Changing Perceptions and Redefining Roles

Alumni Brett Fadgen Duquesne University School of Nursing

An Alumni Profile of Brett M. Fadgen, MSN, CFRN, CRNA

Brett Fadgen asks, “What barrier?”

“I am different,” says Brett Fadgen, certified registered nurse anesthetist (CRNA) with the University of Pittsburgh Medical Center (UPMC). “I never viewed myself as disabled. However, there were people that labeled me without knowing me.”

Fadgen was born missing the lower portion of his right arm below the elbow, a physical challenge that he confronts every day in his work as a nurse anesthetist, but one that is no match for his determination to excel in the health care arena.

An Affinity for Caring

That Fadgen was drawn to nursing is understandable. As a child, he spent more time in medical facilities than most children, and he is the son of a nurse. When his grandfather suffered a severe brain injury, Fadgen then just 6 years old, pitched in to help care for him.

The desire to help others led him to obtain EMT certification while still in high school. Fadgen then served with his community emergency medical service and fire department. He obtained his paramedic certification following graduating with his first undergraduate degree and went on to work as a rescue specialist for Ross/West View Emergency Medical Services outside of Pittsburgh, Pa., and as a flight paramedic for STAT MedEvac. In 2007, he was honored as the state’s Paramedic of the Year by the Pennsylvania Emergency Health Services Council.

Despite excelling as an emergency services professional, Fadgen had set his sights on something bigger.

“My employer encouraged me to expand my education and explore options, and I was fascinated with specialized health care,” he recalls. “One of my colleagues was a nurse anesthetist, and I spent a great deal of time picking his brain to learn more about what he did and the nursing profession.”

Fadgen’s search for a nursing program led him to the Duquesne University School of Nursing’s Second Degree program.

“As a father with a young child, the Second Degree program was the perfect match,” Fadgen says. “The program is rigorous, but it was ideal for me because I was able to earn my nursing degree in just 12 months, and move right into a nursing position at UPMC Presbyterian Hospital’s Cardio-Thoracic ICU team.”

Soon after joining UPMC, he pursued a master’s degree in nurse anesthesia and obtained his CRNA certification. Today he works on a 12-person team and is one of 450 CRNAs licensed to practice at all UPMC facilities. His job takes him throughout the UPMC system, enabling him to work with specialists at each facility.

Writing the Book on Adaptive Training

Fadgen recognized early on in his nursing education that he was blazing new trails that would require him to adapt to the physical demands of the job rather than expecting his instructors or employer to adapt to his physical difference.

“My life and job experience gave me a great deal of confidence that I could succeed as a CRNA,” he notes. “But questions would come up during training sessions and simulations, and I realized that I had to perform procedures similar to every other nurse anesthetist because that is the standard of care and patient safety is the utmost importance. That there were no other references for a situation like mine did not matter. It was up to me to figure out how to adapt to the equipment and adhere to the procedural guidelines with the understanding and acceptance of reasonable accommodation.”

With the support of his instructors, Fadgen did what he had done all his life—adapt to counter his physical difference.

“Nobody knew how to teach a one-armed person how to intubate a patient or place an IV,” he says. “I needed time to work out the techniques and master the skills, so I would ask my instructors, ‘What do you fear I will not be able to do?’ and then had them put me in the station so I could learn to do it correctly, safely and without harming the patient. I had to develop my techniques, test them and practice them until I could perform them flawlessly.”

As he learned the procedures required of a nurse anesthetist, Fadgen literally wrote the book on adaptive techniques that can be used to train and support others with similar physical challenges. For example, Fadgen figured out how to shorten his prosthetic arm and developed a gripping device, similar to vise grip pliers, which he uses to place suction quickly to prevent aspiration. Or he attaches a common hose clamp to the pressure limiting valve to provide a better grip, and uses it to raise or lower the pressure.

He also developed an approach to address any misconceptions colleagues might have about his capabilities and put them at ease when they work with him for the first time.

“I had to do the same thing as an EMT or a firefighter, like any new person in any job—show them I could handle a hose or safely carry someone out of a house,” he says. “People wonder how I can complete a skill with one less arm or hand, so I demonstrate the procedure with my adaptations so they can see the way I perform the skill, and do it efficiently and safely.”

Fadgen is often requested by his colleagues and other health care disciplines to provide anesthesia for them and their loved ones.

Changing Perceptions…And Redefining Roles

“It is a two-part process,” Fadgen says. “You have to do what is necessary to overcome your disability, and then you have to overcome other people’s misconceptions or lack of understanding about you. I want to be the person that changes those perceptions.”

Fadgen will continue to change his colleagues’ perceptions and those of future generations of aspiring health care professionals. He is an adjunct faculty at UMPC’s School of Nursing and teaches courses at the Peter M. Winter Institute for Simulation, Education and Research, one of the world’s most advanced simulation centers for training medical professionals.

“My nursing degree from Duquesne University opened so many opportunities,” Fadgen says. “As a nurse anesthetist, I get to be the face of health care for my patients. I am with them and responsible for their well-being throughout their procedures, communicating with the surgeon and anesthesiologist, or working to anticipate or respond to any situation that may arise.

“Perhaps most important, I get to be a father that my kids look up to. I take great pride to walk the walk in everything I teach them. I am very proud of what I do.”

This article has been reprinted from Nursing Magazine, Vol. 5.

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