One of my fond childhood memories is of attending the 1964–1965 Word's Fair in Queens NY. This exhibition of cultures and industries was fascinating. Although the majority of the pavilions were United States commercial companies, there were also 21 state pavilions and 36 foreign pavilions. It was the dawn of the space age and the fair's theme was “Man in a Shrinking Globe in an Expanding Universe.”1 The world was so big, and events that happened in other countries seemed so distant, so far from my life in a small Connecticut town. Seeing the way people in other countries lived, sampling their food, and seeing their clothes was an expansion of the world I knew. There were technological wonders, including the General Electric exhibit of the “home the future,” outfitted with time-saving devices that only a few wealthy people owned at that time. The information exhibits proclaimed two broad themes: that rapid, globalized communications would draw people together and that this would break down barriers of misunderstanding. It was the dawn of the information revolution.1 A distinct highlight for me was the Pepsi Cola exhibit. It was a tunnel-of-love–style water ride developed by Walt Disney called “It's a Small World: A Salute to UNICEF.” In various areas, there were familiar scenes like France's Eiffel Tower, a Dutch windmill, and India's Taj Mahal. The animated figures danced and played with animals while they sang, in various languages, the song “It's a Small World.”1 The words were simple and the tune was the type that lodged in your mind and you hummed it all day long. “It's a small world after all; it's a small, small world.”
I grew up, and the world did too. Rapid, globalized communication became a reality. Now we know about events as they happen. Americans watched the World Trade Towers collapse. Within hours, on amateur video, they saw the tsunami that struck Southeast Asia. And they knew that Princess Diana had perished in a car crash in Paris while England slept. The internet, instant messaging, cell phones, and podcasts are all methods never anticipated by the developers of that World's Fair, but they came to be, and the result is a flood of knowledge about our world, 24 hours a day, 365 days a year.
In nursing, I have come to see what a small world we live in and to appreciate the unity of purpose that nurses share, regardless of nationality, resources, or educational background.
ENA was invited to coordinate the international nursing track at the Third Mediterranean Emergency Medicine Congress in Nice, France, in August, 2005. In that role, we collaborated with nurses from England, Spain, Turkey, the Netherlands, Romania, Slovenia, and Lebanon as they prepared presentations highlighting emergency care in their country. The day of their presentations was a remarkable experience as each presented an aspect of their practice. Highlights include how hospitals in the UK are using nurse practitioners in triage to rapidly expedite care for nonacute patients. In Slovenia, a national research study evaluated EMS education, the level of providers, and patient outcomes. The speaker from Spain described the nursing shortage as it is affecting European nations. A research study of how the city of Beirut, Lebanon, responded to a car bombing that injured hundreds of innocent bystanders emphasized the impact that violence and civil disruption has on many nations. I was humbled listening to the Romanian speaker describe the improvements in trauma care for their patients with the addition of 2 helicopters for aeromedical transport, as I thought about the number of helicopters that service my city of Philadelphia alone.
In November of 2005, ENA representatives attended the Royal College of Nursing's Emergency Care Association conference. It was an international conference, and many attendees came from European, Asian, and African nations to participate. The signing of an international declaration of friendship and cooperation by representatives of the attending nations during the opening ceremony was a touching reminder of our common purpose as emergency nurses.
In March of this year, ENA again was invited to participate in an international collaboration opportunity. I had the privilege of spending a week in Beirut, Lebanon, along with 2 ENA colleagues, teaching and consulting at the American University of Beirut Medical Center. The workshops were attended by nurses from across the country. They drove up to 4 hours to attend the courses and some did not speak or understand English, but wanted the education. Fortunately, they brought interpreters to help! The hunger for learning was apparent. We had the opportunity to observe in their emergency department and consult with the staff on the practice of emergency nursing. They will become the first international site to take the CEN examination on-line and are requesting that ENA return in the future to do TNCC courses.
Other international activities for ENA in 2006 include bringing ENPC to Portugal, and later this year TNCC will be taught in the United Arab Emirates and South Africa. In all the places ENA has been privileged to visit, the process is the same. We work together with our colleagues in those nations to strengthen the role of the emergency nurse, sharing knowledge and building skills needed to improve the delivery of care to their patients.
We emergency nurses are a small sister/brotherhood of people who share a common purpose, a common goal. Regardless of how we sound, what language we speak, or the clothes we wear, we care deeply about the patients who come through our doors, and we seek the same outcomes for them—relief from pain, relief from fear, to place them on the road to recovery, or provide a peaceful transition from one life to the next if our efforts fail. We support the patients' loved ones, and we work as a team with our coworkers and other health care professionals. Variance in the practice of emergency nursing is the result of such things as access to supplies, equipment, and educational opportunities; hospital financing to support nursing positions; traditions; and cultural norms. But at our core, we are all the same. We are emergency nurses, we love our practice, and we want to be our best. All other differences fade in light of our common purpose, common belief, and common values.
It's a small world after all…
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