WRIGHT-PATTERSON AIR FORCE BASE, Ohio – In the intricate realm of medical care within the 88th Inpatient Operations Squadron, “dominating the dirty work” is an inherent responsibility.
The squadron operates as one of the 88th Medical Group’s crucial components. It encompasses a team of 144 specialists whose primary objective is to provide medical, surgical, OB-GYN and intensive care inpatient services to a significant portion of Wright-Patterson Medical Center’s 62,000 beneficiaries and Veterans Affairs patients.
The 88 IPTS mission is to deliver cutting-edge training, treatment and teaching to the warfighter and beneficiary through ready, reliable care. Comprised of three essential flights – Intensive Care Unit, Medical Surgical Unit, and Labor and Delivery – the squadron’s responsibilities are paramount, focusing on 24/7 patient care.
“The No. 1 responsibility of the squadron is around-the-clock patient care,” said Col. Sarah Martin, 88 IPTS commander. “The active-duty, civilian, contract nurses and medical technicians of IPTS ensure the delivery of high-quality inpatient care services for all TRICARE beneficiaries, including uniform wearers, dependents and retirees."
Given the critical nature of their roles, squadron members are tasked with caring for patients at all hours, necessitating 12-hour work shifts, often called a “Panama schedule.”
“Our nurses and technicians utilize scheduling strategies that prioritize sufficient work and rest cycles,” Martin said. “The scheduling rotation commonly employed in hospital settings is what we refer to as a ‘Panama schedule,’ which are 12-hour shifts, with teams alternating between day and night shifts over a three-month cycle.”
The challenges of critical care
The Critical Care Flight, or ICU, is a four-bed unit that provides nursing and medical technician services for complex medical and surgical patients. The unit’s nurses and technicians have additional training in caring for the most complex medical issues.
Within the ICU, enlisted technicians have demanding responsibilities. These include not only caring for ICU patients but also monitoring telemetry or cardiac activity such as heart and respiratory rates for the entire hospital.
“Fifty percent of our enlisted manning each day is dedicated to telemetry monitoring, and the other technicians are there to supplement and assist in patient care with the nurses,” says Tech. Sgt. Jonathan Brewer, 88 IPTS ICU Flight chief.
Nurses frequently need support, especially during extended periods spent aiding within a patient’s room.
“Critical care patients require a lot of hands-on one-on-one time,” said Capt. Scott Collins, 88 IPTS ICU nurse. “You can be in a patient’s room for 30 minutes to an hour and then have to turn around and start the process again.”
Vital roles in the MSU
The Medical Surgical Unit is a 20-bed unit that provides nursing and medical technician services for active-duty, family member and retiree patients requiring overnight medical and/or postoperative care. These populations require less monitoring than those in critical care.
Enlisted technicians undergo rigorous training, including a five-week critical care course and clinical rotations in civilian hospitals, to equip them with the skills needed for their challenging roles. Their tech school involves EMT certification and covers IV, ambulance training, nursing treatments and patient communication.
Medical technicians are versatile, mastering various skills to work in diverse hospital areas, covering a broad range of patients.
“Enlisted medical technicians are a jack-of-all-trades – we can go almost anywhere in the hospital and do anything that’s required,” said Master Sgt. Laina Angel, 88 IPTS medical technician.
Medical technicians and nurses must work together to ensure a holistic approach to patient care.
Technicians monitor vital signs such as blood pressure, heart and respiratory rate, and temperature and provide essential support by assisting with various nursing duties, which can involve administering medications, dressing wounds or attending to other medical procedures as directed by the nursing team.
Responsibilities held by technicians also include ensuring the proper insertion of new IVs, maintaining their functionality, addressing any concerns related to them, gathering medical information from patients to facilitate a smooth transition into their care and assisting patients in their health care journey beyond the clinical setting. This includes accompanying them to medical appointments and consultations, ensuring patients are comfortable and have everything they need while continuing to care for them.
“I mostly monitor vitals and aid with some nursing duties like managing IVs, handling patient intake, assisting with appointments and ensuring their return,” Airman 1st Class Joshia Pearson said.
As a nurse, 1st Lt. Jake Flores has responsibilities that include monitoring patients, observing their vital signs and assessing their overall condition, as well as accurately administering prescribed drugs, ensuring the right dosages and monitoring the patient’s response to medications.
“As a registered nurse, I’m responsible for monitoring patients, following doctor’s orders to progress their plan of care and get them out of the hospital, administering medications, and being the eyes and ears on the floor for the providers,” Flores said.
MSU nurses and technicians encounter patients with varying acuity levels, necessitating different degrees of care. High-acuity patients demand more attention and specialized care such as frequent turning to prevent bedsores, assistance with eating and closely monitoring medications that affect urinary patterns.
Staff members also manage critical events such as “code blue” and rapid-response situations, where immediate action is vital.
“A ‘code blue’ means they’re not breathing, their heart’s not beating, either, and you need to get everybody in there and start resuscitating them right away,” Flores said.
The dynamic nature of their roles requires adaptability to patient needs, whether managing a larger team with less patient care per individual or a smaller team with more intense care for critically ill patients. Personnel say flexibility is key to providing effective care.
MSU nurse and technician experiences also extend to deployed settings, where they are trained to handle tasks beyond the regular nursing scope, such as intubations and chest-tube insertions.
Labor and Delivery handles all stages
The Labor and Delivery Flight encompasses an eight-bed unit dedicated to comprehensive care during labor, delivery and postpartum phases.
This unit operates around the clock, ensuring continuous nursing and medical technician services. It focuses on catering to women in labor as well as mother-and-baby postpartum couplets, emphasizing a supportive and attentive environment during this crucial phase of maternity care.
Squadron leaders said the flight stands ready to serve expectant mothers as needed, ensuring their care during labor, delivery and postpartum phases when patients are admitted.
Continued improvement a focal point
Members of the 88th Inpatient Operations Squadron continually rotate work centers to maintain expertise and gain new skills, with regular recertification in EMT training and tactical combat casualty care every two years, enhancing their ability to respond effectively to patients.
“When you’re in a specific work center, you become very much a subject matter expert where you’re at but can lose sight of everything else. That’s why they rotate us around the facility so much,” Laina said.
With a relentless dedication to around-the-clock patient care, 88 IPTS officials said squadron members “dominate the dirty work” by embarking on demanding 12-hour shifts and bearing the weight of crucial responsibilities including not only patient care but also vigilant telemetry monitoring for the entire hospital. Collaboration between medical technicians and nurses is essential and together, they navigate the challenging landscape of health care, constantly adapting and evolving to serve a broad spectrum of patient needs as the squadron continues to enhance its expertise to ensure excellent care and remain selflessly devoted to patient well-being.