Nurse Heroes
I did what I knew how to do … and I’d gladly do it again

By Wendy L. Bonifazi, RN, APR, CLS
December 13, 2004

Nurses never know when they’ll be called upon during off hours to use their knowledge to save a stranger or loved one. NurseWeek/Nursing Spectrum and the American Red Cross are honoring 10 nurses who came to the aid of others. A special ceremony Dec. 3 in Washington celebrated these heroes.

Coming together in tragedy

Debra Watkins, RN, MSN, was driving to work at 7 AM when two trucks on the bridge ahead of her collided head-on. She pulled over, leaped out, and noting that one truck’s driver seemed fine, dashed to the truck that was burning. The driver was talking, but the female passenger, crammed under the dash, wasn’t breathing and had sustained severe trauma. “She had no heart rhythm, but was bleeding profusely, filling her oral and nasal cavities,” Watkins says. “We had to get her out to get him out. Two male volunteers were so trusting, doing anything I asked. The truck was blowing up little by little, so another man kept telling me it was the tires or whatever else exploded.”

Watkins kept clearing blood from the airway, and a bystander tossed her a mask when she began breathing for the victim. A student nurse arrived and assisted with CPR after the victim’s pulse was lost. After both victims were out and the truck was engulfed in flames, rescue crews arrived. The woman was intubated and transported by Care Flight, the flames were extinguished, and the news cameras rolled. Watkins told the student nurse to go on TV so her professors would know she had a legitimate excuse for missing school. She herself called work to say she’d be late, went home, changed her clothes, and went to work.

Watkins trained as a paramedic and ran emergency squads for a year before joining the Dayton (Ohio) VA Medical Center 19 years ago, where she works as nurse manager of the ICU and ACU. “I never forgot those [emergency] skills, and they got me in the ICU,” she says. “I still work the floor as much as possible to keep my skills up and in touch with reality.”

Nobody would have known what she did, but when the police decided to issue awards to the rescuers, they asked the VA which nurse was late that day.

The female passenger is recovering from serious neurological damage, and “it was hard to accept recognition at the expense of someone’s trauma,” Watkins says. “I accepted so I could see the others. We came together in tragedy, but the feelings they gave me I’ll never forget. “I care for heroes every day. The other rescuers say I’m the hero they couldn’t do without, but they’re heroes because I couldn’t have done without them.”

Human, not a hero

When Mary Evans’ brother died at 34, she was working. “I wasn’t there,” she says. “He needed CPR. Maybe he would’ve lived.”

His death inspired her to become a nurse after 18 years as a school secretary, caring for students who were sent to the office with everything from illness to compound fractures.

Now a clinic nurse at Newton (Miss.) Regional Hospital/Clinic, Evans, an LPN, is close to her extended family. She put work on hold to care for her mother at home for two years while the family coped with Alzheimer’s, and she took responsibility for a toddler.

On Jan. 31, she was awakened by her six-months-pregnant niece who lived next door. Moments later, they were stunned by an explosion. Flames and smoke were pouring from the niece’s home, and four children — ages 2, 3, 5, and 7 — were trapped inside.

The back door was too hot to touch, and so was the front. So Evans, still in just her nightclothes, had her son wet her down with a hose, then broke a window, boosted herself up, and crawled inside. “I couldn’t stay in long because I could feel my skin burning and couldn’t see through the black smoke,” she says. She called to the children, but nobody answered. Although she didn’t know if any lived, she crawled outside, hosed down again, and reentered. This time, feeling her way, she found Katie, who is blind, and carried her to the window. She also saved two other children, one at a time, but couldn’t find Jamien, 5. Evans still mourns the bright, polite boy who publicly recited Martin Luther King’s “I Have a Dream” from memory.

Although the rescued children sustained only scrapes, Evans was cut by glass and her hands, stomach, and hair were burned. “I had to do it, and I’d do it again, not only for them but for anyone else,” she says. “If you’re a true nurse, you want to save lives, and you just help people. I’m not a hero, just human. If I help one person, maybe they’ll help somebody else.”

Always something to do

Laurie Fox, RN, BSN, was driving home from her 12-hour shift as a clinical nurse 2 in Dartmouth-Hitchcock Medical Center’s same-day program in Lebanon, N.H. It was dusk on October 21, 2003, when a motorcycle helmet struck just above her windshield. Ahead, an oncoming vehicle had struck a motorcycle so hard that the bike’s tire was embedded in its grill. It kept going even as the motorcyclist toppled onto its hood and was slammed onto the middle of the unlit, twisting highway.

Fox swerved around him, pulled over, and raced to his side. “I didn’t want to move him because of possible spinal injuries, but the traffic was bumper to bumper with at least 10 oncoming cars,” she says. “I literally had just seconds to move him. I tried to pull him straight, but he was dead weight, and I threw my back out.”

The victim was moaning, unresponsive, and bleeding profusely. He had an extremely weak pulse and shallow breathing. Fox had a first-aid kit; she used gauze to clear away the blood and a barrier dam to hold down his tongue as she performed CPR while repeating, “Hold on, buddy, hold on.” She kept him alive for 10 minutes until an ambulance arrived.

“I was never involved in a trauma before,” Fox says. “In hospitals, you hit the button and the team comes running. I had that barrier and first-aid kit in three cars for 10 years and never needed it, but I would have helped without it. Blood can happen any day.”

Fox was so covered in blood that she “looked like a murderer,” and a bystander threw away her coat. The next day she was tested for HIV at occupational health.

Although Fox was fine, the motorcyclist sustained severe brain damage, multiple fractures, and internal bleeding. She visited him throughout his hospitalization, and the grateful family visits her monthly during his clinic appointments. “A lot of cars didn’t stop, but there’s always something you can do,” Fox says. “Seeing him recover is such a miracle.”

Fulfilling her destiny

Mary Pennington, RN, RNFA, CNOR, was driving her two children home from school when another vehicle ran a red light and stop sign, smashing the passenger side of her car and spinning it twice. Despite her blaring horn and screeching tires, she told her son, “We’ll be OK.”

Pennington, a registered nurse first assistant at WakeMed in Raleigh, N.C., sustained rib fractures, muscle damage, and severe bruising from her seat belt. Son Hunter had seat belt and air bag bruises and glass cuts, but 11-year-old Caitlin, who took the brunt of the crash, was unconscious, not breathing, her head lying on the seatback.

Pennington, minus a shoe, hurried to Caitlin, but the door wouldn’t open. Leaning through the shattered window, she began rescue breathing. “She had lacerations all over and lost teeth, so I was pulling clots from her mouth while breathing,” Pennington says. “Her neck was unstable, so I held it while leaning through the window and breathing, giving it all I had. The ambulance came in 10 minutes that seemed like forever.”

A paramedic entered the car, and another took a protesting Pennington away. “Her blood was all over my face, so they thought I was badly injured, and I shook so badly they thought I was in shock,” she says. “I begged them to land a helicopter there to take her to the trauma center, but they drove us all to a hospital ER. An hour later, while I was in X-ray, LifeFlight took her out.”

Initially, Caitlin was on a ventilator and heavily medicated; it was days before she had surgery, eventually followed by months of rehabilitation. “We’re blessed to even have her,” Pennington says. Although Caitlin has come far since the Dec. 18, 2003, accident, the brain shearing during her traumatic brain injury left her without taste or smell and with short-term memory loss.

“Not every woman can give life to a child more than once,” Pennington says. “Maybe my destiny was to be a nurse because it allowed me to save my daughter.”

Applying nursing skills

Like other New Orleans residents, Deborah Johnson, RN, BSN, is choosy about which nightly parade to watch the week before Mardi Gras.

In 2003, some colleagues and Johnson chose the parade that took place Feb. 18. She is the hospital information systems assistant director (and occasional pediatric staff nurse) at that city’s Tulane University Hospital & Clinic.

The parade had just begun when they heard gunshots 25 feet away, where they had stood moments before. With nowhere to run, the huge crowd fell to the ground. “I can still hear the rhythm of those two guns emptying,” Johnson says. Turning, she saw several teens fleeing, one with a gun. Instead of running away from the scene, she ran toward it to see what she could do. After tripping on streetcar tracks and injuring her head, she found the victims and a police officer.

“My main thought was for him to find other health workers for more help, and some did [come to help],” Johnson says. While the others tended the three other victims, Johnson assessed a young woman. “She was hit in the upper thigh, bleeding quite a bit, hysterical, and very panicky because she didn’t know what happened,” Johnson says. Since it wasn’t arterial bleeding, she ignored suggestions to apply a tourniquet and instead used a jacket to apply pressure. “You try to limit blood exposure, but don’t not apply pressure because of it,” she says. She was so focused that until ambulances arrived, she didn’t notice the police had moved spectators, taken pictures, and put up crime scene tape.

Her service wasn’t over. Afraid of retaliation, no witnesses had surfaced. “Despite my own fears, I wanted to be a model for others,” she says. “Sometimes nobody will be first or stand alone. After I told police I saw one gunman, several witnesses came forward and identified others.”

The police soon caught the suspects, and the witnesses stayed inside a police car while identifying which teens shot into the crowd. “I would do it again. ... We have to be that way,” Johnson says of her actions. “Sometimes all that’s needed to help a person through is to hold their hand and offer support, but nursing gives you a lot of skills in problem-solving and intervention. You just have to apply them.”

Providing support and calm

Driving home on the thruway from a spiritual retreat, Janet Hansraj, RN, BSN, saw a car overturned in the ditch. She gathered up her silk sari and scrambled down the 3-foot embankment. The driver, who had been thrown clear, told her there were other victims. One was so muddied and bloody that Hansraj couldn’t tell “if he was white, black, or green.” Another, bleeding, was walking in traffic, so Hansraj told approaching spectators to hold him because he was in shock. A fourth was trapped under the car.

“Gas was spilled all over — you could see and smell it everywhere,” she says. “People were screaming at me to get away before it blew up. But I couldn’t live with myself if I stood by.”

Hansraj told those who didn’t want to help to leave, said someone should call 911 for three ambulances, and asked for T-shirts to stanch the blood and volunteers to lift. A tattooed motorcyclist, another man, and a tiny woman clambered down to help. “I showed them how to logroll and lift the boy, while I supported his head,” she says. “He was almost scalped, and his ear was hanging into my hand, so I wrapped his head. He was semiconscious, not breathing. We had to keep him aligned while we walked up the bank and put him onto the pavement. I kept telling him, “You will live. You’ll be fine,” even though she doubted he’d survive his burns, fractures, and critical injuries.

When the petite woman mentioned she’d like to become a nurse, Hansraj said, “Start learning now by holding his head and talking to him while I triage the others.” Once the ambulances arrived, she gave a report, then went to dinner with friends. “I didn’t go to the hospital because I couldn’t help him anymore, and his death would be such a loss,” she says.

Hansraj, a telemetry/critical care nurse at Pascack Valley Hospital, Westwood, N.J., was working one day when the director of nurses asked for her help in identifying the nurse who saved a caller’s son’s life on the thruway two weeks before.

“I was so happy he was alive, and by his full recovery four weeks later,” Hansraj says. “His mom said that since I saved his life, now I was his mother, too.” She’s attended his graduation party and family dinners, and keeps his photo with her children’s on their family shrine. “Nurses must provide support and calm for all patients,” she says. “Our inner self must be at peace so we can help others.”

Stepping forward

On July 3, 2003, Joanna Kenney, RN, CRRN, was at an independent living facility when it was hit by lightning from a fast-moving storm. The building shook and fire alarms clanged, so Kenney, a clinical supervisor for Provena Care @ Home, Elgin, Ill., was checking on residents when she learned a construction worker was injured.

The facility was being built in three phases, and the newest was just an outer shell with some interior framing. Kenney climbed three flights of open, sideless, wood-frame stairs, then crossed 250 feet of plywood flooring full of dust and hanging plastic to the roughed-out balcony frame, where the victim lay in the pouring rain.

Because she hadn’t worked in the ED or ICU, she says, “I didn’t know how bad it was. But his face, lips, and tongue were blue, and his tongue protruded. I checked his carotid, and he did have a pulse. Since it was two days after [Chicago’s] Wrigley Field porches collapsed, I realized I couldn’t go out [to where he lay] because it would be too much weight with two other men there. One was talking to 911, so we asked if we could move him.”

As they moved him inside, she saw the back of his shirt smoldering, so she pulled it aside and stomped out the fire. She sent someone to the on-site CNA, Lindsay Frisbie, for the facility’s CPR mask.

“Since it’s independent living, our only equipment was that mask. There was no crash cart or emergency team — we were the team,” she says. “I lost his brachial and carotid pulses and started CPR.”

Since Frisbie was out of breath from running up and down nine flights of stairs, she took over compressions while Kenney provided rescue breathing. “It seemed like forever, but could have been five minutes” by the time rescuers arrived to intubate the victim and transport him to a burn unit.

“They sent us out because it was so hot and there was no ventilation or moving air,” says Kenney. “We walked downstairs in a fog, then watched the news to see what happened to him. A week later, we learned that he was OK and being treated for burns from his brother-in-law, who came to thank us.”

Because of the storm, the victim was putting up his last piece of sheetrock for the day when he was struck by lightning and caught fire. But it was by chance that Kenney was there that afternoon — usually, she was in another building. “I think of him every day,” she says. “If it’s my family, I hope someone else will have the strength and courage to step forward.”

‘You don’t abandon patients 85’

“I was always so grateful to older RNs for their support and letting me be where the action was,” says Evelyn Personeus, RN, LMT, a psychiatric nurse at Bergen Regional Medical Center, Paramus, N.J.

Just after midnight on June 10, 2002, the action took the form of a sports car that awoke her when it crashed in front of her home. “I recognized that deep boom, so I called 911, then ran to the scene,” she says. “The driver was OK, but flipping out in shock, so I had to calm him before helping the passenger.”

She couldn’t open the door, but climbed through a broken window and squatted on the driver’s seat to minimize cuts from shattered glass. “The car was crushed and the rear was wedged on a pole,” she says. “A transformer was at the top. I thanked God for its light — and that the transformer didn’t fall.’’

As soon as she got into the car, Personeus saw fire flickering in the engine and a 19-year-old boy pinned under the dash. “I couldn’t release the seat belt because the impact broke the back of the seat; it shifted, and he was shoved backward,” she says.

“His head was hyperextended, he was gurgling blood, and it was pouring out of his ears, mouth, and nose. I couldn’t leave this kid because if I did, he’d die. A strange peace came over me. He was in my hands.”

As neighbors tried unsuccessfully to extinguish the fire, Personeus provided sternal rubs. “It looked like his neck was broken, so I couldn’t do any worse if I picked up his head to breathe,” she says. “I could hear blood deep in his chest, so I kept his head up the whole time. I wouldn’t let him go or get out myself. You don’t abandon patients, and he was my patient, somebody’s beautiful baby, and a good boy with a seat belt on. If he died, someone would be holding him during his last minutes.”

When police arrived and ordered her out of the burning car before it exploded, Personeus, afraid he’d drown, refused to go or let go of the boy’s head until officers extricated him. They all made it out just before the interior caught fire.

Days later, visiting the boy in the ICU, Personeus discovered his father was a high school classmate.

“Eric had a long row to hoe, but he got his life back,” Personeus says. “I would do it again. There’s a proverb that if you know what to do when it’s needed, woe to you if you don’t. This is what I went to nursing school for, and I stepped in because I’m a nurse. I’m so thankful I have the knowledge and experience that kicks in during crises.”

An angel?

Theresa Miklusicak, RN, BS, was driving her new SUV on the highway when she glimpsed a family passing her in a black vehicle. Moments later, she saw it fly across three lanes of traffic and land off the right shoulder.

She slammed on her brakes and pulled across one lane so she could park in the median. Telling her daughter to stay put, she ran across the highway to help, and when she got to the hatchback, a little boy scrambled into her arms.

“From the way he held it, I knew he had a broken tibia and probably ankle, as well as cuts on his face, head, and arms,” says Miklusicak, outpatient surgery staff nurse at Battle Creek (Mich.) Health System. “There were about 30 bystanders, but nobody would go the 90 feet down the hill. I screamed, ‘Please, please help, there are others. I can’t let them die,’ and one lady came down and took the boy. I told her to keep him warm and comforted, then knelt under the hatch to get out the others. I heard moaning, but couldn’t see through the black smoke.”

She extricated a little girl with significant head trauma and an injured arm. Again, bystanders wouldn’t make eye contact until she carried the child up the embankment and found a woman to help. She repeated the process with the cold, shaken mother, who didn’t speak English or Spanish.

And finally, she helped an adult man crawl through the hatch. “He had a jumbo forehead laceration spewing blood, so I held it for him,” she says. “I was covered in blood but didn’t think about pathogens, just did what needed to be done. I kept him standing within six feet of the vehicle while immobilizing his cervical spine by cupping the back of his neck and thrusting his jaw forward. He was at least three inches taller than me, so my arms tired. I yelled I could do much better with something absorbent and asked for T-shirts, napkins, or tissues, but nobody brought anything until a trooper came down with a first-aid kit. Finally, a bystander helped me bandage him, and I moved him up the hill. I got everyone to the ambulance and gave report.”

The paramedics later said every injury she identified was accurate. Witnesses said she’d saved the family’s lives. The little boy asked if she was an angel. But her own daughter said, “That’s what my mom does. She saves people.”

Miklusicak now keeps a mask in the door pocket and surgical gloves in her first-aid kit. “I can’t grow a garden to save my life, but I can save lives,” she says. “Deep down, nursing and nurturing are ingrained. I don’t know how I kept it together, but I did what I was trained to do. I’d do it again, but I learned to shut my ignition off next time.”

Sole salvation

When a three-vehicle, high-speed Marine convoy crashed in an Iraqi desert dust storm on Easter Sunday in 2003, the collision injured 13 Marines and ejected three from their Humvees. The most severely injured was the Navy corpsman, who was thrown 30 yards. They thought he was their sole source of medical care.

Others, restrained by their lap belts, also sustained serious injuries. Among them was the unit’s historian and personnel/administrative chief, Staff Sgt. Charles Peworski. His left arm was numb, he was dazed from hitting the windshield, and his knees had slammed into the dashboard. But Peworski had something else, courtesy of the GI Bill: a BSN.

As soon as he got out to secure the vehicle and establish a safe area, “I was no longer a historian — I was a nurse,” Peworski says. Working with Staff Sgt. Joel Oyama, another Marine who was also a nurse, the two started triage, assessing the injured for external and internal injuries.

The medical corpsman was in shock with multiple head and neck injuries and fractures of the hand and knee. Another soldier had severe facial trauma. Peworski used the field first-aid kit and provided nursing care. Working one-handed, he established three IVs, applied pressure dressings, treated soldiers for shock, monitored vital signs, and stabilized fractures and other injuries.

“It seemed like hours, but it was probably 30 minutes before some medics arrived and helicopters came to Medevac the most severely injured,” Peworski says. “I didn’t really notice my injuries until the end. My only thought was that we had Marines down.”

Despite extensive soft tissue damage that may include permanent nerve damage to his hand, Peworski returned to his battalion for 10 days of light duty before resuming his duties completely. He returned to the United States for active duty. A week later, he was back at his civilian job as RN house nursing supervisor at Mayo Clinic Hospital in Phoenix.

Although he had finished his eight-year military contract with stints in Kuwait and El Salvador and now could go to inactive status, Peworski did not. In July, he returned to active duty to rebuild Iraq’s infrastructure.

“Like nursing, it’s rewarding, just in different ways,” says Peworski, who also received the Navy and Marine Corps Achievement Medal. “I enjoy helping people.”’

Judging

Entries were judged by nurse leaders affiliated with the American Red Cross and/or Nursing Spectrum, based on narratives of the event and letters of nomination and validation. Nominees met criteria including the following: the nominee saved or attempted to save a life under adverse circumstances and outside his or her defined work duties; it occurred between May 2, 2002, and May 2, 2004; and he or she must have been licensed as an RN or LPN at the time in any state or territory under U.S. jurisdiction. Nominators did not have to be nurses or affiliated with the American Red Cross or Nursing Spectrum.

Wendy Bonifazi, RN, APR, CLS, is a senior staff writer for Nursing Spectrum.