“I love the challenge of bringing the ICU to the patient”

By Maureen Gilmer, Riley Children’s Health senior writer, mgilmer1@iuhealth.org

Becca Walsh doesn’t have time to check out the view from high above Indianapolis as the IU Health LifeLine chopper comes in for landing.

She and her colleagues in the air and on the ground are busy saving lives.

Walsh works as a pediatric/neonatal critical care transport nurse, a dream job she’s held for two years.

It wasn’t her original plan. She went to Indiana University and earned a degree in journalism because she loves to write, then switched her focus and topped that degree off with another in nursing. (Her mom works as a nurse in the Mother-Baby unit at IU Health North Hospital.)

She landed a job in the pediatric intensive care unit at Riley Hospital for Children in 2018, supplementing that with occasional shifts in the Emergency Department.

She loved the challenge of the PICU, but after five years there, she decided she was ready for more – shifting her sights to IU Health’s LifeLine team two years ago. Now, the 33-year-old puts her skills to work in the sky onboard a helicopter or in the back of an ambulance, stabilizing neonatal and pediatric patients on their way to Riley.

“LifeLine was something I was interested in since nursing school,” she said. “I love the challenge of bringing the ICU to the patient. It’s you and your partner in a tiny helicopter or ambulance.”

The biggest challenge initially was embracing the autonomy that comes with the job.

“As a bedside nurse, I had the doctors right there on the unit to be a second set of eyes on my patient and they put the orders in for whatever the patient needs,” she said. “Now, it’s my responsibility, primarily, to be that decision-maker based on our protocols (and in consultation with physicians at the hospital).”

The change of mindset has been empowering in the best way.

“It’s one of the ways I needed to grow as a nurse,” she said. “It’s been good.”

Walsh and her colleagues currently work out of the Downtown Indianapolis heliport, where they share one helicopter and multiple ambulances, sometimes traveling by air as far as South Bend or Evansville. There are other LifeLine bases, each with a helicopter, in Terre Haute, Frankfort, Columbus and New Castle.

The Downtown site will close next month to make way for a proposed soccer stadium. Operations will shift to Mount Comfort, just east of Indianapolis.

Walsh, whom we met earlier this month before her 12-hour shift started, comes into the base ready to go at a moment’s notice. She’s wearing a flight suit, complete with a surprising number of pockets to hold her equipment – medications, tape, stethoscope, scissors, hemostats, alcohol swabs, knife, markers, pens, flashlight, even a Fidget toy to distract young patients – all within easy grasp as she tends to infants as small as 1½ pounds up to teenagers.

More equipment is positioned on the emergency vehicle – most anything needed to keep a patient stable during transport, including mobile NICU beds for the babies.

“I came to LifeLine with a five-year background in the PICU and a year of PRN time in the Riley ED, so learning the NICU population and how to care for the tiniest babies was a challenge …,” she said in recalling one of her earliest transports while still on orientation.

The patient was being transported from another Indianapolis hospital to Riley for possible emergency ECMO treatment due to sepsis.

“The baby was on multiple IV drips/medications to help with her blood pressure and heart function but was still very unstable. We had the challenge of figuring out which medications we could take with us (we have a limited number of IV pumps we can take safely on transports), but we also needed to do it quickly,” Walsh recalled.

Getting the patient to Riley safely meant maintaining all the medications she needed, in addition to giving other meds and fluids manually, all while bumping down the highway in the back of an ambulance with a respiratory therapist who was managing the patient’s airway and ventilator.

“We drove lights and sirens … to Riley, and the patient was placed on ECMO within a few hours after we brought her to the Simon Family Tower NICU. I remember feeling after that transport that I knew this was the role I wanted to be in, that it was going to challenge me and help me grow as a nurse.”

Outside of her office in the sky or on the road, Walsh recharges at home with her pets and plants. She adopted her first dog in 2019, then began fostering senior pups two years ago.

“I have four dogs with me now – two fosters and two of my own – and a bunch of plants, so my house is basically half dogs and half plants,” she joked. “It’s a jungle and a little chaotic, but I wouldn’t have it any other way.”

As much as she loves working as a LifeLine nurse, she never quite gave up the PICU, choosing to work occasional shifts on the unit in addition to her LifeLine role.

“The PICU will always have my heart. I love the kids and the high acuity. I wanted to get back in the chaos and keep up with my skills and relationships with physicians and nurses and patients,” she said. “That was the biggest thing I missed, seeing the progress of the patients.”

She did get to reconnect with a former LifeLine patient recently at the Riley critical care walkathon.

“The mom remembered me. It was very touching for her to recognize me and come up to talk and to see the patient.”

Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org