1 May, 2019

Kate flies to help when sick kids need fetching

Devonport’s Kate Forrest is an intensive-care nurse who helps fly sick children to Auckland’s Starship Hospital for treatment. She talks to Helen Vause about the challenges and rewards of her role.

Kate Forrest is a paediatric nurse in Starship Hospital’s intensive care unit (ICU), and a member of a highly trained team that flies around the country to bring sick children to the hospital for specialist treatment.

When Forrest leaves Devonport for work and is on duty with the retrieval team, there is no telling what her day will hold.

If they’re called on to uplift a very sick child, she could be hopping into a chopper with a paediatric doctor and taking off from the hospital roof.

If their destination is beyond the helicopter’s reach, they will be racing off to a waiting small plane.

Forrest has been working in Starship’s ICU for 20 years. The tight group of doctors and nurses who make up the retrieval team receive 300 to 400 calls every year to fly out and pick up sick kids, often at a moment’s notice. Forrest has lost count of how many of the high-pressure emergency dashes she has been on.

Sick children are brought to Starship because it has paediatric expertise and more specialised equipment, which can make all the difference in the young patients’ recovery.

The children get better outcomes when they are treated by people who really know what they are doing, says Forrest. “That’s why they send for us.”

It’s a job that often stretches her, she says, and it’s a job she loves.

“Every day I go out the door to work I feel lucky to have a real passion for my job. It’s such a privilege to be part of a team that is saving lives and making a real difference.

“When we fly out on a retrieval trip, we’re planning and talking through options depending on the information we have about the condition of the patient we are going to pick up. We have to be prepared for anything every time. But you never really quite know what you are walking into until you are there, on the ground.

“I always feel the shock of the parents. But most of the time they are just very relieved that you are there and they’re grateful their child is going to have the chance of the best care available.

“It’s often a very fragile situation. Before we can take off back to Starship, we have to be sure the child, or baby, is stabilised for the flight. But you can never quite know what is going to happen with the patient at altitude.

“The art of intensive-care nursing is to be anticipating what’s happening with the child and intervening and managing them every moment of the journey. I’ve been through this scenario so many times, but it’s always stressful and you are always giving your all.”

The journey is quite tough physically too. The space on the aircraft is very cramped, without full headroom, making it doubly difficult for the medics to move around on what can be as long as a two-hour flight back to the hospital.

It’s also exhausting and noisy, says Forrest, particularly in the helicopter.

She tells of some hairy landings her colleagues have been through. All of the medics have done training in how to escape from a helicopter underwater, which puts a bit of an edge on the demanding and critical work they’ve stepped up for.

It takes time to recover from a retrieval flight. “Certainly I’ve been known to come home pretty wired. It can be hard to come down again sometimes after we have been going flat out in a high-pressure situation.”

From her first week in paediatric intensive care nursing, Forrest says she was hooked on the job and knew it was where her career lay.

“In this job the challenges never stop. You are constantly using your brain, constantly problem-solving. In the intensive care unit, there is a tremendous sense of team work among very dedicated, highly trained staff. Everyone has to be really on top of their game, all the time. It’s a very positive atmosphere and it always feels very special to be part of it.”

“You are working with people at their most vulnerable. And often as a result of the team in the unit, a child is going to have the chance to live a much better life than they otherwise may have had.”

The good news is that around 97 percent of children in the Starship intensive care unit do make it out into the wards in very much better shape than when they arrived.

“The art of intensive-care nursing is to be anticipating what’s happening with the child and intervening and managing them every moment of the journey. I’ve been through this scenario so many times, but it’s always stressful and you are always giving your all.”

Kids get better very quickly, says Forrest. She also points out that outcomes have got better with advances in techniques, medications and knowledge, and with “smarter” technology. During her years in the job, she’s seen conditions being treated that may once have been non-survivable.

Many of the babies she’s nursing have cardiac issues. But kids are also brought into the hospital with serious disease, and with horrific injuries from car accidents and bike, skateboard and scooter accidents.

British born and trained, Forrest says she’s sad to be regularly seeing what she calls the “diseases of poverty”.

“Things we don’t see back in the UK any more – like rheumatic heart disease caused by untreated strep throats, nasty pneumonias and skin infections. Make no mistake, we are seeing this in New Zealand. It’s the result of failing policies, poverty, poor housing and overcrowding. These are diseases we shouldn’t be seeing in New Zealand.

“And we are seeing the consequences of parents not immunising children. I’ve seen whooping cough passed on to tiny babies less than one month old. It is a horrible, horrible disease. It really winds us all up at work because it is pretty much preventable.”

Alongside the day job, Kate is also a volunteer with the Hearts4Kids crew, a medical team from New Zealand that travels to Fiji to perform life-saving surgery on babies and children. The team of doctors, paediatric surgeons and nurses made the first of their annual trips in 2014. They all use their annual leave to make the time to go to Fiji together.

The surgery is undertaken to repair the simple congenital heart defects that more than 300 children are born with each year in the Pacific Islands. Forrest says these children would otherwise be unlikely to have access to the surgery.

Over five days, the Kiwi theatre team operates on as many as 20 children in Suva and Lautoka.

“We are going absolutely flat tack for 72 hours over the week. I’m very very proud to be part of this terrific initiative, which is making a huge difference in people’s lives.”

It costs about $85,000 for the Hearts4Kids Trust to get their volunteer medical team to Fiji to operate on 15 or more children. By comparison, it costs around half that to get a single child down from the Pacific Islands for the same operation at Starship.

Hearts4Kids is also working to empower local medical and nursing staff and to build their skills and expertise in the field. Fundraising is a big part of making it all happen, says Forrest.

At the same time as working in an intensive medical role, Forrest and her husband Simon have raised three girls in Devonport.

Has seeing the worst that can happen on a weekly basis made her a nervous ‘helicopter’ mum?

Forrest laughs at the thought: “No, I’m pretty laid back. My girls always wore helmets and, yes, I did let them climb trees.”

She is hot on safety, and it’s no surprise to hear she’s been known to intervene when she’s spotted cars carrying kids who were not wearing seatbelts.

This article originally appeared in the May 3 edition of The Devonport Flagstaff. Download PDF.