In November, University of Arizona College of Nursing Associate Clinical Professor James Reed, DNP, MSN, BSN travelled to a health clinic in El Fuerte, Sinaloa, to take part in 22 life-changing surgical cases. The effort was launched by Liga International, also known as The Flying Doctors of Mercy, a philanthropic volunteer organization that has been providing medical, dental and eye care to impoverished people in rural Mexico since 1934. For four days, Dr. Reed and one of his residents, DNP3 student Haley Simpson, lent their Certified Registered Nurse Anesthetist skills to operating room procedures that benefited residents of the surrounding community.
“It’s a feel-good mission,” Dr. Reed says, citing the positive patient outcomes he and Simpson were a part of. “It was great seeing the patients get through these procedures safely and comfortably, and then feeling the appreciation shown for the efforts of the medical and nursing team. The patients we saw have chronic conditions that would be hard to manage without Liga International.”
This is the first time UArizona Nursing representatives have taken part in the Liga International mission, but Dr. Reed hopes to expand the college’s participation in the future to three missions per year. In addition to the personal satisfaction he received from improving the lives of his patients, Dr. Reed is excited about the potential learning advancements for UArizona Nurse Anesthesia students.
“It was great seeing the patients get through these procedures safely and comfortably, and then feeling the appreciation shown for the efforts of the medical and nursing team. The patients we saw have chronic conditions that would be hard to manage without Liga International," ~ Associate Clinical Professor James Reed, DNP, MSN, BSN
“It’s important for the residents to get out of their comfort zone,” Dr. Reed says. “Many of them will be working in complete independent practices when they graduate. The innovation and the intellectual flexibility that’s required to do these things is value added for our residents’ educational experience.”
Amplifying that sense of innovation and flexibility, the Liga International mission came about because of the initiative of U.S. military veteran Haley Simpson. While volunteering at a University of Arizona-sponsored COVID vaccination clinic at the Douglas, Ariz. Point of Entry, Simpson coordinated the trip after meeting Liga International volunteer Ellen Paige, M.D. “Improving access to healthcare for underserved communities is very important to me,” Simpson says. “So, when I learned about Liga’s mission, I knew I had to present it to Dr. Reed.”
Dr. Reed, a Tucson native who is also a U.S. military veteran – a former Army medic deployed 12 times to war zones supporting counter-terrorism work – obtained his Bachelor of Science in Nursing (BSN) in 1992 from Uarizona Nursing, making him a proud Wildcat Nursing alumnus, backed by 23 years as a certified registered nurse anesthetist (CRNA). He worked with UArizona Nursing professor Lisa Kiser, PhD, to successfully navigate the process of obtaining approval from the University for the Liga International trip, resulting in a private small aircraft trip across the Sonoran Desert to El Fuerte.
He and Simpson joined 25 other volunteers for two days of life-changing and life-enhancing surgeries for in-need patients. “The whole experience gave me an overwhelming sense of pride and it filled my heart with joy to be able to make such a great difference for so many people,” Simpson says. “Dr. Reed and I had to overcome several obstacles to ensure our patients received safe anesthesia and the volunteers in the Operating Room were not exposed to anything harmful.”
The UArizona nurse anesthesia team quickly identified areas for improvement and decided it would be safest to avoid volatile agents due to lack of means for scavenging anesthesia gases. “Using all the skills I’ve learned so far, I formulated a plan to do most of the procedures via neuraxial anesthesia, MAC, or TIVA,” Simpson says.
During their two days in El Fuerte, Dr. Reed and Simpson delivered anesthesia for 22 patients between the ages of 18 months and 87 years old undergoing gynecologic, podiatry, and general surgery. “I felt very welcome in the community, and it was palpable how thankful the patients were for the service we were providing,” Simpson says, noting that many patients walked, rode the bus, and hitched rides on motorcycles to sleep outside of the clinic to receive lifechanging surgery the next morning.
Dr. Reed has high praise for his Mexican health care colleagues, who were able to bridge language barriers by alleviating any concerns with the patients and to obtain informed consent. “They were so appreciative of us being there and I think in a lot of ways they were learning from us, too,” he says. “The whole experience was beneficial for everybody that participated.”
As for the future, Dr. Reed hopes that this inaugural mission will open the doors for more involvement from UArizona Nursing. Ideally, he would like to organize three or four trips per year during the clinic’s operational period – the first weekend of each month between November and May. He envisions bringing three nurse anesthesia students and one faculty member per trip, although he hopes ultimately to be able to include BSN students and Advanced Practice Registered Nursing (APRN) students to assist with primary care and intake procedures.
Dr. Reed sees the mission as a differentiator between UArizona and other programs that adds value added to the student educational experience. “It's very exciting,” he says. “Our program is really fighting to create an entry level CRNA that can work anywhere independently, and that is focused on rural communities that lack access to anesthesia care. Having an experience like this where they have to innovate, all the while having a seasoned faculty member there with them to help guide them is one of the benefits of this activity."
Photos courtesy of Dr. James Reed