- Associated Press - Monday, September 22, 2014

FLORENCE, S.C. (AP) - The helicopter, a single-engine Bell 407, touched down at McLeod Regional Medical Center. With another helicopter already parked on the concrete heli-pad, the landing zone was smaller than normal though still very manageable.

Several McLeod medical staff members and a security guard waited to receive the delivery: a critically ill patient being transported from an area community hospital.

The patient was taken out of the helicopter and put on a wheeled hospital bed. A McLeod medical staff member pushed the bed toward the hospital. Two helicopter EMS crew members flanked the patient.

Alice Serenyi, a flight nurse, was on one side. She wore black coveralls and a backpack and held a medical monitor in place.

She’s part of a crew of four full-time nurses, four full-time paramedics and four full-time pilots, along with part-timers, who are attached to McLeod’s Air Reach helicopter.

Seldom are helicopter EMS teams seen up close, and in some ways, that’s a good thing. To need their services is to need medical transport when speed is crucial. When the ambulance just won’t cut it.

Helicopter EMS services, though virtually ubiquitous nowadays, are especially important in rural areas, where hospitals are far apart and have varying levels of capabilities.

Serenyi has been on the job since March and recently transitioned into a full-time flight nurse. Her past experience, though, includes other flight nurse positions and extensive domestic and international work in emergency departments and intensive care units.

“We’re the jack of all trades,” Serenyi said during downtime at her team’s base at the Marion County Airport in Mullins. “Most of all what I really love is the autonomy of my job.”

Flight nurses and paramedics need to be prepared for a variety of medical cases, which are generally all critical. The acronyms of medical certifications and training needed read like a list of New Deal-era government programs: PALS, ACLS, NRP, TNATC, BLS, ITLS, CFRN, FPC.

The job attracts a certain type of medical professional, one who is OK with working in the cramped cabin of a helicopter. Everything is at one’s fingertips, because there isn’t much room beyond that.

The helicopter Serenyi works in holds one pilot, one flight nurse, one flight paramedic and one patient. Space is tight.

“This is like a BMW two-door,” Serenyi said.

“I didn’t even have my driver’s license, and they were driving me to EMT school,” Serenyi said, remembering how, from an early age, her parents supported her interest in health care.

Serenyi, an only child, is from Pennsylvania.

“I always grew up in a rural place, where you sent invitations out for the trick-or-treaters to come to your house,” she said. “The closest town was 15 minutes away.

“I spent a lot of time by myself. I spent a lot of time outdoors. If there was a hurt bunny rabbit, I would be the one to put it in a shoe box.”

Regular summer trips to see her father’s family in Hungary meant ample time on airplanes.

“It’s just excitement,” she said. “Off to a new place.”

In nursing school, she designed an independent study course about the role of flight nursing. That got her up in a helicopter.

“That was the first time I flew, but luckily I liked it,” she said.

At the airport in Mullins, Serenyi and her team wait for the next call inside their air-conditioned and furnished doublewide trailer. They already have replenished and repacked their medical supplies. Bags wait by the door.

“We are a family,” she said. “We have a house, we have our own independent living quarters.”

But, “the minute the radio goes off, our time stops,” she said. “Our focus is on the patient.”

A company dispatcher in Texas will alert them to an emergency call.

“As soon as you hear that, we’re gathering all of our things,” she said. “The idea is to be quick and be safe and get going.”

Downtime also means paperwork. Charting is a necessary but far from glamorous part of the job.

Charting can take hours.

“It’s the clinical picture,” Serenyi said. “When you read it, you have to feel like you were there with me.”

“If there was no charting, I would work every other day,” she said.

“It comes in cycles,” said Carol Palmer, Serenyi’s flight paramedic colleague. On rainy days, weekend nights and times when fields are being burned, the team generally sees more calls. Of the helicopter’s trips, 50 percent are hospital-to-hospital transports and 50 percent are on-scene calls.

Teamwork and trust is crucial. In the air, it’s called Crew Resource Management.

“You’ve got to have it,” Serenyi said. “You have to have communication, you have to have my back, and I have to have your back. You might hate each other, but if you don’t have Crew Resource Management in this job, somebody is going to die. We have a really good team here.”

Serenyi works 24- and 12-hour shifts and commutes from Pawleys Island.

“I don’t mind the commute, because it gives me time to make my to-do list and think,” she said. “It gives me time to debrief. I guess it’s self-reflection and time to critique.”

If she took a helicopter, the commute time would be cut in half.

Relatively new to the area, Serenyi has a job that provides an introduction from a unique perspective.

“I’m sort of learning my new home state from the air,” she said.

Christine Martin is one of the staff members at McLeod who receives the helicopter EMS flights.

“I love it,” she said as Serenyi’s helicopter came in to land. “I’ve never rode on a helicopter, I never will ride on a helicopter, but I love coming out here for information. It’s teamwork. I’m just afraid of heights.”

___

Information from: Morning News, https://www.scnow.com


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