Jemma Gardner uses advanced skills to work solo, flying across the frozen north.
You’re a nurse, flying above the icy Canadian Arctic landscape. It’s taken you four hours to fly here after a 90-minute delay caused by bad weather and, when you land, you’re unsure how stable your patient will be.
This is the life of Jemma Gardner, one of four nurses working at the Keewatin Air base in Iqaluit, Nunavut, servicing 11 northern Canadian Inuit communities of various sizes – some as small as 100 people. Most of these communities are hours away from larger towns and therefore also hospitals, so they are staffed by nurses that act as the towns’ GPs and emergency department.
Ms Gardner’s job is to work with a team of pilots and nurses to fly to a northern community or to fly people south to a larger more specialised healthcare facility.
Southern calls are either for Iqaluit to Ottawa (medical) or Iqaluit to Winnipeg (psychiatry). The travel time ranges from 20 minutes to four hours one way in a King Air or PC12, or in a jet if heading south.
“Obviously, being in the Arctic, the weather can often delay these trips and sometimes this can lead to a stable patient becoming unstable or vice versa,” says Ms Gardner.
She is used to facing the unexpected, though. She worked in an accident and emergency department in St George’s Hospital in London after graduating and believes that, although some nurses don’t think new graduates should be exposed to that level of pressure, it “made me the nurse I am today. Obviously, being thrown in the deep end is not for everyone but, after my first shift in the resuscitation room, I knew this was for me.”
Her current role is different, mainly because of the autonomy. “The team you work with is your pilots and, in critical cases, another nurse. Because of this you are required to obtain advanced skills that a nurse normally would never be expected to learn, such as advanced airway management. This includes intubation training in the operating room and classroom and surgical airway insertion. I practised on pig tracheas we bought from the butcher’s – it was the closest thing to human tracheas.”
Other skills learnt include inserting cook catheters for pneumothorax, inserting umbilical vein catheters for neonatal resuscitation, delivery techniques and further in-depth review of advanced life support, paediatric advanced life support and neonatal resuscitation.
“The calls are not all critical but, when they are, you are the one to make decisions. It is odd but amazing to be determining the meds that will be used for an intubation and successfully intubating someone who is in respiratory failure and, in a peri-arrest state, making them stable enough to transfer,” she says.
The schedule involves being on call 24/7 for two weeks. “Aviation rules in Canada mean pilots can fly for 14 hours then have nine hours’ rest. During busy times, all of us can fly for the full 14 hours and be back out as soon as we are rested nine hours later. This can be extremely exhausting,” she says. The upside, though, is two weeks a month off, resting in Vancouver, which Ms Gardner says she “definitely needs”.
Although the climate may be unfriendly, Ms Gardner says the solo work is great at expanding more than just your geographic horizons.
“Having worked mainly at large inner-city hospitals, I am used to working as part of a big team, which I love, but this job has allowed me to test my skills and knowledge in a whole different way from before – that is an experience I am not sure I would be able to gain anywhere else.”