"And there wasn't even a doctor there!"
May 3, 2005 -- Today Nicole Brodeur's column in the Seattle Times told the story of local ED nurse Joanne Endres, who, as the only health professional on a plane flight from Minneapolis, apparently saved the life of a man having a heart attack. The theme of the column, "Flying solo, nurse is enough," is that the public does not understand what nurses do, and it includes some excellent observations about that. The piece might have gone a bit deeper on how Ms. Endres actually helped the patient, but on the whole it's a commendable effort to highlight and remedy nursing invisibility.
Endres works at Evergreen Hospital Medical Center in Kirkland. According to the column, she responded when a flight attendant asked for help from anyone with health training. Endres spoke with the patient, who'd had bypass surgery and had a pacemaker, and gave him some of his nitroglycerin and an aspirin. She "did her best in the narrow, bumpy aisle with the plane's medical kit as the man fell in and out of consciousness." Others helped her start an IV, and she monitored the man's pulse. The plane returned to Minneapolis, the patient was carried off, and apparently we do not actually know the final result. It might have helped to hear a little more about how Endres' actions helped the man. We do know that the plane's passengers cheered as she returned to her seat, and that one marveled, "She just knew what to do...And there wasn't even a doctor there!"
Those comments bring us to the most interesting part of the column for us: its focus on public understanding of nursing. Brodeur leads the piece by noting that "Joanne Endres had gotten used to the bouts of burnout and the weary knowledge that people don't get what she does for a living." Apparently that has started to change, because after Endres got back from Minneapolis, she wrote an intense, detailed e-mail about her experience that has been widely circulated, and "[f]or the first time in years, people asked, really asked, what it was like to be a nurse." Her e-mail has reportedly spread to nursing schools, hospitals, and "others who need reminding of what nurses do." Charles Pilcher, an ED physician at Evergreen, sent the email to "his staff," along with this comment: "I guess the only way a nurse can get recognized for the truly quality work you all do is to do it when there's no one else around to take the credit," Pilcher wrote. "I bet Evergreen could run for several days even if none of the doctors showed up." (Yes, he did say that.) We could quibble with Brodeur's phrase "his staff;" since the text suggests Pilcher's message went to nurses, who report to nursing management, they presumably could not be considered "his staff."
Pilcher's comments are astute observations as to nursing's central role in hospital care, and about nursing invisibility--especially since, needless to say, the "no one else" taking credit is virtually always a physician. As it happens--irony alert!--Endres' e-mail explains that, at the insistence of a physician on the ground and despite her own better judgment, she gave the heart patient another nitro pill, which caused him to crash. Fortunately, Endres was able to stabilize him, in part through use of an "advanced kit"--which the plane crew is apparently supposed to save for physicians. No word on whether the physician on the ground has been taking credit for saving the patient.
Endres' powerful email is a great example of what nurses (and physicians like Pilcher) can do to remedy this invisibility. Of course, it's not in accord with what Suzanne Gordon has called the "virtue script," which dictates that nurses stay in the background and avoid taking credit for their work. But the "virtue script" seems more consistent with the profession's current crisis than with any real solution to that crisis. A comment Endres made, apparently to Brodeur, suggests that she is aware of the good that can come from accounts like hers: "If I am helping nurses feel validated and inspired again, I am thrilled."
The Center commends Nicole Brodeur and the Seattle Times for this column. Physician Charles Pilcher deserves credit for circulating Endres' email with his helpful comments. And we salute Joanne Endres for her work and for circulating her story widely, which not only helps burned-out nurses recharge, but also teaches the public what they do, which is critical to improving the working conditions that drive nursing burnout and threaten patients.
See the article "Flying solo, nurse is enough" by Nicole Brodeur in the May 3, 2005 edition of the Seattle Times. See the e-mail Joanne Endres wrote about her experience.