The ENA Member Spotlight showcases members and their varied experiences, backgrounds and ways they share their skills in the ED and beyond.
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September Member Spotlight: Rachel McFadden, MPH, BSN, RN, CEN,
Rachel McFadden, MPH, BSN, RN, CEN, has devoted much of her professional and volunteer efforts to caring for people who are marginalized, particularly those struggling with substance use disorder.
“There is still a lot of stigma about drug use,” said McFadden, who is an emergency room nurse at Hospital of the University of Pennsylvania and works in the social services agency Prevention Point Philadelphia’s wound care clinic.
McFadden works to ensure a patient’s dignity is protected, no matter their circumstances, whenever and wherever the person is receiving care. Sometimes that’s the ED, sometimes it’s at the wound care clinic or even on the streets where she has volunteered to help unhoused people get the care they need.
While she feels very passionately about destigmatizing substance use disorder, McFadden knows that preaching about it to peers isn’t the right approach.
“If I do what I feel is right, people are watching,” she said. For instance, she once worked with a colleague who was “an excellent nurse, but she didn’t have a lot of patience for people with substance use disorder.” After they worked alongside each other for a while, the nurse said, “I really appreciate how you engaged with these folks,” McFadden recalled. Later, McFadden learned that nurse was dealing with her own emotions surrounding a relative struggling with substance use disorder.
“It’s about meeting people where they are. I assume that everyone I work with wants what’s best for their patients,” McFadden said.
McFadden initially planned on becoming an infectious disease doctor. She earned her bachelor’s degree in biological sciences at University of Chicago and started working at an HIV clinic in Chicago staffed by many doctors and one nurse practitioner.
“I met her (the NP), and I was like, ‘Oh, this is it. This is what I want,” McFadden said. She moved to Philadelphia and earned a bachelor’s degree in nursing from the University of Pennsylvania. She recently completed her master’s in public health administration from Johns Hopkins Bloomberg School of Public Health.
In addition to direct patient care roles, she is also a Bloomberg Fellow with Penn Center for Addiction Medicine & Policy, conducting research and leading nursing education, such as one program earlier this year to build awareness around Xylazine, which is responsible for some of the wounds she herself has treated among her patients.
“I love nurses. Nurses can make or break a visit (to the ED) for anyone,” McFadden said. “I care about stigma because as nurses, we are in a powerful position.
“We can be such a place of respite,” she said of the ED. “One safe night off the street can be powerful.”
McFadden knows that burnout among nurses is real, and she has worked to prioritize her own needs to avoid it. One of the ways she cares for herself is by heading into the wilderness for respite and a recharge. Her love of the outdoors even led her to obtain a wilderness medicine certification through the National Outdoor Leadership School several years ago. She said that her NOLS experience proved useful when she was doing street-based emergency medicine, and she plans to renew that certification.
McFadden said she wants to see better support for nurses, particularly trauma-informed care. When nurses don’t have the care they need, it’s much more difficult to give of themselves, she said.
“You have to protect the emotional health of nurses,” McFadden said.
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