Normally, on our ten bed hallway, at least one child is obviously the victim of abuse or neglect. About a third of the time, they are hospitalized because of abuse or neglect... so my chances of having a kid who is in for abuse are probably 10%. When I staff on the floor, we have a 5 patient assignment - and some days we discharge 3-4.
And as far as how you deal with it - that's a tough question to answer. You watch kids almost killed then sent back to the home where it happened. That's reality. You see girls raped and moms still defending the rapist. Gosh - you see all kinds of things.
But that's what we do, right? We witness those things - because that really is what happens in this world. And I go home hoping that for my 13 hours, that child knew that I loved them and cared for them the best that I could. I chart my @ss off if there is any chance it may help in court. I advocate to CPS and the cops and social work until I'm blue in the face. And I hope that maybe, just maybe it makes a tiny bit of difference.
It's always the worst when they are close in age to my kids or they remind me of mine. Or I really identify with the parents somehow. It's hard to keep distance. I've called in sick once because I just couldn't face my assignment - but I regret it because that kid faces worse than I've ever had to. I signed on for this - he didn't - and I wimped out. I wish I had done better. I hope I can the next time.
But my favorite nurse told me that not everyone is meant to live a long life. Not everyone is meant to live a happy life. And she just has to believe that there is a God with a purpose because otherwise she just couldn't keep going into rooms.
As far as leaving it at work - ya got me there.
I get better at it every year. But I don't know anyone who is able to completely leave it at work. Peds is a unique place - and child abuse is a terrible heart breaker. But the rewards are rich.