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Published May 03, 2019
The University of Wyoming prepares students for nursing careers, from the bachelor’s to doctoral levels, in a variety of clinical and other settings. However, how would a trained professional nurse practitioner respond to someone needing emergency medical care in a remote wilderness location -- with no medical equipment, no protection from the elements and no immediate contact with outside assistance?
Such a setting is exactly what the National Outdoor Leadership School (NOLS) Wilderness Medicine for the Professional Practitioner program prepares medical professionals to handle.
NOLS, a leader in wilderness education, headquartered in Lander, and UW’s Fay W. Whitney School of Nursing recently brought second- and third-year Doctor of Nursing Practice (DNP) and family nurse practitioner students together with physicians, nurses and nurse practitioners from Wyoming and across the nation for training at Wyoming’s Table in the Wilderness. Located about 30 miles from UW’s campus, this remote camping area provides access to rock climbing, hiking and canoeing -- a perfect setting for learning to provide emergency medical assistance, if needed, in a wilderness or resource-limited environment.
“Whether it’s travel abroad or engaging in outdoor activities in Wyoming, the possibility of an accident or injury always exists,” says Esther Gilman-Kehrer, a clinical assistant professor with the Fay W. Whitney School of Nursing. “As medical professionals, being knowledgeable about providing leadership and emergency medical care in a remote, backcountry setting is a valuable part of the education made available to students in UW’s Fay W. Whitney School of Nursing.”
In all, 24 students, including nine UW nursing students and two instructors, took part in the two-day training that included patient assessment; treating head, spine and chest injuries; as well as responding to weather-related injuries from cold, heat and lightning. Students also received instructions on group leadership skills.
Josh McNary, a longtime instructor with NOLS, and Dr. Brian Gee, an emergency medicine physician, both from Lander, explained to students some of the most important steps to follow upon encountering an injured person in the wilderness.
“The first thing you look for is the person’s awareness,” McNary says. “Are they awake and oriented to their surroundings?”
He says sometimes that outdoor recreation accidents can involve alcohol and other recreational drugs. Both instructors note that stabilizing the patient to prevent further injury is a critical first step.
“While living in Lander, I interacted with many NOLS wilderness medicine EMT students doing their clinical rotation in the emergency department,” says Stephanie Ferris, a DNP student from Jackson. “I found this course valuable not only for my own backcountry pursuits, but also for helping patients be ready for their next adventure. This course also did an excellent job discussing leadership roles in the wilderness context, which can be transferred over to the health care setting in many ways.”
Gilman-Kehrer participated along with students during many of the wilderness training exercises.
“This is a wonderful opportunity for our students to take a leadership role in the care of individuals injured in resource-limited settings like the wilderness or communities impacted by natural disasters,” she says. “They will learn to test their medical skills against realistic situations and implement decision-making wilderness guidelines -- for example, how to manage life-threatening injuries when evacuation may not be readily available.”
Jeff Shideman, from Cody, a current DNP student with experience in rural emergency medicine, says the course was valuable.
“Well before I began my health care career as a paramedic, I took a wilderness first aid course from a NOLS instructor while in high school,” he says. “I expected that this NOLS Wilderness Medicine for the Professional Practitioner course would be much the same, with lots of outdoor scenarios and great opportunities to learn. Our instructors, both very experienced in backcountry leadership and medicine, covered topics ranging from anaphylaxis to improvising emergency equipment with limited resources.”
Shideman notes that living and working in rural Wyoming will likely present occasions to use this practical knowledge.
“I would highly recommend this course for anyone else looking to bolster their abilities in providing backcountry medical care,” he adds.
UW nursing students who took part in the training, listed by hometown, are:
Casper -- Shawn Snyder.
Cheyenne -- Jenna Nazminia and Lara Vanden Hoek.
Cody -- Jeff Shideman.
Craig, Colo. -- Meghan Pankey.
Douglas -- Kellie Creaser.
Gillette -- Crysta Sullivan.
Jackson -- Stephanie Ferris.
Torrington -- Taylor Lenz.