Lindi writes:

I’m a young nurse who works in a Pediatric Cardiac ICU.  I live in a house with three other roommates who all work hard but I don’t think they have any idea what my days are like.  It is refreshing to see 20-somethings act like 20-somethings, burdened only by the chain linked fence that will replace our rustic wooden fence in the back yard… And not by the child that just died today.

I return home from what should have been an easy day at work with a patient who remained in the ICU for some HFNC. . . . Enter an 18 year old mom.  This mother has been in the hospital for 5 months with her first born.  She is proud of what she has learned and is very comfortable with the equipment on her daughter.  She makes comments like “don’t you think I should be a nurse?”  I encourage her but in my mind I think about how much she needs to learn about her own daughter first.

She calls me at 1130 am for an update on her daughter.  She confesses that she just woke up.  I politely laugh and give her an update.  Her daughter finally gets to sleep when she arrives with the baby’s father.  I tell her she just fell asleep but she goes in and tries to wake her.  Talking loudly.  Lifting the baby’s arms up.  Turning the lights up.  Putting a cellphone up to the baby’s ear. “Your daddy is here! Wake up, you haven’t seen him in a while!”

Sure enough the baby wakes up, crying.   “Nurse she is awake and I think she needs her diaper changed.”  Frustration hidden with a smile I change the diaper.  I explain that in an ICU infants need their rest.  It is important to their recovery and growth. (Shouldn’t she know this after 5 months?  I think to myself)  With nothing but attitude she asks why her daughter is naked and not wearing her onesie.  I explain about her getting warm with a low grade temp.   While on my lunch break she has another nurse help her dress her little princess.  Sure enough her daughter overheats, spikes a temp, and now has to be pan cultured.  For 2 hours we stick needles into her without any success.  Mom stands there telling us we need to stick her in the forehead because that was where they got blood from her before.

Meanwhile, the child is naked again, fever gone.  Her temp was most likely environmental since her WBC were trending downward and she had no central lines… chest was closed and healed. We are torturing her child and she continues to tell us what labs we need to draw, how to draw them, what lights are to be dimmed, what the signs of infection are.  It is exhausting dealing with this woman.  I understand that parents feel helpless and having any sense of control over their child’s care makes them feel better.  But this woman needed to be a mom and not a nurse.  I am kind to her, although I really just want to call her at 5am when I wake up, put a cell phone to her ear, cover her in blankets and stick 10 needles in her forehead and  see how she felt about all of it.

At home my roommates laugh in front of the tv.  Talking about things that amuse them.  I enter a little high strung wondering about a crock pot that had been cooking since the night before.  I am asking questions trying to figure out if it had ever been cooled.  I realize their food poisoning was not that big of a deal.  Let them laugh about co-workers, eat spoiled food, and be 26 years old.  It might rub off on me and relax me.

Cat writes:

First, I’m not a nurse. But I wonder what you think of this (and this is NOT a criticism of anyone–just an open question.) My Mom is on a Telemetry floor after passing through the ER and ICU. She went unconscious during the night. Her BP fell and she was found to have double pneumonia. She has had congestive heart failure and spinal stenosis for several years. She has very limited mobility (sits and sleeps in a recliner, can still use a bedside commode with assistance.)

Okay, so I’ve been wondering why she’s in so much pain. I’ve asked every nurse that has come on shift (not in a pushy or rude way, either). I have carefully explained that I have never seen my Mom in this much pain, and she is not a complainer–but she’s complaining non-stop. She whimpers, cries, pleads and begs for help. Well, this has been going on for over 10 days. Today, they noticed her leg was rotated out and took an X-ray of her hip. Yup, she has had a broken hip for probably the entire time she’s been in the hospital. How did this happen?? (Or rather, why have my questions been ignored?)

I even had one nurse sit with me for 45 minutes and, I have to say, very patronizingly “explain” to me that Mom’s pain, while real, was exacerbated by her anxiety and lack of trust. (Hmmm….wonder how trusting I would be of people who were torturing me–or so it probably seems to my poor, confused Mom.) Let me just say here, I don’t blame any of the nurses. In fact, I believe they are some of the best I’ve ever seen. So my question to you is, how does something like this happen? This is a state-of-the-art hospital which has received national recognition as one of the top hospitals in the country. Yes, I know that “things happen” and sometimes, that’s just the way it is. I guess I am frustrated and wonder what your opinion is (you, the nursing community)? Do you believe nurses don’t listen to family members? (The condescending nurse assured me that she could “see” that Mom was not in “that much pain.”)

I hope I don’t sound like I’m blaming the nurses. Is there anything I could do so that this doesn’t happen to someone else? I can’t imagine having an untreated broken hip and being shifted around continually, being given physical therapy, etc.? (Mom was on decent pain meds, but still…) Do you think elderly patients fall through the cracks?
Okay, I’m done. Thank you for any feedback. I genuinely want to know what you think, and I hope I haven’t offended anyone. Incidentally, my Mom was a Registered Nurse for many years. I feel sick at seeing her treated (even though unwittingly) like this.

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I’m very sorry that you and your mom have been going through this.  It has not been my personal experience that a broken hip would go undiagnosed for 10 days.  I find it astonishing that absolutely no one noticed that your mom’s leg was rotated.

Of course we as nurses encounter family members who want to advocate for their loved ones.  Sometimes they can be overbearing with concerns that are fairly unfounded.  But when I hear stuff like, “She isn’t a complainer, I’ve never seen her in so much pain before,” it sets off warning bells in my mind that something is really wrong.

I do think that elderly patients fall through the cracks on minor issues, but I’m surprised about your particular issue.  Can you imagine if she’d had no one advocating for her?  No family around?

Thanks for the submission.  I hope other nurses who read this will chime in with their thoughts.

“Zookeeper, RN” writes:

I am an RN at a very large public safety-net/regional trauma center/teaching hospital. It is a very interesting place to work as a nurse as there is always some kind of drama going on. I work on a medical floor where we see lots of infectious disease (HIV, MRSA, VRE, TB, c. diff, you name it), complications of IV drug use and booze, diabetes, renal failure, and many psych co-morbidities. As we are a public safety-net hospital, we see a lot of the same people over and over again because, well, no one else in town will take them.

One such gentleman we see quite often, we’ll call him Sammy, was assigned to me recently. Sammy is what happens when you drink too much for waaaay too long. His liver is shot and all those toxins that a healthy liver would filter out have permanently damaged his brain, so he’s confused, but pleasantly so. He’s yellow as a banana, and he has a history of leaving AMA (against medical advice) – he often will just get up and walk out. Which is another reason why we see him over and over. But I digress.

So Sammy is my patient. He wanders a lot, around and around the unit, talking to people and going into other patients’ rooms thinking it is his . On this particular admission Sammy has been wearing a flowery silk kimono over his hospital PJs. It’s kind of dirty but he refuses to give it up and I have 9 zillion other things to do besides argue with Sammy about his wardrobe. During my shift, one of my other patients codes, so I am tied up for a good hour or so. When I am done, I go check my other patients. Can’t find Sammy. I check all his favorite hang out spots – no Sammy. I have him paged throughout the whole gigantic hospital – he does not come back. I call Security and they look for him (“Oh yeah! We know Sammy” they say) – no dice. I am starting to think he has left AMA again. The ER is screaming at us because they have 50 people in the hallway down there that need Sammy’s bed.

We are about to give the room away when our unit secretary answers the phone. She starts laughing. She’s laughing so hard her mascara is running down her face. She looks at me and says “It’s for you.” I pick up the phone to hear “This is Officer So-and-So from Central Booking. Are you missing a man in a kimono?” As a matter of fact, I am, I say.

Turns out, Sammy did indeed decide to blow that popsicle stand and walked out of the hospital. He wandered up the street to the nearest drug store, where he was promptly arrested for shoplifting. Now, keep in mind he kinda stands out – his skin is day-glo yellow and of course, there’s the splashy kimono. (Side commentary: WHY do we bother arresting this guy? He can’t tie his own shoes let alone summon enough brain power to plot a crime. Total waste of taxpayer money). Anyway, down to Central Booking he goes where someone at last notices the hospital PJs and his ID band and give us a call.

An hour or so later, Sammy returns to my unit wearing a new outfit: a bright orange jumpsuit and carrying his kimono in a little plastic bag (very sad!) I ask him if he is all right. He looks bemusedly at me and says “Well sure hon, why wouldn’t I be?” I explain he left the hospital and was arrested. “I was?” he says. “What did I take?”

At this point I am thinking Sammy has suffered no injury from his adventure. And then he asks me for a sandwich.

Anne writes:

A friend once said that if you throw enough putty at the wall, something’s bound to stick!  Well, here’s some unedited putty.

I’d been practicing nursing for 20+ years when I was diagnosed with lupus and fibromyalgia and there was a nasty bout with previously well-controlled epilepsy. I needed to stop working, stop practicing my chosen profession of nursing.

I began freelance writing to occupy my time and found instant success and satisfaction; hey, I had my own byline and received pay, (albeit poor), for articles! This was life affirming, and at the same time invalidated feelings of low self-esteem because I was no longer able to work in nursing.

Several years later, a new clinical editor was unable to increase my compensation for a column that I was editing, so she called to offer me a place on the magazine’s masthead instead. However, before doing that, she needed to do a routine background check and call me back.

I’ll never forget that telephone call. “Were you aware that your license is no longer active?” I hemmed and hawed a bit, then then realized the unpleasant truth. I had moved from one state to another and planned to apply for reciprocity in my new state – but forgot.

I felt naked and numb all at the same time. This license was part of my identity!  As a result of my forgetfulness to renew my license, I was stripped of a title (RN) although no one could take away my degree (BSN).

In spite of the fact that I believe once you’re a nurse you’re always a nurse, I’m no longer registered and I can’t say that I belong to that larger collective of Registered Nurses. I’m not like ‘one of you’ anymore. I never thought that losing a license could make me feel so small and so humble and insignificant.

I don’t usually post this kind of story submission, but it does ring a bit true.  I do know preceptors sometimes have a difficult time providing feedback to their preceptees at the end of the shift, only to spring problems and issues on them later.  Anne, RN writes:

It was toward the end of my orientation as a new grad when I got a message from my day shift preceptor, wanting to know “how orientation was going.”  When I called her back she proceeded to tell me a long list of everything I had done wrong over the weekend with my night preceptor.  I was at home on the phone and she was at work talking to me, so I felt backed into a corner.

Meanwhile, over the weekend, my night preceptor told me I had done a great job as she scrambled onto the elevator to go home. I had given an antibiotic late on Saturday night and I had acknowledged it and the next day made sure I gave it on time. My night preceptor told me when I acknowledged my lateness not to worry about it since nurses that have been working for 20 years forget things sometimes. So I thought nothing more of the situation, that is until I received this phone call.  On her long list of things I had done wrong was that I gave this antibiotic late. Her other criticisms included only giving IV pain meds when the patient had PO ordered, meanwhile my night preceptor had told me that since the patient was NPO i shouldn’t give them because it would make her sick.

Then she proceeded to blame me for another nurse’s needle stick, which she later apologized for. She also said that people were saying that I didn’t care and that I always looked bored, which is completely not true. Most nurses go into nursing because they DO care. After 8 weeks how do other people think they can judge you on something so personal?  I had a lot of respect for my day preceptor until that day when she backed me into a corner, since then I can’t think of her in the same light as I once did.

My night preceptor was awful as I am sure anyone can tell, always giving me positive feedback and going behind my back to tell others that I was awful. On my first night shift with her she was talking about sex half the night, which made me extremely uncomfortable and as a new person I didn’t think I could say anything. Luckily my night preceptor has since left my floor but I still have to see her on occasion and my day preceptor has an important position on my unit.  I wanted to share my story because I think it is a great example of how nursing eats their young.  There were many nights when I went home crying and wanting to quit nursing.  Nursing is harder than I ever thought in nursing school, but I am a tough person and I have since successfully completed 3 weeks on my own!

And since it’s been over a month since I received this submission, hopefully Anne is now off orientation and doing well!

Anon, RN writes:

I’m trained as an ICU nurse but lately I’ve been picking up these shifts in an outpatient pain treatment clinic. It hasn’t been an easy thing to get out of that critical care mindset. In critical care you stick with the ABC’s (airway/breathing/circulation). In clinic nursing the first question after the procedure is, “Does my patient have a ride home?”

So I’m working there the other day. Pretty much twiddling my thumbs all day and bored out of my mind because there’s really not much to do except take vital signs and fill out intake forms. But then one of the clerks grabbed me.

“There’s a patient in the bathroom that needs assistance.”

Indeed there was. I found a patient who needed me to help her out of a little situation, let’s just say. So I got her cleaned up and brought her in to the room where she would have her procedure done. I slapped a pulse ox on. Her oxygen saturation was about 70%. With a very good waveform.

Thankfully my critical care mindset kicked right back in. Step one, get her on some oxygen. Step 2, find out what the hell is going on.

Turns out she’s a COPD’er (Chronic Obstructive Pulmonary Disorder – like emphysema) who uses oxygen at home, normally 3 liters. She told me sometimes she just doesn’t bother with the 02 if she’s making a quick trip somewhere. I asked her what about today? This is a little more than a quick trip. She said she ran out of oxygen, and they should be delivering it while she was out.

I got her down to 3 liters and her oxygen sats kind of waivered between 82-88%, which is fine for someone with COPD.

She was completely stable so the doc did the procedure at the bedside. Which was all for the best because at that point she was really in quite a lot of pain.

I asked the charge nurse what we should do about discharging her. This is where the story gets really crazy.

“She only needs to be close to her baseline, in order to be discharged.”

“Yes, but her baseline is that she is on home oxygen, which she didn’t bring today and her 02 sats are in the 70′s without it.”

“It’s okay. We’ve discharged her with 02 sats in the 70′s before.”

!!!

I explained to the charge nurse that it’s not okay to discharge someone with 02 sats in the 70′s. Especially if they “forgot” their oxygen that day. It was at that point that I decided I really had no use for this “charge nurse,” and tried to come up with an answer on my own. First I tried to find out if the patient’s son could go to her house and get one of the tanks that was being dropped off. No dice. He had no money for a cab ride and we couldn’t even confirm really that the oxygen had been delivered. I tried to find out if there were any kind of social worker around that might be able to identify some resources for the patient, maybe give her a loaner tank to take home. Again, no dice. So the only other plan was to take this patient to the ER.

We arranged for a transport person to come, and I went to find a portable oxygen tank for her. The charge nurse asked the transport person if he could return the oxygen tank to the clinic. “No, I can’t,” he said. Then the charge nurse said, “Well you can’t take it, then. If it leaves our floor it will never come back.”

!!!

At this point I decided I would transport her to the ER (it was the next building over) so I could bring the precious oxygen tank back to the clinic. Also, the patient was getting a little somnolent, which is never a good sign when you are worried about hypoxemia/hypercarbia, so I figured it would be best if a nurse accompanied her. So I took her to the ER, and got her safely checked in.

When I got back to the clinic there was some talk about how we can avoid this in the future, blah blah blah, we never should have done the procedure on her, yadda yadda yadda, and the conclusion was that if she turned up at the clinic again with out her oxygen tank, we should just turn her away.

How about some patient teaching?

How about some communication with her PCP to find out why she thinks it’s okay to go anywhere without oxygen?

How about a better EMR system so we could “flag” her and alert her other providers that she needs better education?

If anyone thinks we are even close to fixing healthcare, well. I’ve got some land down in Florida you might be interested in.

Submit your own story!

Here’s a story submission by Michelle G, RN. My thoughts are in italics at the end.

I called first thing this morning to see if they needed me to work extra. Sure enough, a scheduled nurse was not coming in. I show up on my unit which is the medical floor to see that I have been assigned 4 patients. Wonderful! Great not to have 5 right off the bat.

Today I take care of a gentleman who I had taken care of just 4 months ago. He was diagnosed back then with liver failure and was not a candidate for liver transplant. This admission brings him in with End Stage Liver Failure which means he could have a few weeks to under 6 months to live. He is in denial and refuses some of the treatments/medicines/blood draws. Patient’s wife is excited to see that I will be his nurse again with this admission. Patient has been noncompliant and has not been following medical advice. He is on a 1500ml fluid restriction but doesn’t seem to want to adhere to those restricitons nor acknowledge them. I gently remind him about his fluid restrictions during the day which seemed to agitate him. I explained to the patient why the fluid restrictions…there was a reason for this.

Well, now he wants a wheelchair to go outside. I know exactly what he wants to do….smoke. We are a smoke free hospital but I am not security. I explained I am not going to babysit him nor police him. I explained to he and his wife that we can not cure him nor are we going to give him anything that will make him better. If the patient wants the extra juice or cup of ice than who am I to restrict a dying man?! Who are we to deny a dying man’s last pleasures…ice, a smoke, a visit outside on a sunny day?

Much of nursing is not only carrying out doctor’s orders and educating the patient why those orders are there…but looking at the BIGGER PICTURE.

At the end of my shift; patient and family were greatful to have had a nurse that took the time to explain the disease process and plan of care but also most importantly to treat him as a human being with respect and care.

What do you think?

I think Michelle is absolutely right. If the patient is able to get all the information he needs, then it’s up to the patient to make the decision. If there is no cure what what ails – heck, sometimes even when there is – a life lived with restriction after restriction with no pleasure at all is probably not worth it to many people.

“milly rn” writes:

Another day, another patient – of kuwaite nationality. No surprise I work in an icu in a private hospital in london uk. kuwaite families ship their loved ones out to london when given any kind of grim diagnosis in the misguided hope that we over here will be able to fix the problems! they usually arrive half dead having been rotting in one of their own country’s hospitals for weeks ( tip – dont get ill next time you visit kuwait) all paid for by the kuwaite government (nice lot arent they!)

Anyway mama m arrived, supposed to be very sick ventilated unstable blah blah blah……….. in a wheelchair launched herself into her bed on arrival with no assist (we didn’t have time to get near her such was the speed of her action all we saw was a blur of black cloth) and proceeded to mime the urgent need for food and beverages moi moi moi sista!!!( translation -water water water sister!!)

moi & munchies were obtained, mama was happy, family were happy. doctor not happy – mama had a K of 7 and no percievable kidney function at all.
cue bit of action…..insertion of 1 vascath, trundling out of 1 Prisma CVVHD machine….priming of machine ……..attachment of mama to said machine.
followed by 12 hrs of machine alarming constantly….. stopping constantly… generally not doing its stuff..mainly due to the fact mama was a rolling around in the bed…as you in the know will know, not good for flow in a vascath not good for attempting cvvhd (or to the uninitiated the sort of continuous dialysis thingy we do in icus for clapped out kidneys & clapped out patients)

mama could not sleep (nurses could not read gossip magazines), due to the godamned racket the prisma machine was making & also probably if im honest due to the nurses (me & collegue) stomping up to the machine cursing & restarting it approximately 500 times every hr…….for 12 hours……..

mama who supposedly spoke not one word of english apart from the term sista (nurse) announced wearily in the morning-’mama no sleep machine crap!’
i was very impressed! that woman will go far in this city of ours.

I wasn’t sure if I should post that submission, because it is a bit insensitive and because I don’t have the patience to edit it enough to read smoothly. It’s literally been in my inbox for 2 YEARS and every time I read it, the end just cracks me up. Because sometimes the CVVH machine is crap. -ed.

“Catheter Commander LVN” writes:

Having worked for 2 years in the ER, my experience became most helpful when I went into Correctional Nursing. You ask, “why do they fake a seizure?” They fake it for several reasons here: To get out of their cell when the facility has been locked down. To get the attention of staff. To get to an outside facility (hospital) where the women are much more abundant and prettier and the FOOD is sooooo much better.

We now on a case by case basis use the hand drop, pen across the nailbeds and brushing of eyelashes to determine validity of the “seizure.” We’re running about 95% on the FALSE side now. Before, we just tossed in an IV, threw on some O2 and out the door they went to the hospital. Since we started doing these checks, the seizure activity has slowed tremendously, go figure. Its nice to see them walk back to their cells, head hanging with a write-up for attempted staff manipulation.

And finally, “loved nursing RN” submitted this:

My mom, an active 83yo was fine till she got hit by the truck called CNS Lymphoma. Getting her admitted to , we thought she had a good chance at recovery. The last 7 months have been a nightmare with hospital acquired infections, 3 rounds of pulmomary edema, poor transfer of info at change of shift, blatant lies by staff from nurses up to and including administrators.

The infection control standards are appalling, compassion lacking in most of the doctors and NPs even knowing I am a nurse with a wide variety of technical skills did not put them on guard to do the right thing. No they would argue that keeping a used red rubber suction cath in a liter bottle of saline on the FLOOR was acceptable clean technique. Administration would never acknowledge a mistake. When I suctioned mom myself because of a 2 hour wait for the nurse, I was reprimanded and threatened with my license. The large medical centers are not what they should be.

Yikes.

Submitted by My Own Woman:

It was one of those rare nights on midnight shift where the ER was eerily quiet. The quiet and calm doesn’t happen often in the ER and the nurses try to take advantage of it when it occurs. After all the supplies were stocked in each room and the trauma carts and the Zoll monitors were checked to make sure all was functioning properly; the nurses sat down together for a rare moment of rest. It was 4 AM, the time on night shift where the wind starts to go from your sail before you catch your second wind about 5AM.

As we sat and talked about non-nursing related things in our lives the Ambulance phone went off. I got up to take the call. “This is A-1 Ambulance. We’re bringing in a 20ish year old male with severe injuries to both of his legs. He was hit by a car while riding on the back of a garbage truck. His heart rate and respiratory rate are within normal limits. His blood pressure is slightly elevated and he rates his pain in both legs at a 10 out of 10. He has an IV established with Normal Saline at 100 and we have him on high flow oxygen. We’d like to give some Morphine. He has no allergies. ETA 5 minutes.” I relayed the information to the ER doctor who authorized Morphine 2mg IV and we will re-evaluate upon arrival.

The patient arrives to the ER 5 minutes later without any relief from the previous Morphine. His legs are deeply cut and crushed at the level of the knees where the car clipped him while he was riding on the back of the truck to collect garbage. His vital signs were stable except his blood pressure was elevating probably in response to the increased pain. After an assessment by the nurse and the ER physician, Dilaudid 2 mg IV was ordered and given along with some IV fluids. X-ray came to the department for a series of xrays on his legs. The Patient Care Technician came into the room to draw blood and do an EKG. All the while the patient kept asking me if he was going to lose his legs. “Please, am I going to lose my legs? Please tell me.” I couldn’t answer him, I had no way of knowing at that time but the prospect of him losing his legs was a good probability. He had no pedal pulses and no sensation below his knees. I told him, “I don’t know right now, we have to wait to see what the tests tell us.” It was an honest answer. He turned to the Patient Care Technician and asked her the same question, she immediately responded, “No, you’re not going to lose your legs, quit thinking like that. Everything is going to be fine.” I wanted to scream at her but held my tongue and tended to his immediate care.

We cleansed his gaping wounds behind his knees and bandaged them with sterile water and gauze. We gave him repeated dosages of Dilaudid as we prepped him for surgery. It was horrible watching this young man with his whole life in front of him crying because of the pain and the uncertainty of his diagnosis that must surely have been going through his mind. After a short time we shipped him off to surgery and the Emergency Department was relatively quiet once again. We had added a few more patients in the time I spent in this man’s room, but everything seemed to be under control.

I couldn’t get the young man off of my mind and the scene and conversation I had witnessed between the Patient Care Technician and him. Finally, after wresting with my conscience, I took her aside and told her that telling him he was not going to lose his legs was not a very good thing to do. I told her that she could have very well given him false hope and that is the last thing you want to do to a patient. She apologized to me and told me “she just wasn’t thinking.”

The night ended without any more trauma and we all went home to our beds. I had the following day off and went about my normal routine. The following day I returned to work and my arm was grabbed by the Patient Care Tech that had helped me with the young man two days earlier. Her eyes were red and swelling with tears. “He lost both of his legs,” and as she spoke the words the tears rolled down her face. “They cut off both of his legs, they couldn’t save either one of them.” At first her words were not registering in my mind until I realized what she was talking about. The young man who she told would be just fine had lost the very thing he was so concerned about and wanted reassurance about. The tears welled up in her eyes more. “How could I have done that, how could I have said everything was going to be ok?” My heart went out to her. In her attempts to ease his mind, she let him down and herself. “How can I ever make this up to him?”

I shook my head back and forth and said, “You can’t do anything for him, but you can learn from him and never tell anyone things that you don’t know for sure. You learned, and learning is a good thing.” She replied, “Yeah, I learned, but I still have both of my legs.”

This is a very good lesson. However, I can’t help but wonder if despite her comments, the patient really knew deep down that he was going to lose his legs. Denial is a double-edged sword. It can keep one from seeing what’s really going on, but it’s also a highly effective coping mechanism meant to protect us from knowledge that we aren’t ready to process. I doubt that the young man took the tech at her word. I’m not condoning what she did, but really? Truly? Deep down, I don’t think he was surprised at the outcome. So tragic. -geena

I’ve updated the sidebar links again. My loooovely husband got me my Image Manipulation Program of Choice for Christmas and it’s been so very nice playing around with it again. I’ve added some blogs, deleted some, and in checking to make sure the links work, I’ve noticed that some of your blogs underwent a makeover. So if the mood struck, I went ahead and redesigned your button.

As always, if you don’t like your button please feel free to make one of your own and I’ll replace it. You need to stick it in a .jpg file that’s 90 pixels x 25 pixels. Yeah, it’s small.

Here’s a story submission from “traumanurse,” and she sent it almost an entire year ago:

I am a fun-loving person. I work in a Level One trauma unit. We have a lot of fun as all the RN’s and MD’s are great people and we make a great team. This helps a lot with all the drama in trauma.

We have a few resus’ every week. And these are fine – training and adrenalin take over and we actually manage to maintain a sense of humor before, during and after- but it’s going home that gets me.

How do I explain to my small children that I am not a mommy right the moment I get home? That I need a couple of minutes to myself just to become a mommy again? I am the highly professional person that has just witnessed the life seep away from someone’s husband, father, child, and now I have to be the referee in the fighting, dish up equal portions and put Barbie’s shoes on- so they stop slipping off. I think is the main reason I prefer night shift is because you get home when everyone is asleep – so I can do mindless things like water the garden or feed the cats – or just sit and stare into space.

To explain to a non-medical person what it’s like is very difficult. In a resus- it is not a human being. It is not someone’s dad. It is an airway, a chest, a blip on the ECG; a vein to put a drip up. A pupil that may or may not react to light. These are the patients that you leave behind when you go home – nonsensical and they don’t haunt your dreams. It’s the ones that grab your hand, that make you look at them, that make you SEE them, who make it difficult. How do you explain this to your five year old? That fine line between life and death. That fight to keep someone from going to the “light.” There is no light in the trauma unit/ICU – there is only the adrenaline taking over – the clear instructions, there is no pain – no emotion – until it’s over. Until someone said those words: “time of death”.

How do I explain this?

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I’ve sometimes found it very difficult to come home and act as though something emotionally earth shattering hadn’t just happened. Sometimes it’s hard to get back to “life” because whatever has your brain scrambled won’t leave your thoughts. Sometimes I’ve found that it’s because it doesn’t feel right to go back to normal life. After witnessing and being a part of a profound moment in someone’s life, it feels like you literally have to take some time and process it and honor it in a way before you can get back to your normal life.

I usually take the drive home as an opportunity to absorb events that happen at work. Sometimes it takes me a lot longer – days, even. There are some situations at work that still haunt me years later. I have a feeling it’s like that for almost everyone.