A Varied Career

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Transport nursing is the best combination of emergency and critical care nursing ... I feel like I have the best job in the world.

Emily Colyer

There isn't much that Emily Colyer has not done or seen in a near-20-year career. A married mother of two, Colyer, BSN, RN, CFRN, CTRN, CEN, NRP, worked in several states and did so for a while as a licensed paramedic, before combining that with nursing. She's now a transport nurse. Oh, the stories she could tell — and did, including, how she received an NTI scholarship from AACN and attended the conference for the first time.

"I went to nursing school intending to become a midwife," she said. "Midway through school, I took an EMT course to fulfill my elective requirements ... and then I was absolutely hooked on emergency medicine. Following graduation, my first position was in a very busy Level I trauma center/emergency department in Detroit, Michigan. It was an amazing experience and the best education I could have asked for. I learned evidence-based practice from incredible nurses and physicians — and, looking back, it was the best decision I could have made. It was a trial by fire, jumping straight into that as a brand new nurse, but I loved taking care of anyone who walked (or rolled!) in the door — not knowing whether you were going to receive a patient with an MI, or a gunshot wound to the chest — or both, in the same hour. I loved it."

Travel nursing and national parks

After working there, Colyer began traveling and doing short-term contract work in emergency departments around the country. As luck would have it, the first move was a life-changing experience.

"I went to Yellowstone National Park, to work in the seasonal hospital there," she said. "It was a dream job: work with amazing people all day, hike the backcountry all weekend. And, I met my husband there. He is a Park Ranger with the National Park Service, and we have since moved around the country to some incredible park locations."

Working at different parks may have been the gift that kept on giving though, because one of Colyer's stops provided another career-altering series of events.

"Our last Park Service duty station was a small town that didn't really need another ED nurse," she explained. "So, since I had that old, unused EMT license from back in nursing school, I called up the local EMS agency and asked them if I could come learn to work for them as an EMT. And I did!

"On hiatus from nursing, I worked for two years as an EMT, and it was another incredible learning experience. Instead of having my patients brought to me and settled on an ED stretcher, I was now going into patients' homes and out on the highway, into the forest, and onto the snowmobile/ATV trail to retrieve my patients. It was a humbling learning curve — but once again, I worked with amazing people who taught me a lot about rural EMS. After two years, my department sent me to paramedic school. I finished out my last couple years there working as a paramedic.

Transport nursing

"We moved to Omaha, Nebraska a, few years ago and I had to decide: continue working in EMS or go back to nursing? I decided to go back to nursing, but knew I would miss working in the field and on the ambulance. Again, as life has it: there was a transport nursing position open at Children's Hospital & Medical Center in Omaha, and I jumped into that."

"Transport nursing is the best combination of emergency and critical care nursing: you never quite know what you are going to get, but you show up and you begin providing definitive care for your patient and safe passage to whatever comes next for them. Taking care of acutely and critically ill patients is very rewarding, and doing it at altitude or while going 70 mph down the highway is so rewarding. And honestly — taking care of kids is awesome. Being able to laugh and make transport into a game for young kids, or to snuggle babies who don't feel well, every day, I feel like I have the best job in the world."

"We care for so many neonatal and pediatric patients who are critically ill, and each one of them is very special to us. Their stories are unique — and when we can care for them and provide them safe and compassionate care on their way to definitive surgical or intensive care, it's so rewarding to be a part of their story.

As is so often the case, there is one particular case that Colyer always remembers.

An experience to remember

"However, one of the kids I cared for recently really impacted me — and what was unusual was that he wasn't critically ill or experiencing a dramatic illness: he had just come to his local ED with vague symptoms that weren't being helped by home treatment. Unfortunately, their initial impression was leukemia. Our team was called to transport him to Children's for further evaluation and to begin oncology treatment. Now, this diagnosis came completely out of left field for this family and for this young man — but we settled him in the ambulance, began treatment, and transported him to Children's. As far as I knew, he had subsequently begun chemotherapy and was responding well — and had delighted the entire staff with his outgoing and friendly personality.

So, I was walking through the inpatient unit recently when I heard a young man call out my name. I turned, and there he was, sitting at the nurses' station in an isolation gown and mask. He proceeded to challenge me to a game of Connect Four — and then to beat me soundly for four games, before he honestly beat me at three competitive timed word searches. He was a master, having had little else to occupy his time for weeks at a time during his oncology treatments. I left the unit laughing ... and more than a little humbled! He asked me to come and play with him again, and I agreed, sincerely telling him that I hoped he'd be out of the hospital and home playing with his brothers soon, instead. He was brave and honest right back to me and told me he didn't think he would be out very soon. I told him I would see him soon, then, and was going to bring Scrabble or something he didn't know how to play...and I would beat him next time!

"I was genuinely struck by the fact that he knew my name and remembered our transport. I didn't intubate him, or manage his ventilator, or administer life-saving medications while on the way to the PICU, and he had met a hundred caregivers during his repeated hospital stays ... but he hadn't forgotten me or our transport. I was part of his story. I made a promise to myself that day that I would remember to treat every patient as a compassionate and caring part of their story. All of us — we belong to each other."

NTI scholarship recipient

It wouldn't be a typical year for Coyler without a first and 2016 was no exception. She was a member of the first class of recipients for scholarships given by AACN to attend the annual NTI conference. It was the first time attending for her.

"NTI was incredible. I was blown away by the possibilities at NTI. When I looked online at all of the courses available, I felt like the proverbial kid in a candy store. There was so much to choose from, and my only regret was that I couldn't sign up for all of the sessions. When I actually arrived in New Orleans, I couldn't believe it: the energy and excitement of having thousands of like-minded nurses all together, in one place, was incredible. It was even better than I had imagined."

In other words, it meant a great deal to her.

“NTI supports excellent clinical care in a very direct, tangible way,” she says. “To be surrounded by so many people who are really eager for education and genuinely desire to be the best clinicians they can be for their patients is really inspiring. You come away from NTI with a renewed inspiration to be a truly excellent nurse.”

So what would she say to a donor about the NTI scholarship program?

“That their donations are really being used to better patient care, down to the very essentials of bedside nursing. Our transport team implemented new ventilators for our smallest patients this year, enabling our neonatal transports to provide consistent PIP/PEEP with accurate inspiratory times down to fractions of a second. When I program the ventilator settings now, I'm very mindful of what constitutes alveolar recruitment for a neonate and can adjust my settings accordingly — this is directly due to the mechanical ventilation workshop I attended at NTI 2016. I know that what I learned through the generosity of donors is helping me care for my patients and provide them with the best and safest transport I can give.

In fact, she can’t thank donors enough for supporting her NTI journey.

“I am genuinely grateful for the money that donors have given to AACN,” she says. “I know that the time I spent at NTI has increased my knowledge and improved the quality and mindfulness of my nursing care, and I am humbled that people have given their hard-earned money to this cause. Thank you.”

Balancing work and 'life'

Like all nurses, leaving work at work can be daunting, but forging a healthy work/life balance is made easier with her support system.

"I have a wonderful family," she said. "My husband and I support one another's career paths, and we've had an incredible ride so far. Our kids are awesome and are always up for chasing new trails and family adventures. My best day is an afternoon in a pine forest and an evening with a campfire and people I love. I am so grateful them and for the rare privilege of doing this work."