by Matthew N. Skoufalos
When Sandy Brickel was a teenager, her mother, a police dispatcher, was seriously injured in the line of duty.
When that happened, many things changed for the Ft. Wayne, Ind. native, one of them being that Brickel began to seriously consider a career in health care.
“The health care professionals were very attentive and caring toward her,” Brickel said. “I really respected the health care professionals for doing that, and right then and there I knew that I wanted to be a nurse.”
Brickel has worked in hospital nursing for most of her life, doing everything from pre-op, critical care and step-down units to her current assignment in recovery and surgery.
After traveling through most of the American Southwest, she settled in Plano, Texas, where she works for a privately held, physician-owned hospital.
“I love it here,” Brickel said. “I love the people.”
She’s talking about the culture and hospitality of Texans, but Brickel may as well be talking about the reason she goes to work every day. She said that in the beginning of her career, she used to be intimidated by the responsibility of caring for the critically ill.
After 20 years, however, Brickel has really discovered that the possibility of being called on to save a life is just one of the many deeper levels of human interactions that the job offers.
“I’ve spent my whole career working with critical care patients,” she said. “They need us. If something’s going wrong we are the first ones that are there. To save a life is something that very few experience, and you don’t forget that, and neither do the families, and neither do the patients. That’s why we keep going back.”
Patients coding on the floor at night is always “a scary thing,” Brickel said, and she’s had some deeply emotional close calls that didn’t always turn out the way she wanted.
She recalls how she was caring for a particularly ill patient, a mother in her thirties, whom the staff revived while she could hear her children crying in the hallway.
“We tried everything to save her, and we did bring her back to life, but later on she did end up dying,” Brickel said. “I cried in the bathroom; I don’t know how long. I think those are the most heart-wrenching stories when you try and you try and that’s all you can do.
“We do what we do because people are sick and people need us and people appreciate it,” she said. “The husband was so grateful because we did try. He wasn’t upset. He thanked us so much for trying. He knew she was sick.”
In moments like those, Brickel said, nurses learn to rely on one another. New, old, rookie and expert nurses all join together to function as a team. The collaborative aspects of the profession trump all else, she said, which is a strong enough case for ongoing education. Also, most contemporary health care models emphasize the necessity of team building as leading to improved health outcomes.
“When I first went to nursing school, we were taught traditional nursing,” Brickel said. “We lose a lot of good graduate nurses because some of the older nurses won’t have anything to do with [them]. You have to change with the times, and changing isn’t in their blood.
“We need to work together as a team to teach each other to succeed, [and] I don’t think we’re all working together; I think we’re pulling each other apart,” she said. “We all benefit from the same thing: our patients benefit from us, we benefit from them.”
Compounding the problem, Brickel said, is a shortfall in nursing education that has not kept pace with the shortfall in nurses and doctors. Without enough educational leaders, she said, the next crop of professionals won’t have the skill set necessary to meet the challenges of delivering care in a changing field.
“We need to focus on that,” Brickel said. “We need to get more educators in the classroom to teach nursing students. There’s so few of them that I think we need to focus more on looking at that issue.”
Brickel is continuing her professional education. She is currently finishing a master’s degree at American Sentinel University, and plans to pursue a Ph.D. in nursing education at the University of Texas.
“I think all nurses ought to know that continuing your education is highly important,” she said. “We are responsible for ourselves and we are responsible for others. We need to be an example for other people and our peers.”
The ability to attain a critical care skill set is developed over time, Brickel said, and requires orientation to the process that can take a year or more to develop. It requires extra schooling, professional mentorship and additional time on the job to acclimate to evolutionary changes in technology.
“You can’t just walk into a room and say, ‘Hi I’m here to take care of you,’ take some vitals and leave,” Brickel said. “You have to be able to walk in and look at the situation and decide what you’re going to do, think in depth; that takes a lot of thinking. You have to like what you do. You have to be patient.”
Brickel also would like to see Congressional approval of new rules that would allow nurse practitioners to practice independently across state lines.
“If they let RNs practice to the full scope of their practice, we will be able to do more,” she said.
“If they let us use our license throughout the United States we can travel more, we can fill in spots in rural areas where there is no critical care,” she said. “Now they can run clinics, write prescriptions, so now these people who waited months and months to see a doctor can see a nurse practitioner, that will help.”
At the root of the entire profession is caring, Brickel said. People need to be reminded that they entered the career because they want to help others and because they want to be a part of somebody’s life.
“I’m a caring person,” she said. “I want to share that with somebody else. I want to be there for them when nobody else is. Some [people] just come to the hospital to have a companion. I can’t tell you how many times I’ve worked in the ER and somebody comes to the hospital just to come to the hospital.
“A lot of times I was the only person with someone when they died,” Brickel said. “Nobody cared about them, but I do. I feel like it put them at peace, that they didn’t die alone, that I did something good for them. I feel like they transitioned in peace.”