Wilderness Medicine

[CamperNurse, ADN, RN]

So I love to camp and hike... like LOVE (have you read my UN?). One of my life goals is to become a triple crown hiker and I was wondering what opportunities there are to transition/ utilize my nursing license/ skills in a wilderness setting are?

I have seen that NOLS offers some backcountry medical courses but they seem more geared to paramedic/EMT. Also, I have looked into the Wilderness Medical Society but that seems mainly geared towards MDs.

Are there any nurses out there that work in "wilderness medicine" of some type? How did you become involved in that area? What roles are available for nurses (RN and APRN) in this area? Are there any resources or professional organizations that you would recommend checking out?

Any other thoughts, advice, opinions, words of wisdom, etc that you can think of that my questions did not cover? Thanks, I look forward to a discussion around this topic!

[Guest219794]

Not a huge amount out there, though I think some jobs may exist.
I am both OEC (ski patrol) and EMT certified.  I do both patrol and search and rescue.  I bring with me my RN brain and accumulated slills, and work under one of those certs at a pretty basic level.  
For the most part, folks in the wilderness who need nursing care, need to get out of the wilderness.
There are remote expeditions, sailing programs, etc. that probably use nurses.

 

[CamperNurse, ADN, RN]

OK, so even though you are an RN you are able to work under a different license (or just certification?). What are the potential legal ramifications of working below your licensure level in this situation or are there any? Note: I am a new nurse so there is still a lot I am learning about situations like this.

[Guest219794]

Absolutely able to work under a different license or certification.
A great example is ski patrol.  There are thousands of ski patrollers in this country, many of whom are docs, mid levels, medics, nurses, etc...  But, while patrolling they are, for the most part, working as an Outdoor Emergency Technician providing first aid.
Doing that job does not shut my nurse brain off, but I have no access to anything other than a first aid kit.
Liability- not much of an issue.  Plenty of armchair lawyers like to argue this, but in reality, nurses and docs don't get sued in this environment.  

[Jedrnurse, BSN, RN]

Well, at least there'll be built-in social distancing there in the wilderness...?

[AdobeRN]

I don't have any advice to contribute - just want to say that this would be so interesting as a job.  I hike, camp and have taken the Wilderness First Responder course just for my own personal safety while on the trail.  Don't have plans to be a Triple Crowner ? but would love to hike the AT one day - besides local area backpacking in TExas , my husband and I have only done small sections (3-5 days) of JMT and day hikes of AT.  Good Luck to you!

[CamperNurse, ADN, RN]

thankyou! fitting in hikes that long with a career will be a challenge, but hey I'm going to try. 

[Hannahbanana, BSN, MSN]

NOLS and SOLO welcome anybody to their wilderness first responder, wilderness first aid, and higher classes. I took them routinely (first, then to recert) for years when I was more likely to be out in the great outdoors than I am now (bad knees got me). They're great, no reason to think they're aimed at special populations. Go for it. I still find myself using some of those skills in the community, long past my retirement.

[Guest219794]

I will put a plug in for Wilderness Medical Associates.  They use a systems based approach that resonates with medical professionals.
Prior to becoming a nurse, I taught for them, and would occasionally have a doc as a student.  Intimidating for a basic EMT.  But, they would always praise the curriculum.
I am occasionally in an instructional role now, and I still use the basic concepts and systems based approach I learned 20 yeas ago with WMA.
If you can make the time, take a WFR.  Shop dilligently for a good course.  If you decide to go that way, PM me, and I will point you toward an excellent instructor.

 

[Kerivara]

This is an excellent and comprehensive resource on the topic.  Be prepared to dedicate a long period of time if planning on reading the whole thing.  

[SummitRN, BSN, RN]

Some general rules about Wilderness Medicine as a field:

1. There is no money in it.

2. When there is money, it isn't much.

3. The more money there is, the less wilderness medicine is involved.

4. The most reliable pay is in teaching.

5. It is fun and flashy... until you are 6 hours into the litter carry.

6. KISS. A lot of neat tricks are only neat in the setting of a course, but then you can't remember at 0200 on the side of a mountain.

7. Real wilderness medicine is a lot of basic nursing (paraphrase of Drs. Wilkerson and Moore).

8. Except for antibiotics and narcs, Wilderness Med is 99% BLS. (AKA I wish all my partners were WFRs.)

9. Flavors are many including rescue medicine, expedition medicine, austere medicine, and uncommon environmental medicine.

10. I forgot 10... I just made these up just now. You do that a lot in Wilderness Medicine.

[Camillemm]

I would suggest looking into the Indian Health Service.  Some stations are quite remote...the bottom of the Grand Canyon, Canyon De Chelly to name a couple locations.  When I was looking to move to the southwest from VT 30+ years ago, the Indian Health Service flew me to New Mexico ((all expenses paid) and toured me all around the southwest; they were aggressively recruiting RNs at the time.  I would imagine they are still in need of RNs, especially the southwest, northern plains, Alaska.  I didn't end up working for them (a little too remote for me) but I recall the pay and benefits were fantastic, even gave a housing allowance.  Good luck.