I’m an Intensive Care Unit (ICU) nurse, not a rock climber. In fact, I don’t like heights at all.
But on a sunny September day, I was halfway up a climb on the Yellow Wall in Western North Carolina, and I was stuck.
It was a beautiful morning, with tree top colors hinting at fall and layers of Appalachian Mountain views in the background. Seven nurses were on a five-day backpacking and rock climbing trip, sponsored by the North Carolina Outward Bound School (NCOBS).
I reached out to NCOBS the year before to pitch the idea of an expedition for ICU nurses. I knew they offered courses for educators and veterans, and after the last three years of COVID-19, I couldn’t think of a group that needed some outdoor therapy more than ICU nurses.
To my pleasant surprise, NCOBS quickly said yes, they’d love to offer us a free, five-day backpacking and rock climbing course.
My original vision was to get some outdoor rest and relaxation but also to build teamwork and communication across ICUs. We regularly float to different units, and I thought this would be a way to foster connection between nurses. In the end, though, it exceeded all my expectations personally and professionally.
We backpacked for two days to get to the climbing area, carrying 40+ pound packs with all our group gear, food, and personal items. We slept under tarps and filtered water collected from mountain streams. We also talked about work—up and over mountain trails, we talked about the stress of working in the ICU. We laughed at all the dark humor we use to cope with the life-and-death situations we encounter every shift. We shared stories of the grossest body fluid encounters, sickest patients, saddest cases, hardest days, and best outcomes. Most of us did not know each other before the trip, but we bonded quickly through the shared joy and struggle of the expedition.
We climbed on the third day, and I was on my second attempt. My first try was more of a “get-to-know-you” visit on the rock face. The second time, I was face-to-face with the rock I was determined to climb. My breathing was heavy. My fingers clung to tiny holds, and my feet in big hiking boots searched for a secure spot to push up to the next level.
In preparation for our climbing day, our instructor said, “If you feel like you can’t go any farther, go just six inches more.” But I was stuck at the same spot I encountered on my first attempt. From below, I heard my coworkers call out suggestions like “By your left knee, there’s a ledge!” and “Right foot, big step up.” So, I yelled down, “I’m going six inches more!”
And then six more inches, and six more. Six inches at a time I made my way to the top. I knew my coworker at the end of the rope had my back—literally since he would use the belay system to stop my fall if I missed a hold.
Our instructor also said it would be a missed opportunity if we took this week as just checking boxes without finding deeper meaning. For me, it was hard to NOT find meaning around every rock and up every hill. The entire trip felt layered in metaphor as we shared the load of heavy gear, split into groups to filter water or set up camp, and encouraged each other during hard moments. But the significance of the climbing contract, an agreement among each other, impacted me the deepest.
Before each climb, the team opened a climbing contract. When it was my turn to climb, my coworker, Rob, would belay. I started by asking the climbing instructor to check our gear. For me as the climber, she checked the knot through my harness and assessed my helmet. Then the belay, she checked Rob’s harness, knots, carabiners, and ropes through the Air Traffic Controller, a device used to manage the rope attached to the climber and catch falls. We also had a backup belay, Shelby, in case something happened with the first belay, as an extra layer of protection. With an all-clear from the instructor, I turned to Rob and said, “Rob, on belay.” He acknowledged the contract, and said, “Shelley, on belay.” Then when I was ready to go, I said “Climbing!” and Rob said, “Climb on!” We talked to each other throughout the climb. I eagerly accepted feedback on where to find the holds and next moves. After I made it to the top and rappelled down, we closed the contract when I said, “Off belay” and in turn he confirmed, “Belay off.” Then we released the ropes, unclipped, and celebrated. And yes, we all celebrated!
My belay crew was just as happy as I was because my success was also their success. It’s the attention and intention behind the climbing contract where I find meaning. Our nursing work in the ICU is demanding and cannot be done alone. It can be scary, and the route unclear. I tell the students and new graduates I precept that no one goes home at the end of the day with a badge saying, “I did it all myself!” We must work together in the ICU to take care of our patients that are often intubated, sedated, paralyzed, and prone. It’s not just nice to have a team of nurses in the ICU—it is necessary.
Near the end of the course, I reflected on how to bring this experience with me to nursing. What if I came to work each day, looked at my nurse neighbors, and said with intention, “I’m here for you today. I’ve got your back. I will help you turn your patients, clean them up, or give your medicines. I’ll listen to you or give suggestions and encouragement. I won’t let you fall. I’ve got you.”
That would be, “Teamwork, on belay!”
Shelley Booth, MA, BSN, RN, TCRN, is a Surgical-Trauma ICU nurse and a member of Sigma’s Eta Psi Chapter.