"The Saturday before Thanksgiving, 1981, working as ED nurses at UMASS Medical Center in Worcester, MA, Pam Bell and I took care of a 17 year old adolescent who was paralyzed from the neck down because of drinking and driving. The next day, when we walked into the emergency department there was a 19-year-old young man in the trauma room. He too was paralyzed from the neck down because of a drinking and driving crash. He had a breathing tube in his throat, and his mother was rubbing his arm, but I was the only one in the room who knew the patient could not feel anything. I stepped to the bedside and the patient mouthed the words, "Thank God I’m alive." I left the trauma room with tears in my eyes. The patient had two Mai Tais earlier that evening."

"On Thanksgiving Day, a patient who had been in a drinking and driving crash arrived [at the hospital] by helicopter. He needed emergency surgery. He had a 50/50 chance of living or dying! His family didn’t come to the hospital, which was unusual. When I called them at home, the person answered the telephone would not let me talk, to Mr. or Mrs. Smith. I explained who I was, and he asked if I could tell him what was going on, because the Smith’s other son had been killed in the same crash, along with a cousin. When I got off the telephone, Pam and I looked at each other and said, When is it going to stop? If people could see what we see on a daily basis because of drinking and driving, maybe they would think twice. We decided to show them."

Barbara Foley, RN
Emergency Nurses CARE Co-founder and former
Deputy Executive Director
Hear Barb Foley's interview on the History of the Injury Prevention Institue/EN CARE

The following Monday, out of anger and frustration, Pam and Barbara sent one hundred and seventy-five (175) letters to area high schools to explain their goal to talk to students about the consequences of drinking and driving and underage alcohol use. From the one hundred and seventy-five letters mailed, they received seven affirmative responses. The first program was held at a community college during an alcohol awareness day health fair. Barbara and Pam took a Stryker Frame and one slide (Use Common Sense When Driving). They learned that they would never take a Stryker Frame again – slides are much lighter to carry. The second program was held at a high school, but they needed approval from the school committee, faculty, and student council before they were allowed into the health classes. Once approval to teach the program was granted, they spent the day and conducted six health classes. They received a great response from students and faculty members. The school halls were buzzing. They never needed to write another letter after doing about seven (7) programs that first year.

During the 1982/1983 school year, the program spread just by word of mouth. Fifteen (15) schools wanted the EN CARE program to be taught to their students. In the spring, Barbara spoke to representatives from twenty-four (24) high schools to promote the program.

During the 1983/1984, Pam and Barbara continued to work full time as they taught EN CARE programs on their days off. They were bombarded with requests from forty (40) schools and began to get burned out.

During the summer of 1984, they already had booked programs for the next school year and really felt that they needed support from someone. Until then, they were using their own money to print materials, send mailings, and place telephone calls. The tremendously positive feedback that they received was self-indicative that they had a program that was much needed and wanted by community members. Barbara and Pam asked the Massachusetts Governor’s Highway Safety Bureau and the Massachusetts Emergency Medical Services (EMS) for financial assistance. Both organizations were interested in EN CARE; however, they were unable to provide financial support at that time. Nonetheless, EN CARE continued its expansion.

In the fall of 1984, Governor Michael Dukakis gave Barbara and Pam the highest award in the state of Massachusetts for public service by a state employee, and they were featured on Chronicle (an evening TV magazine show).

In January 1985, EN CARE was included in the Governor’s State of the State Address and received considerable exposure. Other nurses became familiar with EN CARE and began inquiring about how to join the organization. Unfortunately, there was no organization! It was just Pam and Barbara!

Because of the rapidly raising interest, Barbara and Pam decided to incorporate EN CARE in April 1985. With their new status, EN CARE was then able to receive funding from other agencies to support their initiatives. That same month, the Massachusetts Governor’s Highway Safety Bureau and EMS gave EN CARE grants for the first training session. The training session was also held in April 1985 and included fifty (50) nurses from three states: Massachusetts, New Hampshire, and Connecticut. The grant allowed Barbara and Pam to reduce their hours working at the hospital as full-time ED nurses to a part time status. Those grants allowed them to concentrate on the growth of EN CARE.

Following the first training, it did not take long for other states to demonstrate interest in the EN CARE program. Six months after the initial training (i.e., October 1985), EN CARE went to Illinois to do the first out of New England training session. This was a very exciting time. Barbara and Pam began this outreach effort because of the unnecessary traumas they saw at UMASS Medical Center. They went one step beyond what most nurses do, by writing letters to the high schools and presenting programs. They felt that if their message reached one student in a group of six hundred, it was worth their time. It never occurred to them that their effort would grow into a nationally recognized organization.

In September 1986, Barbara became full-time Executive Director of EN CARE while continuing to work at area hospitals on a per diem basis. EN CARE would not be what it is today without all the dedicated volunteers across the country. It has been an uphill battle with funding, but the enthusiasm from the nurses, paramedics, and emergency medical technicians has been tremendous. The greatest rewards have been the students’ reactions to the program: “Thanks for telling the truth,” is one of the favorite quotes. Students listen to the EN CARE volunteers, knowing that they care.

In 1995, EN CARE became an affiliate of the Emergency Nurses Association, the world’s largest emergency nursing organization, with a membership of over 27,000 members devoted entirely to the advancement of emergency nursing practice.

EN CARE TODAY

In 2001 the organizational structure changed and EN CARE became the ENA Injury Prevention Institute and remained located in Alexandria, Virginia. This affiliation has benefited the public and both organizations with a collaborative effort to provide education and marketing to promote injury prevention and healthy lifestyles. The restructuring also saw an expansion of prevention programs. The ENA Institute for Injury Prevention included the Bike and Helmet Safety and Gun Safety: It’s NO Accident programs. Emergency Nurses are involved in a variety of prevention programs as well as serving as community liaisons for injury prevention at the Local, State, and National level. The field of injury prevention has allowed nurses to become more involved in the community serving as advocates working collaboratively with a variety of organizations and even serving as legislative advocates working to change public policy and decrease injury.

In April 2003, the ENA Injury Prevention Institute office was relocated from Virginia to the ENA Headquarters in Des Plaines, Illinois.

AWARDS & RECOGNITIONS