After their shifts at the hospital, HUP nurses were quick to help a man experiencing an overdose on a train.

By Daphne Sashin

HUP Nurse Eunhye Grace Cho

Eunhye Grace Cho, BSN, was coming off a 12-hour shift on Founders 14 at the Hospital of the University of Pennsylvania (HUP) one night in April when she stepped onto the subway at 34th and Market streets, put in her earbuds, and prepared to tune out the world until it was time to return to the hospital early the next morning. But the train wasn’t moving.

Cho heard someone scream, “He’s not breathing!” She looked around the car and saw a man a few seats in front of her, slumped over and his face blue, with two other HUP nurses trying to talk to him. She went over and asked how she could help. With another nurse, Cho counted the man’s breaths, which were one per minute – normal is 14 to 20 – and which, combined with the syringe beside him, led the nurses to believe the man was experiencing an opioid overdose. Another passenger on the train stepped forward with Narcan nasal spray, which anyone can use to reverse the effects of an opioid overdose, and administered the medicine.

“It was a team effort, but he’s the true hero in this story,” said Cho, who goes by Grace. “He had the Narcan.”

After a few minutes, when the man wasn’t waking up, Cho asked the passenger with Narcan if he could give a second dose.

“We waited a little bit because we didn't want to overdo it, and the man still wasn't waking up or breathing,” Cho said. She asked for one more dose and administered it herself. “After that, it was almost like a movie. His skin literally went from blue to bright pink, like us, like normal. And then he woke up.”

The nurses tried to keep the passenger with them long enough for arriving medics to take him to the hospital, but he wasn’t interested in receiving additional care. The nurses got off the train and went their separate ways – Cho never got their names in the chaos of the situation – after joking that “work never ends.”

While Cho has cared for many patients with substance use disorder and has administered Narcan in the hospital – Founders 14 is a Medical Surgical Telemetry unit that serves patients with a wide variety of needs – this was the nurse’s first time providing emergency care in public. She said she plans to keep her own supply of the spray with her in the future, should the need arise again.

She’s not alone. HUP Emergency Department nurse Rachel McFadden, BSN, CEN, has led education on evidence-based practices for substance use disorder, overdose reversal with Narcan, and stigma reduction, and often is approached by staff members who have put her training to use outside of the hospital. During Nurses Week this year, she distributed more than 800 units of Narcan to staff at HUP-Main, HUP-Pavilion, and HUP-Cedar as part of her work with the Penn Medicine Opioid Task Force’s Person First Campaign.

Founders 14 Nurse Manager Karen Brooks, MSN, said it was no surprise Cho sprang into action to help a SEPTA passenger in distress.

“Grace is a skilled clinician and consistently demonstrates an ability to think quickly on her feet,” Brooks said. “Her selfless actions really capture the essence of what it means to be a nurse, on the clock or not.”

Anyone in Pennsylvania with primary insurance coverage may acquire Narcan for FREE at any pharmacy using this Narcan co-pay coupon.

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