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Basic Clinical Skills Serve Nurse on Flight

Melissa Ellis, RN, staff nurse in the intensive care unit at Research Medical Center, and her husband, Jeffrey Ellis

by Linda Friedel | Reprinted courtesy of KC Nursing News

Melissa Ellis, RN, had settled into her seat on Delta’s plane headed for her vacation destination. Her lucky husband got upgraded to first class, but she didn’t mind. They would soon be in Puerto Rico.

The all-expenses paid vacation was the second year that Ellis and her husband scored an invitation on his company’s trip. She was looking forward to five days of golfing, sunning, boating and relaxing on the beach.

“It was meant as a reward,” Ellis said.

An hour after the plane left Atlanta behind, Ellis heard commotion in the rows behind her. She heard someone say, “I don’t know what’s wrong with him.” A flight attendant asked for medical personnel over the PA system. Ellis looked at the flight attendant and the faces behind her. The words tumbled out. “I’m a nurse.”

“I immediately got up,” Ellis said. “I am really proud of who I am. I have always wanted to help people. There wasn’t any hesitation at all.”

The flight attendant motioned for Ellis to come her way. Ellis rose and spotted a 30-something-year-old man slumped in his seat by the window. His color was grey. Ellis crowded into the space where she found his wife next to him. He had a pulse, she quickly told Ellis. They had been watching a movie and he just fell out, the wife told Ellis. Ellis felt her adrenalin course through her body as she continued her assessment, she said.

“You are starting out fresh,” Ellis said. “You know nothing about him. The rest of it you don’t know. You have to put that puzzle together.”

As she gathered information from his wife, a passenger identified himself as a pediatrician and joined Ellis at the scene. When Ellis told him she was an ICU nurse, he stayed where he was, but told the flight attendant that Ellis could take care of the unconscious man. A flight attendant gave Ellis an oxygen mask to mount on the victim, but it posed a challenge.

“The tubing was short,” she said. “We had to figure out how to put it on.”

Ellis thought to turn on the regulator and disconnect the tubing to make sure that oxygen was flowing. A passenger in front of the victim slid the oxygen mask over his head. Ellis put the arm rest down for the victim to lie flat, then rolled up his jacket to make a pillow.

“He started coming around,” Ellis said.

A flight attendant handed Ellis a blood pressure cuff and stethoscope. The blood pressure cuff worked, measuring 90 over 60, she said, but the stethoscope was useless. She placed the ends in her ear only to get jabbed and heard nothing, she said. The roar of the engines drowned out any sound she might have heard. Ellis said her mood changed.

“I got a little panicked feeling,” she said. “You’re completely out of your comfort zone.”

As Ellis cared for her patient, he began to stir, then woke up. Ellis introduced herself to the groggy man, saying she was a nurse.

“I’m going to check your blood pressure,” she told him.

She tried his radial pulse again and it was fast and thready, she said.

“On a scale of one to pale, you are really pale,” she told the sick passenger.

That netted a smile. Ellis told him to lie still, relax and breathe in the oxygen. His wife told her they were newlyweds. She knew of no known medical problems and that he did not take any medications, she said. Ellis was impressed with the newlywed’s reaction.

“She was actually so very calm,” she said. “I found it surprising. She was just matter of fact.”

Ellis told the pediatrician and victim’s wife that she believed he was dehydrated and passed out. His wife said he slumped over during a gory scene in a movie that they were watching. As they talked, the passenger improved, so Ellis returned to her seat. She reminded him she would be just a few rows away and to drink water to continue to hydrate if he liked. Ellis went back to her seat, but kept an eye on the man who slept for most of the trip.

“He laid down at least the next hour or hour and half,” she said. “Within an hour of Puerto Rico, he had finally sat up.”

Ellis was surprised when the flight attendant posed a question to her. The pilot wanted to know in her opinion if they should land the plane before Puerto Rico. Ellis scanned the strangers on the plane. She thought about the ailing passenger, and then the others again.

“I remember looking back at all the people behind him,” Ellis said. “I thought about it. I looked at him again. I looked at flight attendant. I really think he passed out. I think he is dehydrated. I don’t think we need to land the plane.”

Ellis was the recipient of some good-natured teasing once they landed in Puerto Rico. She was the talk of the cocktail hour among her husband’s company employees. Some of employees had traveled on the same plane and seen Ellis pop into action.

“The story has already traveled,” she said. “They firmly acknowledged it. It lived the rest of the day.”

Ellis made eye contact with the sickly passenger before stepping off the plane. They waved to one another. She later saw him at the baggage claim area gathering his luggage. Ellis was thankful for the happy ending, she said.

“I saw he and his wife get their bags,” she said. “I know he walked off the plane and got their bags and got on their way.”

The passengers had stayed calm through the ordeal, Ellis said. Nobody panicked, and passengers seemed genuinely concerned, she said.

“Everybody was just calm,” she said. “It just felt very professional. It didn’t feel crowded. People wanted to help, but they stayed out of the way.”

Jumping into action is what nurses do, said Becky Dowell, RN, BSN, ONC, bed manager, nursing administration at Research Medical Center.

“We all benefit from hearing these other stories and experiences,” Dowell said. “It’s one of theses human interest stories that had a wonderful outcome. It could have been any one of us. We all hope when we are traveling there is a good nurse.”

Dowell said she was so impressed with the outcome and response from Ellis, she wanted to let other nurses know about the event. Dowell meets regularly with the hospital’s charge nurses and asked Ellis to present her story to the group. Dowell asked the charge nurses to tell the nurse on their units about what she considered heroic efforts.

“Melissa is just an incredible, incredible critical care nurse,” she said. “He couldn’t have been in better hands.”

Dowell said she has never been in a public situation where she has had to respond to an emergency, but she likes to think she would handle it well. When Ellis presented to the group, she reminded nurses how quickly things can change.

“We all know that,” Dowell said. “How one has to be able to process through the medical situation and your surrounding. That was critical in this situation. The plane was very tight, equipment limited. You think about assessing the resources, equipment and space.”

Dowell said Ellis acted on the code of the good Samaritan. It is instilled in nurses, she said. Ellis used the resources available and her own assessment skills.

“She was forced into looking at his color, looking at his pulse, going by what medications, condition,” she said. “She used her basic clinical skill.”

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