Tragedy in Boston: Nursing Students Get Unexpected Education

Susan Yox, RN, EdD

April 19, 2013

On Monday, April 15, Adrienne Wald, EdD, BSN, director of undergraduate nursing at the College of Nursing and Health Sciences at the University of Massachusetts in Boston, along with her faculty colleague, Kathleen Kafel, MS, RN, and their 25 nursing and 5 exercise science students planned to spend a peaceful, fun, and educational day at the Boston Marathon.

They were working on a medical sweep team, where their job was to identify and aid those with common running injuries or conditions, transporting runners needing attention to the medical care tents. The day was going along uneventfully, but then the unexpected and unimaginable happened, and 2 bombs exploded near the finish line.

Dr. Wald was a few blocks from the finish line when the bombs exploded, but some of her students were near the explosions. "The medical tent is right by the finish line and directly across the street from the tent is where the first bomb went off. Some students were right there and they saw everything," she explained.

All undergraduates, many of the students were quite young and had not yet had any emergency or critical care training. One student, located near the finish, "had to help someone whose leg was severely injured. It was horrific. I'm very thankful none of the students were injured."

When asked what the students' assignments were, Dr. Wald explained, "the medical sweep teams man wheelchairs and they were assigned to different zones around the finish line. The runners come pouring over the finish line, they get their food, they get their medal, and they get their water and that's where we see all the common medical conditions after a marathon."

She went on, "We work the chutes and the finish area for a couple of blocks all around, helping the runners, assessing them, and if somebody looks wobbly or looks like they're going to collapse, or is cramping up, we get them in a wheelchair, and get them to a medical tent if they need to go or just help them get to their dry clothes and walk with them a little bit, to keep an eye out and be sure they're not falling over."

Dr. Wald has run the Boston Marathon herself many times in the past. But this year she had a ski injury and couldn't run. "I thought it would be great for the students to volunteer, it would be a great opportunity for them."

Trying Not to Cause Panic

Some of Dr. Adrienne Wald’s students leaving the marathon course.

During the aftermath of the 2 explosions, Dr. Wald described the chaos. "I was a couple of blocks away and my only concern was for the safety of my students at that point. I'm from New York and I was having 9/11 flashbacks. I truly thought that the Prudential Center was going to come down or the John Hancock Building."

She described how everyone was trying to text each other. "There was a communications person assigned to every zone and I kept saying, 'Andy, what are you getting? What's going on? What should we do?' And of course I was texting the other faculty person there to see if she was okay, if she knew where some of our students were, because all of us were in these different zones."

Dr. Wald explained that she was still a few blocks away from the explosions. "Runners were still coming across and we were trying not to cause any panic because we didn't know what was going on, we didn't know if we needed to get people out of there, we didn't want to cause a stampede."

It was difficult because at first they couldn't get any information about what had happened. "It was eerie. And it was surreal to have these runners elated about finishing the marathon and looking for their families. We just didn't know what was going on."

Dr. Wald went on, "About that time, most students had joined together and we decided to get a few blocks away. Authorities were saying that maybe it wasn't safe and it looked like it was a smart thing to leave. We went all together to the Boston Commons as a group and then we started to make sure that we knew where everybody else was. We checked off everyone. As we left, I kept counting the students. That was my way of coping." They decided that there was nothing more they could do on the scene.

Dr. Wald said one student, who had been near the finish line, said he "couldn't believe how the nurses from the medical tent all ran out just took charge and were so competent and under control and professional."

Debriefing Session

They then moved together to a nearby apartment. Dr. Wald described the time they spent talking. "I did have 2 students who were RN to BSN online students and one of them is an EMT and is an older student who had experience with debriefing, so the two of us led a debriefing session, just what you might expect."

She went on to say that while she was worried that this event might change how students felt about emergency medical care and that they might even think about changing their majors, instead students expressed a lot of conviction that they were in the right place and that they were happy to be able to help.

A follow-up email message from one student, Megan Croake, summed up the feelings of the students. Megan wrote, "I've never been prouder to be a future nurse and a helper. Instead of letting this event make me weaker or timid toward my career choice, I intend to only let it make me that much stronger."

Dr. Wald is suffering herself in the aftermath of this event. She explained, "My colleague and I shared the same feelings — we felt like we didn't do enough. We had all this guilt that we should have gone to the area and been more helpful, but we all did what we were told, which was to stay in our zones and just wait for more information. I knew that there were hundreds of trained people at the medical tent, so I didn't feel like I should run down there."

In the few days that have elapsed, Dr. Wald has been able to find a bit of perspective. She wanted to tell her story, she said, "because I am so proud to be a nurse and so proud of the students that we're producing here. First of all, I was just so impressed that on a holiday at 7:00 in the morning these 30 students got out of bed to go help runners, let alone to be involved in what happened. They're going to be wonderful nurses and they did with their training what they could do."

She was so proud, Dr. Wald said, at how " they were able to use their training and to cope with something that no one could ever have foreseen."

Dr. Wald said she hopes that all the nurses involved will be remembered. "There were nurses who had to immediately respond with all of their skills and then afterwards nurses will care for all these people who have lost limbs and who are completely traumatized.

"Victims will have to rehab for months and there are just going to be so many nurses involved in their care for such a long amount of time. My hats off to all of them for the work they do every single day. We sort of take it for granted but times like this we really just so appreciate each other."

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