Wednesday, June 6, 2012
Trauma
Ugh. Sorry for my non-updating ways. It's all a giant combination of not a lot of interesting stuff, feeling like I have nothing new to say, fear of getting busted by the man, ambivalence, insomnia, and gin.
Anyway. Life goes on. Census at Hood Hospital has finally reached that point in the year where we move from "totally fucking batshit and dangerous" to "still above average for most ERs but isn't it cool that we get to pee when we want now?" I love summer. Now just because of swimming and drinking outside, but because we occasionally get the night at work where we can just screw around and talk like normal coworkers and have a little fun.
Except, to the point of this post, it feels a lot darker to me this year. This is my third summer at this place. Summers seem to get more violent here every year. Or maybe now I'm just thinking about the implications of everything I see. I don't work at a trauma center, but being the lone hospital in the ghetto, I sort of do in a way. The culture out here blows my mind sometimes. The same people that would call an ambulance for tooth pain will not call 911 after being the victim of some really screwed up violent crime. There's probably a few walk in gunshot wounds each week now, and even more stabbings. The new thing seems to be drop-offs from some pretty legit MVCs involving alcohol. Okay, bye c-spine precautions!
When I first started out I was really intrigued by this stuff. I was all about the treatment, the mechanism of injury, all the excitement. Learning new things. Virtually all of the stuff I saw as a new nurse were by no means threatening to life or limb. Critical traumas still get my blood pumping like nothing else, but at this point I'm kind of... over it? I don't know.
I just internalize way too much shit with these cases. I hate to say I've become numb to the nursing home CPRs, but it's really just the truth. It's sad, but it's not anything next to these cases. There's something so inherently wrong with having to tell a mother about the age of my parents that their child is dead. There's something so much more raw and tragic in the reactions of people who have really never prepared themselves for the death of this young a person with exception of maybe their worst nightmares. Of watching someone's world turn upside down right in front of you. I feel a certain satisfaction of being able to call the medical examiner and take out all the invasive stuff, to be able to gently close granny's eyes and wipe her face and lower the lights and make her look almost like she's asleep when the family says goodbye. There is no peacefulness in cleaning the dried blood off a young person's face. To try and wipe up all the blood that just sprayed out of the ET tube across the room before someone's mom and dad come in to see them. It forces you to imagine your own face, and the faces of those you love the most, and how absolutely easily it could happen to anyone at any time. I've been asking myself questions I don't know the answer to. How I would carry on if something like this happened to my husband, or to my little brother. I can't even think about without crying. I think that I would die. I know people go somewhere better. But having them torn away so violently is more devastating than I can fathom.
Almost as bad is the people that come so close to this who still have no fucking clue. People who have been to your facility multiple times because they want to live the thug life and deal drugs and be in gangs and shit. People who have had so many chances to clean their lives up and spare their families this kind of pain, but they don't. You hear them talk about how many of their friends have been shot and killed, but they continue doing the same bullshit. It's so sad and frustrating when you think about all the people you've seen that didn't get a second chance.
I really wonder if and how this gets easier if you see it all the time. I see this just infrequently enough that it causes me to dwell on it a lot. I wonder, as I gain experience, if this will just become another part of the job.
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When it does get easier is the time that you should worry. The thugs will always be with us and the best we can hope for is that some tiny little thing we do will cause them to think twice. And when and if we become immune to others pain, then its time for us to reconsider what we do. Don't become immune.
ReplyDeletei think that there can be a positive side to trauma. for the people that survive (except the hardcore gang crowd, of course), trauma can be a turning point. it makes them re-evaluate their lives, it makes them think about making different choices..being BETTER. do they always go back into the real world and implement that? maybe not. but for a little while, they're grateful for just being alive and that in itself is worth something. and for the ones who don't make it? well, so far for me that part of the job is just as hard as always. and i'm glad for that, because it helps to cut through all the BS we have to deal with and reminds me that i still have a soul.
ReplyDeleteI hope this never gets any easier for me. I already sometimes wonder at how calloused I've become regarding some things, and I don't ever want to get to the point of "oh, just another tragic trauma death."
ReplyDeleteWe'll see, I guess.
Also, I start traveling soon. May head to New England - if I do, I forsee a stop at Hood Home for a fill up on beer.
One of the things nursing has taught me is how fast a persons life can change. I remember watching a family grieving over one of their daughters (they had lost 2 in one night) and seeing the surgeon with tears in her eyes say the asshole who was driving drunk should have to watch it too.
ReplyDeleteLike you, I'm pretty immune to the little old people codes. They lived their lives, had medical problems and died.
ReplyDeleteTraumas, especially violent ones, are senseless, unexpected and can happen to anyone. That's what affects me when it's all said and done. The sound of a mother unnaturally howling because her son died of a gunshot wound is something that will never leave me.
I don't think that any of us become immune, we just try to find ways to deal with it.
So tired of the thugs/gang members maiming one another...the take up precious space that could be used for hard working, honest people who experience life's unexpected speed bumps...and for the malingerers who continually come in for petty issues...
ReplyDeleteRegarding whether or not you would die if it happened to your family ... My stepmom was violently murdered, in our home. You don't die - sometimes you wish for it, because it seems easier than the grieving - but you don't. At the same time, though, you never, EVER forget. Sudden, violent death isnt something anyone should get used to - I think we lose a little of our humanity when that becomes just par for the course.
ReplyDeleteI work in a Level 1 Hood Hospital. My coping mechanism is to pretend that the OR and ICU are magical healing places that fix everyone who enter. More people make it to the OR than die in the ER, so I can believe that more people survive our hospital than die in it. I think it also helps that if someone is going to get shot up, they should be at our hospital, where we have the tools to try to save them and a large supply of students to rotate through CPR.
ReplyDeleteYou were thinking about becoming a hospice nurse. While it is hard job, and almost everybody dies, your patients are usually grateful for your help; when they are asking for pain meds they are really in pain, and you can give the meds without a qualm; patients are happy to see you and their families thank you and tell you, "It takes a special person...." I don't know how you take the abuse and BS you put up with everyday.
ReplyDelete