AACN News—October 2005—Opinions

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Vol. 22, No. 10, OCTOBER 2005

President's Note
Engage and Transform
We Are There for the Long Haul

By Debbie Brinker, RN, MSN, CCRN, CCNS
President, AACN

I sure wish I had a crystal ball. You see, I’m writing this note less than two weeks after Hurricane Katrina reduced New Orleans and much of the Gulf Coast to rubble. With a crystal ball, perhaps I could foresee the many ways in which we and our colleagues will remain engaged by the disaster’s far-reaching impact. Yet, even without a crystal ball, our likely response will be reliably predictable.

We Engage Instantly
Critical care nurses are like that. We engage instantly. Then we remain engaged for the long haul. Some of us are drawn by the immediacy of response. “The heart stopped,” we say. “Gotta get it started!” If we’re on scene, we report to work, sometimes bringing along family members to ensure their safety. That’s what Donald Meyer did when, as a single parent, he brought his 14-year-old son to the New Orleans hospital where he worked until they evacuated to Baton Rouge several days later.

If we’re at a distance, we don’t hesitate to assist as part of a Federal Emergency Management Agency Disaster Medical Assistance Team deployed to a field unit in Biloxi, Miss., as AACN Region 18 Chapter Adviser Katie Schatz from Spokane, Wash., was. Or, like nurse practitioner scholarship recipient Kiersten Henry from the University of Maryland, we work at a Baton Rouge field hospital before providing care to police officers in New Orleans’ French Quarter. Sometimes we become frustrated if our window of availability is limited and we’re not called to duty as quickly as we’d like. We might even post urgent messages on an online listserv, then jump in our car and drive.

All of these immediate responses paid off, as the CEO of Tulane Hospital poignantly described:

By the end of the day we had moved all but … one artificial heart assist device patient, which was the challenge of the week, since the device itself weighed more than 500 lbs. So, imagine hauling this weight three to four floors down a dark stairwell at 90-plus degrees … Let me tell you that the coordination for the patient’s room to the staging area to the helipad into the helicopter was a work of art composed of many painters. It truly was a thing of beauty, and it touched everyone who was there.

Then There’s the Long Haul
Those might be immediate responses. Then there’s the long haul. That is where we truly shine, often without noticing, though it is what we’re most familiar with. Think about it. Once the heart is restarted and the emergency passes, everyone else goes away to do other work. We have engaged, and we stay. We stabilize a patient, monitor endless streams of data and are vigilant for the most subtle cues. We explain and comfort his or her family. We expertly divine what may lie ahead and begin to prepare. New treatments. Transfers. Rehab. A care facility. Home. Perhaps a peaceful death.

Even without a crystal ball, the long haul for New Orleans and the Gulf Coast is crystal clear. It will be a time of rebirth and rehabilitation. A time of unparalleled opportunities to engage and support their transformation. Hopefully, you are well on your way. Maybe you stayed in town to cover for nurses in your unit who went to the coast. Your community may have welcomed Gulf Coast residents, offering them food, shelter and schools for their children. Like Alisa Shackleford and her spouse, you may have agreed to welcome a nurse and perfusionist from New Orleans into your home or help them to rebuild.

Perhaps, you’ve just renovated your unit or coordinated building a new one. What an extraordinary expert resource you could become. Not to mention the opportunity of transforming a unit’s work environment as part of the reopening. Healthy work environment standards become the norm. Achieving certification becomes valued and supported. Families return as team members instead of sometimes troublesome visitors.

As poet Mary Anne Radmacher says, “It takes vision to see an old thing in a new way. Innovation produces excitement! Have the courage to see merit and possibility in the new and boldly walk forward from what is known and familiar.”

The Inevitable Questions
Which brings us to questions that I know we have already begun to ask:

• Am I committed to staying on for the long haul?
• How will I personally engage to support the Gulf Coast’s transformation?
• Is it only about the Gulf Coast? How prepared would I and those around me be if faced with such a devastating situation?
• How will I support my unit, my hospital, my community to engage?
• Will my contribution entail staying where I am or traveling there? Maybe some of each?
• Have I done everything I can to ensure these are the optimal contributions each of us can make?
• How will I know the results?

An unnamed nurse waited in line for a bus after her New Orleans hospital was evacuated. Why did she stay? “I am a nurse,” she said on CNN, “and I stayed to take care of my patients. That is my duty. That is what I chose to do when I became a nurse. That’s what nurses do.”

That is why we will stay engaged for the long haul. It’s what we do. After all, engagement is not an event but a deliberate, enduring process.

And, about that crystal ball—who needs one when we have nurses?

For if we do not do this, who will?
—Robert F. Kennedy

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