, O’Neill looked at the whole patient, including faith, in the plan of care if the patient wanted it. During her professional career, O’Neill looked at the whole patient, including faith, in the plan of care if the patient wanted it.
Sara Kerestes, RN, BC, retired from Inova Health Systems in May 2013 after a 42-year career in nursing in which she worked in cardiology and behavioral health. Within 24 hours of retiring, Kerestes was asked by Jane Stottlemyer, RN, to become an FCN.
Part of the reason Kerestes retired was to spend more time at church since she often worked weekends as a nurse. Though she was ready to retire, she said she wasn’t quite ready to “hang up the stethoscope, so to speak,” so working as a nurse at the church was a good fit.
Stottlemyer always had dreamed of working with patients “mind, body and spirit,” she said.
“For me, it was always a calling,” said Kathy Willson, RN, a former Navy nurse who works in case management. “My faith goes with me wherever I go.”
Just as “our profession follows us,” so does their Christian faith, so putting nursing and her faith together made sense, O’Neill said.
The nurses provide educational programs on topics such as Alzheimer’s disease, transitional adjustments including downsizing to an assisted living facility, diabetes, heart disease, depression and anxiety. They also offer grief support and counseling, flu shots, blood pressure screenings and informal screenings when a member of the congregation pulls a nurse aside with a question.
The FCNs now have an office at the church, which gives them more privacy, and a locked cabinet to ensure they comply with HIPAA laws.
Parishioners often talk informally with the nurses, but when a member of the congregation needs help, a nurse will do a formal assessment and takes information to develop a plan of care, Rich said. The nurses also act as advocates. For example, a patient who receives a cancer diagnosis can ask an FCN to accompany him or her to the doctor’s appointment, listen to what the doctor advises and have the nurse take notes and go over the treatment plan.
Because a serious illness can cause a crisis in a parishioner’s spiritual life, the FCNs also pray with patients and give them devotionals that help, Rich said.
That extra service helps makes the nurses feel good that they are giving back.“I feel that I have a calling to do that,” Stottlemyer said. “It’s just where I should be.”
Karen Long is a freelance writer.
New nurse gets back to basics to help Haitian villagers
By Stefanie Dell’Aringa
Danielle Brown, RN, 28, has been a critical care nurse in the surgical ICU for only one year at Metropolitan Methodist Hospital in San Antonio. But being a new nurse aided her in Haiti when she served in June as part of a Hope Force International medical team in Sous Savanne. “I’m a very new nurse and, in a way, that’s to my benefit because I do remember the basics very well,” Brown said.
Without medical labs or equipment, the team had to rely on basics to treat about 150 patients per day in a church turned makeshift clinic. The team included Brown, a physician, a nurse practitioner, two other nurses, a nursing student and three nonmedical volunteers. All were driven by van to the church and greeted by long lines of people in search of adequate healthcare. “They didn’t have a hospital, lab work or testing,” Brown said. “We’d literally diagnose them based on symptoms. For instance, we’d diagnose a kidney infection by the color of the urine and location of the pain.”
Patients of all ages suffered from stomach aches and headaches, which Brown suspected were caused by dehydration. HFI built a well in 2003, but Brown said villagers did not know water is essential to survival. Many were treated with deworming pills and Tylenol.
During her weeklong stay, Brown saw cases of chronic hypertension, a woman with advanced breast cancer and an 8-month-old baby dying of starvation. “The baby was maybe four pounds and she ended up passing away that night after we saw her,” Brown said. “In that moment, I was seeing the poorest of the poor.”
Treating patients with chronic hypertension was challenging. “Some of these people had blood pressures in the 200s,” Brown said. “You can’t just give them blood pressure medication because if they don’t continue to take it, they can get worse.”
Brown noticed a common complaint among teens and patients in their early 20s, resulting from the national disasters they’d experienced. “I’d ask them what’s going on and they’d tell me they’re crazy,” Brown said. “I’d learn that what they had was anxiety or PTSD, but they didn’t know that this is an actual clinical problem. My heart went out to them.”
Brown grew up with parents who did mission work with HFI co-founders Jack and Cherie Minton. These people inspired her to serve others with compassionate care, so she was excited to accompany Jack Minton on the trip to Haiti. “When people are treated with respect and compassion, it penetrates cultural and linguistic barriers and speaks into the very being and heart of an individual,” Jack Minton, who serves as HFI president, said. “Dani looked people in the eyes, treated them with kindness and made each patient realize how truly special and valuable they are. She was a warm and reassuring presence to the team and the people we served.”
Brown also volunteered with Youth With a Mission, serving in the U.S., Poland, Ireland, Czech Republic and Mexico after graduating high school a year early. “While I was in Tijuana, we built houses for people in need and I also volunteered in an orphanage,” she said.
Becoming a nurse was her goal because she knew she could help in a greater way. “I really had the desire to have a skill I could use to help people,” Brown said. “My family has always said that you can never have too many tools in your toolbox.”
Brown plans to return to Haiti, hoping to one day lead medical teams with Hope Force as it continues to grow. “I see myself in the future wanting to be a big part of what they’re doing because 100% of my heart believes in it,” she said.
Stefanie Dell’Aringa is a freelance writer.
Find out more about Hope Force International at HopeForce.org.
Hooked on serving others: A CRNA gains as much as he gives while on mission trips
By Steve Gruendling, MS, APN, CRNA, and Valerie Simpson, MS, BA, EdS
The greatest thing about being a certified registered nurse anesthetist is that nothing about it is routine. On any given day, one can provide care to a 500-gram neonate, a trauma patient and an octogenarian with a hip fracture. Yet, a defining aspect in my practice has been volunteering for medical missions with Blanca’s House, a nonprofit organization based in Long Island, N.Y., that provides medical and surgical care to underserved populations in Central America and South America.
A friend and former clinical student had suggested volunteering with this nonprofit was something I would find rewarding, and that turned out to be an accurate guess because I was immediately hooked. Participating in medical missions has been the most professionally challenging and personally rewarding experience of my life. I am the Blanca’s House anesthesia services coordinator and have participated in 11 mission trips.
My dad, who has no medical experience, is a regular volunteer and an integral member of the team. Both of my children have participated in the Junior Volunteer Program and have visited orphanages and schools, as well as assisted in the provision of medical care on mission trips. Mission trips are truly humbling experiences for teenagers from the Jersey Shore.
On a medical mission trip, the anesthesia coordinator’s day is long and full of surprises. I usually work from 7 a.m. until 9 or 10 p.m. I often travel to our host facility with a small set-up team, prior to the larger team’s arrival, to begin negotiating for space. Upon the arrival of 60-80 volunteers, the host hospital typically is overwhelmed by the size and scope of what will be accomplished in four or five days.
We need the space to examine as many as 200 patients and to set up five operating tables, a recovery room and a place to admit patients overnight. Many of the host facilities will not operate on that many patients in a year.
We bring all the equipment and supplies needed for the mission — anesthesia machines, autoclaves, laparoscopy equipment, surgical instruments, sterile supplies, patient gowns, our own intranet system for electronic medical records and more. Inadequate electricity and oxygen supply, critical supplies lost in transit and equipment malfunctions all are problems that can arise. The cases can be very difficult, especially the pediatric cleft palate cases. The last volunteers don’t leave the hospital until the last patient leaves the recovery room and is safely admitted to the floor.
It seems every mission presents us with one patient who significantly pulls at our heartstrings. During my latest mission to Guayaquil, Ecuador, from Sept.13-20, we met Graciela, a delightful 5-year-old girl, and her mother and father, who were desperately looking for help. Graciela, has a vascular malformation that has consumed her tongue, cheeks and just about every interior oral structure. In all my years of experience, I had never seen anything so invasive. As we discussed the necessity for surgery, all I was focused on was how would she be intubated. The malformation was obstructing her airway more and more every day, and she can receive nourishment only from a liquid diet.
When I see medical anomalies so advanced on these missions, I realize if Graciela lived in the U.S. with access to medical care, the diagnosis and treatment would have occurred so much sooner and would not have advanced to a life-threatening disorder. There is a happy ending, though. Graciela was approved to travel to Long Island, N.Y., to receive the medical care she urgently needs. Imagine a little girl who will be given back her ability to eat, drink and talk.
Graciela was only one of more than 200 patients we screened for plastic and general surgery and we performed 173 procedures, including 83 surgeries, over four days.
I spend a lot of time fulfilling the anesthesia staffing requirements for mission trips. We require up to nine anesthesia providers per trip, and I am very privileged to have a large number of repeat volunteers who make up the core group.
Believing the future volunteers of Blanca’s House are today’s students, we encourage nurse anesthesia students to participate on missions. I also am always on the lookout for medical equipment, supplies, donations and most importantly, volunteers of all kinds. A charity is nothing without the people who support it. To all of my CRNA colleagues, please take the time to give back and volunteer, you will not regret it.
Steve Gruendling, MS, APN, CRNA, is a staff nurse anesthetist at Jersey Shore University Medical Center in Monmouth County, N.J., and is a clinical faculty member for Columbia University. Valerie Simpson, MS, BA, EdS, is co-executive director/marketing for Blanca’s House.
For more information about Blanca’s House, visit BlancasHouse.org.
To read more about Gruendling, visit the American Association of Nurse Anesthetists website at AANA.com and search “Gruendling” to see his article “A Day in the Life: Steve Gruendling.”
Pigs for Peace: RN finds loaning livestock can help families in the Congo rebuild their lives
By Karen Long
Nancy Glass, PhD, MPH, RN, FAAN, didn’t think the path to reducing poverty and improving health outcomes for families in the Democratic Republic of the Congo would come through the breeding and raising of pigs.
Glass, associate dean for research for the John Hopkins School of Nursing, spends four to six months a year in the Congo volunteering for Pigs for Peace, a livestock microfinance program she founded in 2008 that supplies impoverished women and men in the African country with pigs to breed and sell. “I never imagined myself as a pig farmer in Africa,” Glass said.
Glass’ work in Africa started when she was a Peace Corps volunteer in the 1990s in the country that then was called Zaire. Her work with nurses there prompted her to pursue a career in nursing.
After a civil war, she returned there in 2007 to identify the residents’ needs through interviews and by working with the community to determine a sustainable and effective solution to overcome poverty and violence.
Agriculture and raising livestock were the only real means of sustenance in the community, Glass said. Instead of providing money or giving humanitarian aid — which had frustrated the Congolese people because the model was unsustainable — she decided to supply pigs. “This isn’t a free pig. This is a loan,” Glass said. “We’re not a charity. We’re an organization that helps people rebuild their lives.”
A family member, usually a woman, takes responsibility for the 3-month-old female pig on loan. The program started with 10 families and $400 of her own money. The organization now has 1,500 families in 35 villages raising pigs, according to Glass. “In rural areas of the eastern Congo, there are extremely limited paid employment opportunities; for example there are no industries in the area we work,” she said. “The majority of families survive on farming and raising animals. Breeding animals and selling them at local markets is an important way to survive — and possibly gain wealth and status.”
Pigs for Peace provides vaccines for the pigs and education for the families on how to properly care for the animals, Glass said. Once the pig is 8 months old and can breed, the organization helps find a mate.
On average, pigs give birth to six piglets at a time and can breed twice a year. The family is required to return two piglets to the organization from the loaned pig’s first pregnancy — one to pay back the loan and one as interest — and then keeps the rest of the litter, Glass said. The family can keep all of the piglets from future pregnancies.
If the loaned pig dies before giving birth, the family still owes two pigs to the organization. “If we start making exceptions, the project collapses,” Glass said.
The project requires dedication not only on the part of the families, but also of Glass and other colleagues. It often takes a couple of rounds of breeding and selling the pigs for families to restart their lives. The organization also identifies farmers who need assistance. For example, if a farmer is sick at a hospital and can’t take care of the pig, he can work with the organization and neighbors to get help.
Glass sees the work as fun. “I have a very good time,” she said. “I love being in DRC. It feels like home to me.”
In 2012, a spinoff program of Pigs for Peace called Rabbits for Resilience was established for children ages 10-15. Youth in the program receive female rabbits who are 2-4 months old, and when the rabbit gives birth they repay the loan to the project in the form of two female rabbits. They can then sell the remaining rabbits of the litter, which families can then use to pay for school supplies and uniforms, for example, Glass said.
Karen Long is a freelance writer.
Editor’s Note: If you are thinking about volunteering, take a moment to check out the organizations our 2015 nurse volunteers chose to serve: International Medical Corps; Mane in Heaven; Operation Smile; St. Agnes Nurses Center, West Chester, Pa.; Antioch Consolidated Association for Youth and Family in Arkansas; One Nurse at a Time; Global Outreach Doctors; Camp I-Thonka-Chi, Meridian, Texas; Mercy Ships; Prevent Blindness, Northern California; Hope Force International; The Mango Project; Blanca’s House, Long Island, N.Y.; Pigs for Peace; Bucketts of Love; New Jersey Task Force One; and Healing the Children New Jersey.
Pictured at top are International Medical Corps volunteer Nick Merry, RN; Mercy Ships volunteer RNs and staff; and IMC volunteer Kevin Murphy, RN.
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