Our Human Expedition: Stories of Courage in Uncertainty

By NOLS

May 14, 2020

Our Human Expedition cover grid

As we navigate the challenges and surprises of daily life in a pandemic, we're grateful and inspired by the many NOLSies who are serving those in need during this time.

We are committed to highlighting these NOLSies in our ongoing series, Our Human Expedition.

Follow along on Instagram or Facebook to see new posts every week, and find inspiration in our first few stories here:

(If you are a NOLS alum or instructor working in any capacity to support those affected physically or psychologically by COVID-19, please reach out to us at blog@nols.edu—we'd love to hear from you.)

Avilash Cramer

 
 
 
 
 
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"For the last two months I’ve been working to develop and verify methods of sterilizing N95 respirators for re-use, as a means of addressing the widespread shortage of personal protective equipment (PPE). Re-using a disposable respirator is not something that’s been studied extensively before- it’s a bit like being asked to find a way to re-use a paper plate! Based on our research, one of the hospitals in the Boston area (Dana-Farber) has started using their iHP system (ionized hydrogen peroxide) to sterilize and reuse hundreds of respirators (and other PPE) each week. With that system in use, we have turned our attention towards the issue of identifying counterfeit respirators, which unfortunately seem to be popping up everywhere. I’m exhausted. Many of us have been working 12-14 hour days since the beginning of March. Things are getting better. I only have 7pm meetings three days a week now instead of seven days a week, but there is still an enormous amount of time pressure to get our research out and our solutions deployed. I took a NOLS WEMT class in 2011, and worked part-time as an EMT for three years in college. Resourcefulness and adaptability are key themes of wilderness medicine that prepared me for the work I’m doing now. Something that has changed is how quickly scientists from all backgrounds have come together to tackle these problems. I’ve been working with a team that came together in a matter of days, composed of dermatologists, nuclear engineers, computational biologists, regulatory scientists- just about every scientific discipline you can imagine. For everyone who is in a patient-facing position right now: please know that the scientific community has you in our hearts, and we are working our hands to the bone to create a safer workplace for you and your patients."- Avilash Cramer, 5th year PhD student in medical physics at the Harvard-MIT Division of Health Sciences and Technology

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Jon Lowrance

 
 
 
 
 
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"I work as an anesthesia provider in the operating rooms and procedural areas, as well as in intensive care units. We are the providers who make sure patients stay safe and comfortable before, during, and after surgery and procedures. The pandemic has created added risk to our jobs, but fortunately, the social distancing and shelter-in-place practices have dramatically "flattened the curve." Maine Medical Center has flexed to create emergency capacity to care for COVID19 patients and everyone else who needs care. Because of the concerted efforts of the public, our leaders, and our healthcare system, we have been able to stay ahead. Creating improvised space for a potential surge of critically ill patients is a challenge that demands leadership, teamwork, and communication - all skills that NOLS Wilderness Medicine teaches. Other NOLS skills, including tolerance for adversity and expedition behavior, have come into play as healthcare workers are charged with added challenges in an already high-stakes environment. Self-care, kindness, teamwork, and communication... all of these we model at NOLS. On NOLS WM courses, we encourage students to practice judgment and decision-making in complex environments. What helps to perform under extreme stress is to crack the magical, invisible "Can-of-Calm" and take a sip before committing to action. All of us can reach for the Can-of-Calm right now. We can all benefit from taking a deep breath, evaluating the situation objectively, and acting on things under our control while being comfortable to let go of things that aren't. The number one thing people at home can do is continue social distancing and washing your hands. But there's something else you can do: send a message to your local healthcare workers at your nearest hospital. It matters more than you know. The stress from this pandemic grinds at healthcare workers. Your gratitude is like a breath of fresh, COVID-free air to us. I want people to know that their efforts are so deeply appreciated by everyone in healthcare. We're all in this together. Our little but heroic acts will add up to humanity triumphing over what is a deadly, devastating virus." - Jon Lowrance

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Kelly Sloan

 
 
 
 
 
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“I’m a NOLS Wilderness Medicine and Expeditions instructor, as well as the Program Coord. for @usd_outdooradventures at @uofsandiego. I’m a Grad Student in Leadership Studies and am researching how women practice Psychological First Aid in First Responder roles. I’m also on my mountain rescue team and have served on 4 missions during COVID-19. At SD Mountain Rescue Team we've seen an increase in missing dementia patients because of the added challenges/limited resources for our aging communities and retirement homes. Conversely, in other neighborhoods, where folks are at home and looking for things to do, there has been an outpouring of support from the community (which can actually be harmful to the search, as there can be so many false leads). One of the most challenging parts of my job is that while human connection feels more important than ever, the PPE doesn't show my smile - you really have to be energetically in tune. At school, I provide Psych First Aid to students, which includes phone calls to 100+ students. As Program Coord., I'm responsible for 60 student guides, 20 or so are seniors, and had their last semester of guiding taken from them. I feel deeply for them, and am responsible for guiding them through their next steps. On NOLS expeditions, we're constantly facing challenges out of our control, which is very true now. To quote a fellow instructor, ‘The only thing in the field we're truly in control of is whether or not we floss every day.’ So, my recommendation is to floss. Today. You got this. Reassess tomorrow. However, while a lot of what I teach at NOLS is applicable, I recognize it's not that simple. Loved ones are dying. Not everyone recovers and returns home safely on the bus. A takeaway from NOLS Wilderness Medicine education that’s relevant now is ‘Ligo a ligo,’ a Greek phrase, meaning little by little. It's not just a reference to have patience, but everything is always just one step, then another step, followed by another step. Little by little. That's the mindset I am having with this pandemic. It won't suddenly end, but a small step followed by another will collectively get us there." -Kelly Sloan

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Sarah Schewel

 
 
 
 
 
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"I am a former NOLS instructor. I decided to join a medical mission for a month - kind of like a NOLS course - to @nyphospital (@weillcornell's medical school in Manhattan). We arrived on April 8, right as NYC was at its peak. NY Presbyterian had reorganized their spaces and their providers to staff over 200 ICU beds of COVID patients and almost 480 total. During my first few days, the patients were very sick. Multiple patients every few hours required intubation and transfer to ICU. As the weeks have gone on, I've continued to work with more stable COVID patients and others that have been discharged. One of the things I like about nursing and being a nurse practitioner is the connections I make with the patients through communication and often physical touch. In COVID times, as a provider, we don't even listen to the patient's lungs and are told to just follow respiratory rate, pulse oximetry, and "how the patient looks." In this way, COVID created a sort of distance that makes it harder to connect with patients and really feel like you are helping them. Routinely, I call patients on the phone to update them on any testing planned or to see how they feel later in the day. There are no visitors allowed in the hospital. Each day, I spend over an hour on the phone, updating family members who I will never meet. I'm hoping that NY will slowly reopen and that my children will be able to see their friends again, but in the health care world, COVID is here to stay. Patients will come into the hospital without family members, providers and nurses will continue to keep their distance, and we will all struggle with how to make close connections with our patients without physical touch. This pandemic has really highlighted everyone's "tolerance for adversity and uncertainty." I have learned new ways to connect with patients and their loved ones that still lead to meaningful relationships and allow me to gain their trust. Should medicine be completely virtual, then? These are the questions that will arise out of this pandemic. But for me, an in-person conversation and the physical presence of someone is invaluable." - @sschewel

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Elise Dunn

 
 
 
 
 
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“I work in a hospital ICU caring for patients requiring ventilator support due to the inflammatory lung process that COVID-19 causes. I became ill in the past 2 weeks and was tested for COVID-19 but thankfully it came back negative. Unfortunately, I know 4 nurses in my unit who are home sick with COVID symptoms. They did their best to protect their families, but some have transmitted it to their children. We have adequate masks and protective equipment at my hospital, but there is general unrest and fear of this virus’s potential to hurt our families and community.” Meet Elise Dunn, a Registered Nurse who’s working in Critical Care at a local hospital in Washington and at a non-profit clinic. Elise took our Wilderness First Aid course (swipe along for a scenario photo) and hoped to gain skills she could teach people who are living far from a medical facility. During the pandemic, she says that the most relevant information she learned in her course is, the ability to assess the severity of illnesses/injuries, and to possibly provide some degree of at-home treatment. “Early recognition and assessment of the severity of medical conditions when away from a healthcare facility is important to prevent further complications. If they [the patient] needs hospital care, they will fare better if treatment was begun prior to presenting to the medical facility.” For those at home, Elise recommends, “There is good reason to follow the stay home order... you may never know the damage you caused or the lives you hurt if you are a carrier of the virus and don’t limit your contacts with people, wash your hands, and cover your cough. While you have extra time, now would be a great time to inventory your outdoor gear and make sure you have safe equipment and proper first aid kits. People often forget to check expiration dates of medication inside of those kits." Thank you SO much for your work, Elise. We are committed to highlighting the inspirational and brave work of those in the NOLS community. If you are a NOLS alum or instructor working in any capacity to support those affected physically or psychologically by COVID-19, please reach out in our Direct Messages.

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Dan Sherman

 
 
 
 
 
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"As an RN, I’ve been caring for critically ill patients who have been vented, proned, and therapeutically paralyzed. I am an ICU staff nurse, Relief Charge- RN, and Chair of our Practice Committee at the Good Samaritan Regional Medical Center in Corvallis, Oregon—a level 2 trauma center with approximately 160 beds. Being the regional medical center for 4 satellite, critical access hospitals, the situation at our facility has been seemingly worse than our town’s situation. Some of our challenges have been the time and effort required to properly don and doff PPE, while attempting to group care and treatments, limit personnel entering the room, all while preserving the PPE we have. Otherwise, it’s pretty standard. The most challenging part of my work is the lack of PPE. Initially, a few weeks ago, it was taking over 10 days to get test results back in some cases. That’s 10 days of PPE potentially being wasted for a patient who might be negative. In addition to providing patient care, I’ve also assisted in initiating key policy changes related to preserving PPE and preventing potential contamination. I took the NOLS WUMP (Wilderness Upgrade for Medical Professionals) course in June of 2017 and the WFR recert in 2019. I had hoped to gain a more thorough, meaningful, and thoughtful assessment technique aimed toward a first-responder. The thorough, systematic assessment technique I learned is now adapted into my standard daily practice. My key takeaway from the course that’s relevant during this pandemic is with the scene size-up and body substance isolation. Some of us might think that wearing masks in public is ridiculous. That it might not do any good. But, what’s the harm in doing it? We’ve seen that many could be infectious without symptoms. Wearing a mask will not only protect you but could protect others from you, too. Please, just stay home unless you need something for your survival. For example, if you decide to drive a couple of hours into the woods and go for a long hike, and then something happens to you, there are many first responders who are risking a lot more now if they have to come rescue you for whatever reason." - Dan Sherman

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NOLS

NOLS is a nonprofit global wilderness school that seeks to help you step forward boldly as a leader.