Becca Loux-Clark has spent her career running toward what most of us try to avoid: emergencies.
She rushed to her first at age 14, as a junior firefighter in Pennsylvania. Over the years, Loux-Clark climbed the ranks to paramedic and emergency medical services (EMS) supervisor, jobs that relied on her rescue instincts and expertise with every call.
In 2023 she became the first flow nurse inside Novant Health New Hanover Regional Medical Center’s emergency room, managing the needs of as many as 300 patients a day. The role requires a cool head and creative maneuvering to prioritize trauma patients and ensure that emergency care is provided as quickly as possible.
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An ER patient – or often several at the same time – might come in with a life-threatening injury, heart attack, stroke, abdominal pain or something else. During those critical first minutes, Loux-Clark works with paramedics and nursing staff to provide the fastest care possible.
How many people are in the waiting room? How many beds are available? Those answers shift by the second. And it’s up to Loux-Clark, 34, to manage the patient flow and coordinate transfers to the appropriate inpatient setting.
“You’re constantly trying to put together a human Tetris puzzle,” she said. “Being this hands-on in the medical field is a challenge day in and day out. You never know what you’re walking into.”
Less waiting in the waiting room
Throughout the U.S., surges in medical needs combined with hospital capacity strain present an obstacle that health care teams are working hard to prevent: the risk of a patient leaving before being seen by a nurse or doctor.
Flow nurses are brought into the fold to help reduce that burden. Few understand that better than nurse manager Will Tobin – a former flow nurse himself – who advocated for adding the position when he joined the New Hanover Regional Medical Center team in 2022.
The hospital has 108 treatment spaces in the emergency department, and Tobin saw room to improve traffic and accommodate patients as quickly as possible. “We sat down as a leadership team and decided that we needed somebody to manage the flow,” he said.
Tobin had the perfect candidate in mind. Sure enough, Loux-Clark’s 20 years of training in unpredictable rescues immediately ensured the flow nurse role would live up to its title.
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Before Loux-Clark joined the department, about 5% of patients left without being seen by a doctor. But after the first year, that number dropped to less than 2%, much lower than many hospitals of similar size nationally, Tobin said.
“Becca is one of the most incredible nurses I’ve ever worked with and is a very calming presence, especially on those days where we see 300 patients,” he said.
While attending nursing school, Loux-Clark worked as an emergency medical technician, and later as a paramedic on a 911 ambulance and a registered nurse on a critical care truck. She holds a master’s degree in EMS and a graduate certificate in emergency and disaster preparedness.
Loux-Clark said her work on the outside prepared her for the bustle of life inside the ER, “because I’ve been on the EMS side of things; I’ve been in the back of the truck. It taught me prioritization, and to remain calm in the chaos,” she said.
Keeping cool under pressure
Behind the scenes, emergency rooms must function well despite high professional burnout and turnover. This was particularly evident during the height of the COVID-19 pandemic.
But now, working closely with incoming nurses to think through each step of treatment is helping to achieve balance in a high-stress environment, Loux-Clark said.
That comes down to rigorous organization at the start of every shift. The nursing team is divided into three pods, each named for a local beach: Carolina, Topsail and Wrightsville. As part of managing trauma patients, each pod prepares medical supplies while seamlessly transitioning people from emergency to inpatient treatment.
“We’re constantly working to improve as a trauma services team,” Loux-Clark said. “Together we see the worst of the worst and come back every day for more.”