Written by Suchil Coffman.
About five years ago, I took Steve Pehrson’s Austere Trauma course at our school, and it hooked me. With no medical background behind me, I found myself fascinated by the oft-repeated phrase, “what would you do when there is NO higher care?” I learned about sterile fields, and worked my way through learning to suture, to understand field traction splints, taping techniques, carefully digging through (once) live muscle tissue to remove bullet fragments and the steps of an amputation. I couldn’t get enough. That course changed the direction of my life.
I started helping with the Wilderness First Aid and First Responder courses, got my EMT-B license, took human tracking courses, three levels of scuba dive training, a swift water rescue course, assisted on field clinical teams with our school, and then … made the big decision to go big. All the way.
I started checking out expeditionary medicine and nursing programs, and before I knew it — I was enrolled in the BSN program at UNM-Taos. By the end of Summer 2024, I should be able to sit for the national board exams and become an RN.
I am a baby nurse. Yesterday I finished my first round of first semester final exams and an evaluation to confirm that yes, I made it! … I won’t lie though — I am often conflicted about the health care system, about the manner that nurses have to work understaffed, overworked and under-appreciated, and frequently, in dangerous conditions. I feel conflicted when we talk about solutions to problems, and those solutions are pharma … and I bite my tongue because at least right now — it isn’t the right place.
I also feel conflicted because as a baby nurse, I recognize that I pretty much am an expert at washing my hands (the all important hand hygiene!), but not really much else. Yet. We’re reminded often that we will one day hold tremendous responsibility, which means literally involving ourselves in life and death.
And then I feel strangely excited, and the words, ‘what would you do when there is no higher care?’ floats through my head again. Hurricanes, flooding, catastrophic storms, civil unrest, shortages of medications in under-served areas, a global pandemic … I feel that understanding medicine is a vital skill for me, but also, understanding what I can do when there IS no medicine, or no available hospitals or clinics and its just me … can make the difference of life and death.
I know what to do to set up a clinic for a team in an off-grid environment, and I know what steps to take to ensure both the team and any clients are safe from physical threats, robbery of supplies or compromise of safety. I know how to plan for enough food for teams of two dozen or more, how to make the medicines that can be used by those with substance abuse problems, the young, the elderly and the immuno-compromised … and how to do it off-grid. I know how to organize teams with their strengths to create successful and very efficient clinical teams in pretty much any environment.
And now, thanks to my first semester of nursing school, I know how to do a better intake, how to communicate better with my team members, how to prioritize life threats and what to be looking for in a client’s health.
As a baby nurse, I am simultaneously reminded that I don’t know enough to not be dangerous, but I am also invigorated by the other things that I DO know that give me an advantage in an uncertain world. Today is the first day after finals, and I’m busy working on a physical assessment course that I feel great about for our school and a stack of new courses that I’m teaching, armed with new knowledge and understanding of the world that exists between allopathic and natural medicine.
Today, I only have a vague idea of where my nursing skills are going to take me, but I feel a deep pull and intuition that it will be in the world that is under-served, that is outside the box, and that is waiting for me to bring my own energy to it.