This month we are looking at critical care nursing. In this episode of the Nursing Notes Live podcast, I sit down with our Get to Know Nurse Steven Neher. Steven is a flight nurse and advanced practice RN. He’s also president of the Air and Surface Transport Nurses Association. I talk with Steven about his career in critical care and transport nursing, and also shared questions from current nursing students, as part of our “Ask A Nurse” portion of the podcast.
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Jamie Davis: Hi, Steve and welcome to Nursing Notes Live. It’s great to have you here on the show.
Steven Neher: Well, thank you for inviting me. I really appreciate it.
Jamie: So I always ask the same first question to everybody that I have on the show and that question is why did you want to become a nurse? What drew you to nursing care?
Steven: Well, probably back when I was in college, I took an EMT course. I’m a people-person. I always like to help people and probably just getting involved in that first EMT course is what kind of got me into medicine and nursing.
Jamie: What about your progression of your education? You obviously got your EMT certification and did that for a while but where did you go to school? What was your education like? Did you start out with an Associate degree program or did you jump right in to a BSN program?
Steven: Well, sure. I actually went to a small school for just a two-year degree and actually didn’t know what I wanted to do. I actually worked for a small ambulance service as an EMT just as a way of having income while I went to school. Well, it was through that experience that I had more experience with – engaging with the flight crews and transport teams and things like that and talking with people in the emergency room and ICU when we deliver patients on ambulance service. That’s how I knew I wanted to go to school and be a nurse. At that time, it was really competitive. So I actually had to put my application out and get actually accepted in CSU University because I wanted to get a four-year degree. So I moved to Colorado. I went to UFC and got my BSN at the university.
Jamie: Did you go on and get an advanced degree at some point in your career?
Steven: Yes. Ten years later, being a nurse and working in the ER, working in the ICU, in different areas, I just wanted to challenge myself even more and I’m always just kind of hungry for information. I actually went and became a nurse practitioner as well.
Jamie: Fantastic. Now, we were talking about critical care nursing this month on the show. You’re a critical nurse but you’re a special kind of critical care nurse. You’re involved with transport care as a flight nurse. That’s a really different kind of specialty. Tell us a little bit about what drew you to that particular area of nursing care?
Steven: Sure. I’ve been a transport nurse for about 15 years. What drew me probably is the complex cases that you see. When you’re calling a transport team you’re usually taking that patient to a higher level of care either from a small community hospital to a large community hospital or you’re taking them to a specialty center like a place where they do cardiovascular surgery or they have a special neurosurgeon or maybe a trauma center. So knowing how to take care those types of patients, patients with their disease process or their injury really takes complex knowledge. So that’s probably what made me desire to go into transport and working with those types of patients.
Jamie: It’s definitely a different kind of nursing care. You have that autonomy and they need to have the ability to standalone. What is it about the transport nurse that sets them apart from an ICU nurse or an ER nurse?
Steven: Well, being a transport nurse, when you’re out there transporting, you’re on a helicopter, we call that “rotary wing” or you’re on an aircraft, we call that “fixed wing” or you are on a critical care ground ambulance, an ambulance. You’re usually just a partner or two. It’s usually you and your partner. It might be a paramedic. It might be a respiratory therapist. Some programs are physician/nurse. But most of the time, it’s the transport nurse that has to make those decisions based on best practices. They don’t have somebody that they can call and say, “Can we do this? Can we do that?” You need to know what you need to do for that patient to make them better. Our job is to get the patient from point A to point B safely and either to continue that care or to initiate care that hasn’t been done for that patient. So it can be very difficult. It can be stressful. You definitely have to have a really good knowledge base of all the different specialties. You definitely have to have a skillset that the ER/ICU nurses have. So you kind of have to be a jack-of-all-trades and just be a well-rounded individual to be able to do that role.
Jamie: And you are the president of the Transport Nurses Association. Tell us a little a bit about how that role has changed how you approach your nursing care because being a leader in an organization like that must be challenging as well?
Steven: Yes, I’m very privileged. I’m very honored to be the current president of ASTNA, which stands for “Air & Surface Transport Nurses Association.” We are an often association for transport nurses and actually the only association for transport nurses. Definitely, our mission statement is to be able to provide support and lead the industry for education, for support, for knowledge and for safety for our patients.
Jamie: I always am a big person for plugging associations, being a member your professional organization for nurses, because there are so many benefits that you get from that and I noticed looking at your bio before we started recording that you’re a member of several different organizations including the American Association of Critical Nurses, the AACN, and several others, as well as being president of the Transport Nurses Association. What is it that this membership in these organizations brings to a nurse that really benefits their practice?
Steven: Well, I would highly recommend any new nurse to definitely join an association in which they have a desire to be in such as ANA or AACN or Transport. Definitely, it’s a great way with networking with other colleagues who have similar ideas and passion for that particular type of practice. Definitely, they’re going to have resources for education, for continued professional growth within your career. I think the number one thing is just the resources that they’re going to be able to provide to make sure that you do a good job with your patients.
Jamie: Yes, it’s amazing what I hear from people all the time is just what you just said and it’s that the networking and the connections that you develop because you find people that have already run into problems you are running into and they have found a solution that can make your problem go away or make your solution more elegant and solve the problem in a better way for the patient and that’s the thing I found with the organizations when I talk to different people in different specialties each month here on the show is that there’s so much benefit to be had from being a member of whatever your specialty nursing organization is.
Steven: Mostly, you said it well, that definitely is the benefit.
Jamie: So you’re also a nurse practitioner and I continue to see more and more expanded roles for a nurse practitioner in our healthcare system out there. What is it that you see as the future for advanced practice nursing and nurse practitioners?
Steven: Well, I see us bringing quality healthcare to patients that don’t have healthcare, easy access to healthcare. It’s definitely a growing field. As our population grows, we’re going to need more healthcare providers. I definitely see it as a great profession in our healthcare system to get people healthcare.
Jamie: What is it that somebody thinking about going into a career, especially in critical care nursing, new nurses coming out of school, what skills do they really need to work on developing certifications or classes they need to take to round out there their knowledge base so that that makes them a better critical care nurse?
Steven: I would say just working at a facility that has a high-volume population in whatever it is that they want to do. So they can really have a good understanding of time management and be able to multitask, learning good customer service skills, being able to work independently, working autonomously, staying calm in stressful situations. Those are all things that people are going to learn on the job and, especially if they want to go on to be a transport nurse, that’s really going to make them a stellar candidate.
Jamie: One of the things I think that help, and I know that it influenced you in your career, is the ability to mentor other nurses. I feel like if you’re not being mentored you should be mentoring someone. And this is a process that I think often falls through the cracks in the way we develop leadership in nursing. Tell us a little bit about why you see that as an important role both as how it affected you and how you see that as something that nurses can spread to others?
Steven: Yes. Well, definitely being mentored or being a mentor I think is very important. I think if you’re new to healthcare, being a new nurse, one suggestion I would have is look for leaders within your unit or whatever facility is that you’re working with. Look for people that have good leadership. Look for people that want to teach. They have good people skills, good customer service skills and then really latch on to those people and really pick their brain. Talk about their experiences. Just listen to their advice and look to those people and let those people mentor you for whatever it is the specialty that you’re doing. And you’ll find that it’ll really help in your profession and make you a better person and to really make you a great nurse in the industry.
Jamie: What skills make a good mentor?
Steven: For being an actual mentor, I think these people are usually have the personality types for they want to teach. You just see them in the moment and teaching. They’re usually people-people. They want to show you something. They’re trying to improve a process. Maybe they see a flaw in you and they are trying to improve that. They’re very compassionate about what they like to do. All those different personality traits really make a good mentor. They usually demonstrate best practices. They’re usually the leaders within the community or the unit or the facility in. Those are the people that you want to look at and try to, I don’t know, I guess embrace.
Jamie: Yes, definitely, and emulate what they’re doing and all the things that you want to do as a mentee, you want to be also be that person as a mentor. Last question we have here. Really, is the thing I ask a lot of people when I have them on the show – and it is, what is the best piece of nursing advice that you ever received? That thing that you keep with you whenever you’re out there working in the field or working in your clinic that helps you stay focused on your core person as a nurse?
Steven: I have two things for you. I would share that always listen to that inner voice. Always listen to that inner voice that says, “Maybe you should do this, maybe should do that. Maybe something doesn’t feel right.” Really listen to that, investigate it and see what’s going on. It might be subtle clues as to how to help a situation. Always put the patient first and always listen to what the patient is telling you. They’re going to know more about the situation and they’re going to know more about their injury or their illness than you are. Don’t disregard what they’re saying to you because, again, they might be subtle clues as to what is going on with the patient at that time and that can really be helpful.
Jamie: Well, Steve, I thank you for being on the show and sharing your experience and your knowledge and expertise with us here. We hope you will be able to come back maybe in a future episode and share some more with us because it’s been a lot of fun having you here on the program.
Steven: Absolutely, thanks for having me and if you’re interested in being a transport nurse, you can definitely look me up on our webpage www.ASTNA.org and I would be happy to talk to you more about transport nursing.
Make sure you check out the entire July, 2014 issue of Nursing Notes, where we look at the field of critical care nursing. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month where I’m joined by two critical care nurses to kick off our monthly panel discussion. Karen McQuillan is a clinical nurse specialist at the R Adam Cowley Shock Trauma Center in the University of Maryland Medical System in Baltimore Maryland, and Heather Morey is a nurse manager at the Munroe Regional Medical Center ICU in Ocala, Florida. You’ll find this and other episodes of Nursing Notes Live in the podcast area on iTunes.