VA nurse uses emergency response skills, on the fly

What happens if it's not in a clinical setting and you're cruising at 30,000 feet?

That's the situation a Milwaukee VA nurse found herself in while onboard an international United Airlines flight.

Alexandra Gillen is a registered nurse and currently serves as an administrative care coordinator for the Milwaukee VA. 

Seven hours into a flight from Frankfurt, Germany to Chicago she heard an overhead announcement requesting immediate assistance from a doctor, nurse or anyone with medical experience.

"I am well-versed in the unpredictable nature of medical emergencies … I always knew something like this could happen but you never expect it to actually happen to you," said Gillen.

Earlier at the airport Gillen had noticed a man who appeared to be coughing and sweating profusely while waiting for the airport shuttle bus. 

They were next to each other on the shuttle ride when the man said, "Thank God we're finally moving! I am in so much pain just standing here." 

While she followed him onto the same flight, Gillen recalled thinking "This guy probably shouldn't be here," and took note that he looked unwell as she made her way to her seat a few rows behind him. 

After hearing the overhead announcement, Gillen quickly unbuckled her seat belt and moved down the aisle towards the commotion. There she discovered that it was the same man she had noticed back at the airport. 

"I felt like I was in a rapid response –only this time, the stakes were sky high, literally," said Gillen. "It felt like a surreal, yet oddly familiar, flashback to the days I used to work in the hospital; my years of expertise as a medical-surgical nurse kicked in."

Gillen and the man recognized each other from the terminal, and she found out that his name was Ian.

While assessing him, a passenger from first class arrived at the scene – a dentist. While the dentist took over the assessment, Gillen asked the flight attendants for the fist aid kit so she could gather vital signs. 

Gillen noted that the passenger was not feverish and his vitals were stable. 

The information that Gillen and the dentist gathered was transcribed by the flight crew into their emergency response system.

At that point the patient shared some of his complex medical history and that he had PTSD. Gillen realized she was helping a Veteran. 

"I learned that the Veteran used to be in the Marine Corps and he currently resides in Charleston, South Carolina," said Gillen. "He had been visiting with his brother who lives in Ramstein."

The responding motley medical team gathered what was onboard and provided supportive care with the limited resources that they had.  They stayed with the ailing Veteran, providing comfort and reassurance that he was going to be okay.

Gillen shared with the Veteran that she was a VA nurse and she asked him if he received care through the VA.

He answered that he goes to the Charleston VA and that they take excellent care of him there.

"I was elated to hear he is receiving quality care from VA," said Gillen. "I encouraged him to follow up with his Primary Care Provider when he got home."

They continued to monitor the Veteran, his symptoms seemed to subside and he looked physically better by the end of the flight. At that point Gillen returned to her seat, the plane landed and the passengers applauded. 

"There was a collective feeling of relief and joy felt amongst everyone onboard," said Gillen. 

Paramedics quickly arrived and removed the Veteran. That was the last she saw of him. 

Gillen expressed being a little curious as to how things worked out for the Veteran and whether he is OK now. 

"This flight gave me more than just miles," said Gillen. "It reminded me why I chose this profession, why I still choose to be a nurse, and why I love caring for Veterans. 

Rapid response Nurses at Milwaukee VA Medical Center serve as a resource to the entire organization, sharing their critical care expertise and knowledge hospital-wide through proactive rounding and surveillance for early detection of patient change-in-condition.

Early recognition and interventions like this are proven to improve patient outcomes.

"My interaction with Ian wasn’t just another patient encounter," said Gillen. "It was a profound reminder that underscores the human element of being a nurse, no matter the location."