Monday, March 16, 2015


Back during the first couple years of my career, one of the most common summer injuries was of pedestrians struck by vehicles. Living by a resort town always saw some high school or college kid on vacation who thought they could run across the street before that next vehicle got to the intersection. For the record, the car wins every time. Always.

After time of death was announced on one of these kids, most everyone cleared out of the room. I had looked at the massive skull fractures on the CT scout image, and wanted to see for myself what that correlated to in a real person. So I walked up to the head of the bed and carefully stuck my finger into the gaping wound on this kids' scalp. The doctor walked over while I was doing this and pointed out smaller details that I hadn't yet noticed - how neatly the scalp separates from the skull, how jagged some edges can be while others are the cleanest of breaks. She walked out of the room, and I was left there with my finger still poking into the skull of a dead 17 year old.

I remember being so thrilled with the action of the trauma team, the organized chaos, the medical knowledge versus the brute force to deal with orthopedic trauma. I was still riding the high of this experience, and then all of a sudden I realized exactly what I was doing. I had my hand inside the scalp of a dead 17 year old. A kid on vacation with his friends. Someone only a few years younger than I was. I hadn't even closed his eyes after time of death was called.

That morning after I got off work, I cried the whole way home. How could I have been excited to do something like that? I never wanted to become so immune to the tragedy of the ER that I forgot I was dealing with real lives, real people.

Here I am six years after becoming a nurse. I look back at that day and wonder if I would have cried afterwards if the same scenario replayed tomorrow. Would I still be shocked at the moment I remembered there was a real person on that stretcher? Would I have forgotten it in the first place? Or would I just be excited for a complicated trauma, and never really stopped to think about it at all?

I've changed so much as a nurse. Much of it is for the positive - I'm smarter overall, more confident in my nursing, better able to handle high stress situations. I am way more skilled in the things JCHAO cares about and more solid at the clinical skills. Does this make me a better nurse? I don't know. I do know that I haven't cried on the way home in a long time, and I think that speaks volumes.


EDNurseasauras said...

What makes you a better nurse is that you have cared for patients like this, building your skills patient by patient. What JCAHO measures is how well we don't kill people, measuring stuff that correlates to reimbursement. There is absolutely no humanity in that. We are forced to deny that we are affected by the sheer awfulness of what we deal with so we can go back and do the job every day. Do we cry often? No, or we wouldn't be the right fit for the job. But sometimes you have to cry for 5 minutes with a co-worker about a 20 year old father of two who shot himself in front of his family, and a 37 year old who lost his fight to cancer right in front of you.

Aesop said...

You will not cry about the same things over and over.

You WILL find new things to cry about on the way home, no matter how long you do this. Not every day, but often enough to make the point.

Ask me how I know.

When the time comes that you don't cry about anything you see, ever, it's time to hang it up and move to some other area of practice, or get your real estate license.

Both for yourself, and for your patients.

If anyone else reads that and it hits too close to home, the bell tolls for thee.