Global Guardian: Nancy Faller: V is for Versatile, Visionary, Volunteer
She may be small in stature, but what Nancy Faller, RN, PhD, CETN, may lack in height and girth, she more than compensates for in heart. This globetrotting provider of care and compassion (and sometime poet and creative writer) has been tending to patients in countries from A to almost Z, including with the US military. She personifies the word guardian — she is protective, dedicated to championing her patients’ right to heal. Dr. Faller (or “Nancy Nurse” as she prefers to be called) earned her bachelors degree in 1968 at Saint Joseph College, Emmitsburg, MD. After 2 years of military service and 4 years with the PA Easter Seal Society’s Camping Program, Nancy completed her ET Nursing Education (ETNE) at Harrisburg Hospital in Pennsylvania. She received her Masters degree in 1994 from Russell Sage College (Troy, NY) and her Doctorate in 1997 at the University of Massachusetts – both Amherst and Worcester. She then spent 30 years in Rutland, VT, working across health settings and age groups. The CARE model of ET Nursing — clinical, administrative, research, and education — directed her practice. Nancy began international volunteer work in 1967 after her junior year in college. With a loosely established student group, she headed to rural Mexico where few houses had running water and most had only 2 hours of electricity a day. Automobiles and refrigeration were nonexistent. “We thought of ourselves as Florence Nightingales but were actually Fairly Know-Nothings,” Nancy says. “Proof of that is my first ever wound healing experience. In attempting to stop the bleeding of a young man with a machete injury to his finger, I used a sterile woven cotton gauze compress. The bleeding stopped, but the dressing stuck to the wound. Little did I know the dressing could be soaked off. I spent hours removing it string by string.” From 1969 through 1970, while an Army Nurse stationed in Qui Nhon, Vietnam, Nancy volunteered at the local civilian hospital and at the Qui Hoa leprosarium and orphanage. After becoming an ET nurse, she took advantage of multiple opportunities for volunteering in other countries: Argentina, Australia, Brazil, Canada, Chile, China, Columbia, England, France, Hong Kong, Hungary, Israel, Japan, Singapore, South Africa, Spain, Sweden, and Uruguay, along with many trips back to Mexico. Some of these trips involved only education; others included clinical consulting. Nancy’s most recent volunteer experience was a week spent in Kingston, Jamaica, with the Missionaries of the Poor, an international monastic order that provides care to the destitute, disabled (mentally and/or physically), elderly, and malnourished, as well as orphans and persons terminally ill with AIDS. Nancy says this band of brothers radiates joy and is “never fully dressed without a smile. “Their CARE is infectious – Christian, Affectionate, Respectful, and Effervescent.” Perhaps the biggest obstacle for Nancy is not the natives of the countries she’s visited but the natives of her own country who “insist on always taking first-world medicine into a third world country.” When the basics — predictable electricity, safe roads, viable transportation, and potable water — are lacking, a 2012 ostomy pouch, wound dressing, or catheter is not a top priority. In one situation Nancy encountered, the answer to local ostomy products damaging the skin was simply to adjust the manufacturing process so the edges of the plate were smooth. In another situation, the answer to wound infections was simply providing an alternative to cold water for hand washing. In a third situation, reusable diapers were not the simple answer in the absence of hot water and space to hang laundry. Each situation must be assessed for the economic and environmental elements influencing the question at hand. Nancy has found that the best way for volunteers to be successful at caring for people in a foreign country is to find out how locals would handle the case presented. Sometimes healthcare volunteers can learn of an intervention they would not have considered. Nancy offers the example of a fecal incontinence pouch being suggested for use on a fistula in a large panniculus. The pouch was applied and facilitated closure. The second challenge volunteers face is to find out what products are available and to consider how these might be adapted for a given case. In one instance, a negative pressure system was devised from a Foley catheter, a plastic bag, and IV tubing for use on a fistula. This facilitated both wound and fistula closure.1Reference 1. Faller NA, Zanella A. Management of an enterocutaneous fistula in Uruguay. WCET J. 1991:11(2);36–37.