Re: Medical Escort
I read your post on Flightweb...thought I'd only answer here.
Various airlines hire RN's to function as medical escorts for customers who request it, and there are companies who offer these services. I previously worked for a company that provided medical escort services, and it can be either brutal or a cakewalk...unfortunately the brutal events easily overshadow and challenge your desire to ever do another escort.
Sometimes the patient doesn't really want you there, and makes it very clear to you.
Sometimes the patient is really borderline (or blatantly) a stretcher patient and is being shuttled via wheelchair. Getting medical gear on board can be a challenge (needles for diabetics who need injections and accuchecks).
Sometimes Embassies are less-than-helpful to assist with problems that arise half-way through the trip (i.e. patient was an illegal with an expired visa being deported to a hospital back home and a layover country doesn't want the patient to deplane).
The airline schedules the patient on the wrong kind of aircraft, or takes an hour+ to find a wheelchair.
The airline refuses to give you access to facilities that you've paid for (i.e. first class privacy rooms for the patient during layovers).
LANGUAGE BARRIERS!!! Through almost every evolution of the mission!
Ad these things to the routine problems of modern airline travel, and you've got some real obstacles.
Benign as these patients may be, you need to be able to think quick on your feet, determine when you need to play Mr. Nice Guy, or be aggressive and play hard-ball with airlines, etc.
You also need to think outside the box in helping these patients tolerate these trips; pushing the referring facilities to provide perscription PO benzo's and narcs, anti-emetics, etc. Sometimes you may have to retrieve a patient outside the US, in which case you may be handed drugs that you have never heard of...take them anyways and toss them when out of sight...keeps from offending the referring staff (this can be a hard lesson to learn).
I've allowed things that might make people gasp...allowing a patient to consume alcohol (i.e. wine, low-octane stuff), during transit or eat to their hearts content because it may be the last decent food they may eat for a long while (depending on what third-world crap-hole you are taking them to). Use reasonable and critical thinking, and make sure it won't exacerbate a medical condition or function concomitantly with any medication. Be prepared to do some very real and basic nursing tasks (changing an incontinent patient), in less-than-desirable conditions outside the hospital while protecting your patient's dignity...this can be very challenging.
Be ready to go a couple days without a shower.
No matter how benign the patient, there is rarely anything benign about these transports. I would much rather tackle the bloodiest beer and beans trauma with one arm tied behind my back than deal with some of the challenges of another 1-3 day escort to SE Asia, Africa, or E. Europe.
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