NURSEWEEK: Space and Beyond: Pioneering nurses prepare for a giant leap into the final frontier

Space and beyond
Pioneering nurses prepare for a giant leap into the final frontier

By José Alaniz
October 16, 2000
Photo: Johnson Space Center's Flight Medicine Clinic, NASA

Lisa Marak, RN, administers care to an astronaut at Johnson Space Center's Flight Medicine Clinic in Houston.


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It’s a surreal image: a nurse working in a dispensary on the moon. Trends such as the much-publicized nursing shortage and a booming economy point to an ever-expanding, even stratospheric, market for nurses during the next several years.

But will nursing opportunities keep expanding – all the way to outer space?

"‘Wherever there are patients, there will be nurses,’" said Claudette Gage, RN, chief nurse of the Houston-based Johnson Space Center’s Flight Medicine Clinic, quoting from a short film she made about nurses and the space program, which ends with the lunar dispensary RN. "People liked that ending," she said.

In a sense, Gage said, her profession has already expanded off-Earth.

Nurses, part of the U.S. space program since the beginning, contribute to space shuttle missions, and their role will remain crucial as the National Aeronautics and Space Administration operates the international space station, colonizes the moon and heads to Mars by 2020. That’s a lot of astronauts to care for, both on the ground and – perhaps someday – in the final frontier.

But we shouldn’t expect to see nurses floating in space anytime soon, Gage said.

"If you’re a nurse and you want to fly with the astronauts, this is what you have to do: Get a nursing degree, then get a Ph.D. in something else, in toxicology, engineering, physiology, or become an anesthetist, mechanical and/or electrical engineer," she said, not even mentioning the intense mental and physical training and screening astronauts must undergo. "At the end of it, you’ll have all those skills, and you’ll also, by the way, be an RN. And may be too old to fly by then."

NASA has about 180 astronauts, and anyone wanting to join this elite corps has to be multifaceted, agreed Brenda Rouse, RN, a clinical nurse at the Flight Medicine Clinic. "You’d have to wear two or three hats, and the line’s so long with doctors already," she said.

But nurses actively support those who do go into space, working in diverse fields. The Flight Medicine Clinic serves astronauts and their families. In bionetics, personnel preparing to launch get physicals and those who have returned from space undergo physical rehabilitation. Other specialties are telemedicine, informatics and biomedical research. In the process, these nurses often get to know their special patients well.

Rouse, who helped rehabilitate Shannon Lucid after six months on the Russian Space Station Mir in 1996, was touched when the astronaut greeted her back on the ground with the words, "I’m so glad to see you."

"She was reclining on the stretcher and she asked for a Diet Coke, and I realized she hadn’t had one in six months. We had been friends before and wrote e-mails to each other when she was in orbit. The flight surgeon decided, who better than me to help her with rehabilitation?"

Besides bone and muscle loss, long periods in zero gravity present other medical challenges, such as space surgery, said Rouse, who previously worked in an operating room.

"I went up in a zero-G airplane to help research the techniques. ‘Just remember,’ the surgeon said, ‘this is not an OR.’ There were particulates floating everywhere although, interestingly, not that much blood. We use laparoscopic instruments so that we don’t have to open up the body."

Other nursing responsibilities, such as meeting the crew upon its return from space, can be just as dramatic – especially in the shadow of the 1986 Challenger disaster.

"We do a lot of drills, mock exercises in dealing with a shuttle crash," said Ivonne Galcerón-Garcia, RN, an aerospace nurse at the Kennedy Space Center in Cape Canaveral, Fla. "We have to be able to respond quickly, and as in an ER, we have to make sure we have all the equipment and supplies out there fast. It’s not like in a hospital; you can’t just get whatever you need if you didn’t think ahead to bring it with you."

As the prospect of a long-term space mission grows (round-trip time to Mars: three years), the National Space Biomedical Research Institute, a nonprofit consortium of 12 university laboratories, has been investigating since 1996 what happens to bodies once they leave Earth. A study at Harvard’s Brigham and Women’s Hospital seeks to help astronauts cope once they arrive at their destination.

"The Martian day is a tad longer, but just enough to put the body’s circadian rhythms off-kilter. We hope our study will help astronauts adjust to the changes through light and timing techniques," said Sheila Driscoll, MA, RN, nurse manager of the General Clinical Research Center, part of the National Space Biomedical Research Institute’s Human Performance Factors, Sleep and Chronobiology Research Team. "While we do other research trials that are not space-related, we do take a special pride here in the NASA programs. It does provide some extra excitement to work with John Glenn, to know we’re helping plan a trip to Mars," Driscoll said.

The space nurses use the word "excitement" a lot.

Dee O’Hara, RN, the first NASA nurse, who treated the first Apollo 7 astronauts and founded the Flight Clinic in the 1960s, spoke for many nurses when she said, "I feel fortunate to have been a part of a unique and exciting time in space history."