[ivanaBEEaRN]

Last night I worked and we had a 15month old code come in found in a bath tub. Sadly he did not make it.
The mother came in later after he was pronounced because she was at work when it happened. She was told in one of the family rooms. I can not get the sound of her screams out of my mind. I had chills when I heard the report come in over the radio. I had to escort another family member to the room where she was at and as soon as I saw her I started to cry.
I have wanted to work in trama when I become a nurse, those of you who work in trama and experience that regularly how do you cope? How do you keep from crying when you see the families in such pain?
My hospital is not a trama center, but we were the closet hospital for this little guy, and this is the youngest I have seen code in my short healthcare carieer.

[Wendy_RN]

There are some things that you will deal with better than others. It is never easy when a child is involved. Sometimes there is nothing you can do other than to console the family until other family / clergy arrives. You will learn to cope with things a little more with each experience. I have had days where I held my emotions as best I could while at work (you can't just walk around crying) and cried as soon as I got to my car. All days are not like that though, and when you are able to help someone it is worth it all.

[cccnurse]

When it comes to kids it never gets easier, after awhile you will be able handle the sting a little better. Myself personally, in the case of a pediatric demise, when I can't feel the sting anymore I will need to get out. I hope that day never comes.
How I start to cope is, when I get a minute, I take a step outside, look up to the sky, and ask the Great Spirit to care for the child until it's time for their parents to arrive. Then I put my head down, go inside and get back to work.

[nuangel1]

it never gets easier when its a kid .but you learn how to deal with it.recently it was harder the usual in our ed one of our techs 11 yr old son came in coding they worked on him for 2 hrs and never got it back.the whole dept wheher we were there or not has taken it very hard.

[oooooooooo]

You are not

[Toquay]

The death of a child is never ever easy. I find that while trying to save a life I am too focused on the task at hand to allow the emotional level to surface. It is always afterwards when there are no more interventions left that the full impact of what went down hits me. I see nothing wrong with shedding silent tears with a family as long as you don't become an emotional mess or take focus away from their personal grieving. The whole ER is always very somber after such an event. The roles we are in can be extremely stressful and sometimes we need to give ourselves time to regroup.

Toq

[traumaRUs]

The above posters have said exactly what I was thinking: its not easy and when it does get easy, its time to leave the ER. You are a very compassionate nurse! Don't worry that this death upsets you.

[MLOS]

{{{{Ivana}}}}

See if your department has a critical incident debriefing after such an event -- it can be enormously helpful.

[NREMT-P/RN]

No. Never easier.

I think it may get different (like that is helpful) and you will develop additional ways to deal with issues like this one.

Often, I find that if I let myself think about the big picture it just overwhelms me. I just focus on the now - the clinical reality and immediate. Period. Otherwise, it can really paralyze me. I try to stick to the NOW NEEDS. Then I do what has to be done.

Let's see.

• SIDS baby found in crib, parents screaming - I found the little christmas tree all decked out in baby blue in the corner by the crib too much - so I focused on scoop and run while doing CPR in my arms all the way to the truck, the best way to go. Not sure if it was right, but it was kind. ED worked him another hour and in the end I could look at the parents with the certain knowledge that 100% of everything that could have been done was. Afterward, it stays with you - the baby in blue and the baby blue christmas tree.

• The 8 year old that burned to death in a house fire. I was sent to the ED as the FD rep to keep the family informed (and I had transported the dad with minor burns in the unsuccessful effort to reach his son) and stay with them pending location of the "victim". Mom was brought to the ED by the local PD and she proceeded to tear my dirty, stinky shirt off and hit me in a near desperate attempt to make me disappear (I just kept trying to keep her from hurting herself in the process, otherwise I let her go on) - she screamed in a manner that I will never forget. I can still hear it at times. I also did the final recovery of the child and his body was a near cremation. It still stays with me.

• I was standing in the hall attempting to get a soda when a lady brought in a baby wrapped in a blanket that had been run over by a car at the family reunion. She handed the baby to me and then just proceeded to become hysterical. We worked on the baby for a long time, lived to transfer to pedi tertiary care.

• The little toddler girl with gold curls and raging herpes lesions from the nipple line through the perineum up to the scapula - all because mom left her with her "half uncle" that had abused mom (he was 16 years older, her half brother) but she thought he had "changed".

• The toddler mauled by the doberman that we we unsuccessful at resus with after 2 hours of trying everything.

It just keeps going. And yes, I have cried with the family, my co-workers and even alone in the break room if necessary. Don't beat yourself up over that -


But, I frame it like this - someone has to be the one to care for these patients. (The patient and their families). I know that I am good at what I do. I also know that what I do will remain with these folks for the rest of their lives. While never forgetting that fact - I am committed to giving it all I have, all we have. Sure, it can hurt at times - but, I have the very humbling privilege of being able to be fully present with these patients and their families in their time of exceptional need. That is what I do. I am a nurse. I am their nurse.

I find that over time you do develop a "thick skin" - it just happens. It does not mean that you don't care - I know that we all care. The thick skin is what takes care of you. I find that talking over the difficult cases with pastoral care has helped me at times. I also talk with my co-workers - they really do understand where you are coming from --- they left the same room you did. I have also found that self care has to be a priority (bump it up after the really tough stuff!).

Don't worry. You are having a normal reaction to a very abnormal situation. Take care of yourself - you can then take better care of others!

Bless you and all of us as we go forward never knowing what the day will bring. Grief has no rules and does not discriminate - let those you care about know it - everyday.

[bill4745]

If you don'y cry once in a while it's time to look for a new line of work.