FEATURES

Dealing with reality: Confronting the global nursing shortage

Nurse who fears heights scales Mount Everest on behalf of nursing shortage

by Jane Palmer

A mountain climber afraid of heights is a bit out of the ordinary. A “C” student in high school who earns two master’s degrees and a doctorate in nursing is also unusual. But, then, “ordinary” and “usual” are not words one would use to describe Patrick Hickey, RN, BSN, MS, MSN, DrPH, CNOR, clinical assistant nursing professor at the University of South Carolina in Columbia.

When Hickey, 52, climbed 29,035 feet to the top of Mount Everest in May, he earned the distinction of being the only nurse to have scaled the Seven Summits of the world—the highest elevation on each of the continents. He has used the publicity surrounding his achievement to increase awareness of the nursing shortage and to raise funds for a nursing scholarship at the University of South Carolina.

In accomplishing both his mountain-climbing and professional nursing goals, Hickey prevailed despite obstacles that most would find overwhelming. Acrophobia—in Hickey’s case, a paralyzing fear of heights—was a huge challenge.

“Mountain climbing and fear of heights really don’t go hand in hand,” Hickey notes. “You’d think that the more I did it, the better I would be with dealing with heights, but it hasn’t worked that way.

“I have the form of acrophobia where if someone touches you when you’re on a high object, you want to jump, even though you’re not suicidal. It’s been really problematic.”

Reaching the summit of Alaska’s Mount McKinley requires traversing a ledge just 7 feet wide. Hickey recalls the harrowing experience:

“I was actually crying on this ledge before I went up. The guide already knew I was afraid of heights. He said, ‘Don’t worry, you’ll be fine.’ I went into what I call my old-man mode—just shuffling my feet. I don’t look left or right, just straight ahead. But we were all roped together on McKinley, and the wind was so strong that the rope was in mid-air—it wasn’t dragging on the ground in front of me. So you’ve got a wind blowing you, and you’re walking on basically a snowdrift, with a drop of thousands of feet on each side.”

Everest was a hundred times worse than McKinley, Hickey says. The final summit push is nearly straight up, with a 10,000-foot drop on the left and a 12,000-foot drop on the right. As he climbed toward the peak, he slowed down to a snail’s crawl. His Sherpa (Nepalese) guide, who didn’t know English, thought Hickey was tired and kept pushing him.

“I wasn’t going slow because I was tired; it was because I was so fearful. Fear just paralyzes you—my fear of heights does, that’s for sure. It’s kind of my persona, though. I keep challenging my fears—whether fear of heights or fear of education or fear of whatever.”

Struggling in school
Earning his nursing degrees was also difficult. He grew up in Almonte, Ontario, Canada, the oldest of nine children—eight boys and one girl. During elementary school and high school, he didn’t push himself to excel and felt particularly uncomfortable in math. He barely graduated from high school.

A guidance counselor recommended several careers to Hickey: prison guard, child-care worker, behavioral counselor and nurse. He had always had a fear of prisons; he wasn’t especially fond of children; and he couldn’t imagine counseling others on their behavior when, as he says, he was so “unbehaved” himself. Of the career choices the counselor suggested, nursing was the most appealing. He told his parents about his decision.

“My mom was happy. We’re Catholic, and she had thought at one point I was going to be a priest. She figured nursing was as close as I could get to godliness and servitude. My dad, though, being a macho farmer, wasn’t very happy with my decision. He took it as an insult. He’s made peace with me since, because he’s seen what I’ve been able to do.”

As he worked toward a diploma in nursing, though, Hickey became increasingly frustrated and discouraged. He struggled with clinicals. To study for an exam, he would painstakingly write everything out two or three times to understand the material. He told his clinical instructor that choosing nursing as a career was the worst decision of his life. Instead of sympathizing with him, the instructor challenged him to do more. Seeing potential in Hickey, she assigned him the most complicated patients.

“Surprisingly, I did well. I wasn’t an A student, but I passed the program, which for me was exciting.

“It’s been since then, I guess, that I’ve been on this long road to challenge myself—whether it be educationally or challenging my fear of heights,” Hickey says. “I took it to the max by climbing the highest mountain.”

Similarities between nurses and mountain climbers are easy to see, Hickey says. Both require strong communication skills and teamwork, view safety as a priority, and deal in life-and-death situations.

The 'Holy Grail' of mountaineering Between 2001 and 2007, Patrick Hickey climbed the Seven Summits of the world: 2001 – Mount Aconcagua, Argentina 2002 – Mount Kilimanjaro, Tanzania 2003 – Mount McKinley, United States 2004 – Mount Elbrus, Russia 2005 – Carstenz Pyramid, Indonesia 2006 – Mount Vinson, Antarctica 2007 – Mount Everest, Nepal

Brushes with death
The dangers of mountain climbing, especially Mount Everest, are significant. Hickey says he twice faced life-threatening situations while climbing the highest mountain in the world.

His first brush with death came when he climbed from Camp 3 to Camp 4. At that point, climbers are on their own (at High Camp, a Sherpa accompanies mountaineers). The drops on the side of the cliff were so severe that he slowed down. He already had a leak in his oxygen bottle, and the slower pace caused him to run out of oxygen. As he tried to put warmer clothing on, the jet stream winds of nearly 60 mph ripped the clothes out of his hands.

“I got to the point where I was so hypothermic that I felt like the wind was spinning me around like a little leaf,” Hickey says. “I just wanted to sit down and go to sleep. In my mind, what was left of it, I knew that I’d run out of oxygen and wasn’t thinking right. I knew that if I sat down, I would never get up again.”

Slapping his face and biting his tongue, Hickey dug deep within himself and finally reached Camp 4. There, his tent mates warmed him up, gave him oxygen and forced him to drink fluids. He had only three hours to recover before beginning the last leg of the climb to the top of the world.

When Hickey finally reached the summit, he scattered the ashes of his best friend, Sean Egan, who died two years ago on Mount Everest. At age 63, Egan was attempting to be the oldest Canadian to reach the peak, but he became sick at Camp 3. He climbed back down to a point below base camp, where a helicopter had been summoned to pick him up. He collapsed and died while walking to the helicopter.

“When I was home in February,” Hickey says, “I got Sean’s ashes from his daughter and carried them to the top of the world with me. I took advantage of that moment and released his ashes and said a prayer.”

Hickey’s second near-death experience happened on Everest’s summit, soon after he released the ashes. His right eye started burning and within minutes, was swollen to the point where he could not see. Then the vision in his left eye became blurry. At that point, he was alone on the mountaintop.

He felt panic set in as he realized that he had to make it back down to the safety line, a rope fixed into the mountain that climbers are “clipped" into.

“It was just before I got to my safety line that I tripped and fell,” Hickey says. “Everything went in slow motion. There isn’t much room on the top. If you slip, you’re sliding 10,000 feet into Tibet or 12,000 feet into Nepal. I remember lying there after I fell, not knowing whether my butt was hanging into one country or the other, or if I was hanging, or where I was.”

The Sherpa grabbed Hickey and walked him down to the safety line. It took the guide, who didn’t speak English, a long time to understand that Hickey couldn’t see out of his right eye.

“When my Sherpa saw that I was blind in my right eye, he slowed his pace. It took forever for us to get down—I kept falling, because I couldn’t see my feet properly.”

Hickey’s vision returned three days later. Ophthalmologists think the temporary blindness was caused by a combination of snow blindness and irritation from strong winds whipping snow into his face.

“Nothing comes easy,” Hickey says. “I could have just walked up, made it to the top, took a few pictures, made my peace and then come down, but no …”

Support from significant others
Hickey’s wife, Carol, has supported her husband’s ventures as a mountaineer. She joined him in climbing Mount Kilimanjaro in Africa, a 20,000-foot climb, but one less technically difficult than the other six. During some of the climbs, she waited anxiously, sometimes for weeks, to hear from him. Hickey promised Carol that once he accomplished the Seven Summits, his mountain-climbing days were over.

For more than 20 years, the two have shared a passion for travel and adventure. In 1984, they backpacked around Europe for six months, then traveled around Canada and the United States for another six months before returning to work. Four years later, they stored their belongings for a year while backpacking around the world. In 1993, they spent a year hiking throughout Latin America. Together, they have traveled to 57 countries.

Patrick Hickey’s “monumental” experiences in Latin America triggered changes in his life. His doctoral dissertation examined barriers Hispanics experience when trying to access health care. Also, he joined Partners of the Americas, an organization formed to promote alliances between Latin American countries and individual states in the United States. South Carolina was aligned with Colombia, South America. With the cooperation of the hospital’s administrator, Hickey has sent six shipments of medical supplies, worth more than $1.5 million, to hospitals and clinics in Colombia.

By successfully climbing the Seven Summits, Hickey joins an elite group of about 150 people in the world. His wife, however, often reminds him that it’s the journey, not the destination, that’s most important.

Passion for teaching
After graduating as an RN, Hickey moved to Corpus Christi, Texas, in 1979 to begin his nursing career. As a staff nurse, and later as a manager, he gained experience in medical-surgical, emergency care, coronary care and surgery. He then became director of quality, which eventually led to the position of risk manager in a 650-bed hospital. In 1989, he moved to South Carolina and in 2005, accepted a position as assistant professor at the University of South Carolina.

“I encourage my students to get as many experiences as possible in nursing,” Hickey says. “Before I worked in the ER, I developed good basic nursing skills. I worked 10 years at a Level 1 Trauma Center. For most of that time, I was charge nurse on the evening shift. It was a life-changing experience.”

Hickey often shares his life experiences with nursing students.

“I almost died on the top of the world, but I made it. I say to the students, ‘Hey, I had problems in school. Some of you may be the same as me and you don’t want to say it, but I know you’re out there.'”

In recognition of Hickey’s accomplishments, the University of South Carolina College of Nursing established the Summit Scholarship for student nurses. His goal is to collect $29,035—one dollar for each foot of altitude of Mount Everest.

Challenges of new adventures
What adventures lie in the future for Hickey? Perhaps competing in the Ironman Triathlon—that is, if he can develop his swimming skills. If past experience is any indication, he’ll find a way to meet that challenge.

He plans to write a book about his adventures as a mountaineer and as a nurse. The message in his book will mirror his philosophy on life: “You can do anything with the proper motivation, dedication and support system. Life is full of adventure. If I can do it, you can do it too.

“All my life, I have taken on challenges that pushed me outside of my comfort zone,” Hickey says. “I have struggled throughout school, as nothing ever came easy to me. However, I persevered and gained confidence. I feel that I am in a much better position in life for having pushed myself and hope that I can now help students see their potential.” RNL

Jane Palmer is assistant editor of Reflections on Nursing Leadership.

For more information on Hickey’s climbs, visit www.Amercan.us or read his blog at www.myeverest.com. To make a donation to the Summit Scholarship fund, go to http://www.sc.edu/nursing/SummitScholarship.html.