Can't stop the nightmares- please help

Keely-FutureRN · Jun 29, 2005

Keely, no way could you be responsible for the death of the (blood-vomiting) man. You reported your findings to the nurse, repeatedly, as they happened. Oxygen won't stop the bleeding (obviously this man had been bleeding internally (into his gut) for some time (coffee-grounds emesis does not happen over a number of minutes) and with the amount of blood you describe (that he was vomiting) he MUST have blown a major vessel, or at the very least an artery -you would be impressed at how fast an artery can throw blood. The long and short of it is, the Oxygen (or lack of it) played absolutely no role in this event. For whatever reason, the man had a major bleed (this could EASILY account for his confussion and some of his defiance (don't need this or that), among other things) In any case, rest at ease, there is no way you could have prevented this event, but take solace in the fact that had you (or anyone else) NOT been there, the man would have died alone. With you being there, he at least had every chance available, and he was not alone.
I used to be involved in trauma (paramedic, in the field) and just got tired of it. The amount of blood you described tells me the man was likely dead long before his heart actually stopped. Just too much loss, and nothing anyone could have done about this -not at that point. You have no reason to feel guilty -please don't continue to punish yourself.

Thank you for your support . (hug) It happened almost 2 years ago and I think of the accident all the time. It's makes me feel better to know that I was there at his last few moments and tried to make him as comfortable as possible. It's so hard not to blame myself. It was so bloody and was my first experience with death that I was directly involved in. Sometimes things happen and you can't change it but you just have to move on. Thanks for listening gromit :icon_hug:

Keely

mattsmom81 · Jun 29, 2005

As an adult ICU nurse I have witnessed horrific enough things that have given me nightmares for some time too. I learned while I was a student nurse that I could handle tragedy in adults much easier than with innocent children,decided then and there not to do peds.

Hugs to the OP and please followup...with a private counselor if you feel more comfortable. Some patients DO get to us in the form of PTSD. The trouble with EAP is somehow things seem to get back to the managers, and I didn't want that.

purplemania, BSN, RN · Jun 29, 2005

You are a professional and people come to you for help. Now it is your turn to seek a professional for help. Go, and God bless.

Thunderwolf, MSN, RN · Jun 30, 2005

Caren19, I can relate to you. Get the counseling you need now and work through it. I was dx with PTSD in 2001. Things are much better now, but I had a rough couple years with it. It will get better. I wish you well and the best.

Roy Fokker, BSN, RN · Jun 30, 2005

Caren 19: I agree with much of what has been posted.

While I've never been involved as the others have, I was caught in the midst of a riot. Worst carnage imaginable - fire everywhere, people getting butchered on the streets, screams, police firing into mobs to regain control, arson, looting.... the works.

I was 10 years old at that time.

Over the years, the incident seemed to fade from memory. But when I went back home last summer for vaccation, I was driving my friend around and I came upon the intersection...

... and my mind instantly flashed back to seeing a man with no legs trying to crawl away to safety. My nostrils picked the scent of smoke and burning flesh. Then there were the screams....

... I slammed on the brakes and came to a complete stop in the middle of the intersection. My brain turned to mush. My vision blurred. I was sweating and breathing hard and fast. My friend freaked out - she thought I was having some kind of medical emergency (that, and the fact that the car behind me almost slammed us LOL)

And then, just as abruptly as it had come, it vanished. I looked around me to see the rebuilt intersection, my friends petrified face while I heard irritated honkings from drivers whose path was blocked by my car. I drove away that day, but I was as surprised as I was shocked that the incident would still return - it made it seems like I was back there again. It was incredibily realistic.

I've mostly managed to deal with it over the years - but your sounds like a hard case. I'm glad you are seking help.

As an adult ICU nurse I have witnessed horrific enough things that have given me nightmares for some time too. I learned while I was a student nurse that I could handle tragedy in adults much easier than with innocent children,decided then and there not to do peds.

This is one thing I constantly try and remind my friends about - those who want to do peds.

Handling sick kids is ok - but can you handle one dying? In your arms? Knowing that sometimes, theres nothing you can do?

I'm not saying it has to happen - but it could and one ought to be prepared for eventualities.

Thunderwolf, MSN, RN · Jul 1, 2005

PTSD is more common than you realize. You are in good company. Others have been there.

Gromit · Jul 1, 2005

Keely, thanks! I'm glad I could offer help.

Roy -WOW! That was a remarkable experience. I was particularly bothered by the effect smell, and audio played in your experience. An event that (likely the most) had a profound, and continuing effect on my life was back in '90 (I believe thats the year). I was a cross-trained EMT-A / Firefighter, had a few years under my belt by then. Down the road from our station (same road, about 4 miles) a man and woman had been involved in an argument with their landlord, and the woman was driving. The man grabbed the wheel and forced their car into the path of a stationwagon driving in the other direction -this stationwagon was driven by the wife of a local doctor, and had his two daughters (16yr old, thin, in front, and I'm not sure, but I THINK 14 yr old and a bit on the heavier side in back, behind her).

We got to the scene first, and those of us with med. training went to do our initial assessments while equipment was being deployed. I went to the offending car, both occupants were dead already. The mother in the other car was screaming at the top of her lungs, the powered hydraulic tools whined, and commands were being given, tools retrieved, well, its chaotic, but controlled, just like any other emergency-type situation. The larger girl was in the ditch by the 'wagon, her eyes (both) were bleeding, and she was moaning. (Later, after reconstructing the event, and reviewing to see how we could learn from and improve our actions, we realized she had not been thrown out, but had crawled out of the vehicle) -'mom' was trapped by the dash, and her legs were actually accordioned under the drivers' seat, and looked like ground beef -bones crushed, etc. (I postulated she had the cruise control on, and was sitting 'chair' style) -we flapped the dash and roof, and partially removed the seat from the mounts to get her out. We already knew the girl in the front seat was dead (though her seat had been crushed forward, she was jammed against the dash). Mom and the bigger girl were flown out. Afterward, since we had some newbies with us, (we had to get the dead girl out of the vehicle for the M.E.s' office) we decided to turn this portion into a training exercise and allow the newbies to get some experience (since time was no longer a critical factor, and it doesn't get any more real than the real thing). Long story shortned a little, this girl Oonce this side of the dash had pushed forward, and the seat bent back into place) died with her seatbelt on, she had a little zip-lock baggie from which she was eating grapes (still had the bag cradled in her hand, crushed grape in the other hand which had been pinned to the dash). Outward trauma was not evident, and in the light (it had grown dark by now) she looked as young as she was, and innocent. It was an event that any of us had played out in our youth -on the way home from grocery shopping, eating grapes or some other snack.

---

Our station was an all-volunteer station. This was in the days when 'Critical Incident Stress Debriefing' was JUST getting started. Our station had been doing this (without knowing any name for it) for years. We sat, and talked about the incident(s), if it had any effect or what we could have done differently, etc. we were a very closely-knit bunch. I dare say closer in many respects than family itself.

I left (like the rest) feeling satisfied with a 'job well done' -we worked very well together.

One of our captains put a hand on my shoulder, about made me jump right out of my skin. He was asking me if I was 'ok?'. I'd been standing in the with the driver-side door of my '85 Mustang open, staring into the car, the dome light on, with the buzzer going (in those days, I always left my ignition key in the car). I'm not sure how long I'd been standing there, but for some reason the buzzer/dome light combo would set off the memory of that little girl sitting in the passenger seat, eating grapes, on her way home. She saw it coming -of that I had no doubt. She knew she couldn't do anything, and was way too young to go this way. I pray the sister never knows that her large, unrestrained frame no doubt contributed to the death of the girl. I'd hate to have that guilt.

I unhooked the buzzer and the automatic dome light (could still turn it on, but you had to do so manually) in that car, and in every car I've had since -including my pickup truck I drive today. I don't feel bothered by it, not much, now (couldn't even talk about it, much less write about it -few outside of my fellow crew even know I think about it from time to time, only a handful even know it had an effect. Trauma was the name of the day back then, we had a LOT of accidents in our coverage zone. I have no real idea why the buzzer/light would bring up the memory, since no such sound existed that day -all power/batteries are cut before we begin working such accidents, and the noise from the engines and motors of our tools drown most things out. )

Your event kind of jogged this one. If all I really have left is the compulsion to disable a buzzer and light, I can live with that. :stone

Roy Fokker, BSN, RN · Jul 1, 2005

Gromit - Yikes! :uhoh3:

Y'know what? Even with experiences like these, sometimes I wonder why the devil do I want to get into EMT/ER/OR nursing.

But on the other hand, I really can't think of a more "exciting" field to be in...

By the by: The name Gromit wouldn't be from "Walalce & Gromit", would it? :)

**RosesrReder, BSN, MSN, RN** · Jul 1, 2005

So sorry to hear this. Can you maybe get some emotional therapy. I used to suffer from PTSD and it really helped me.

Good luck,

Jessica

Gromit · Jul 1, 2005

Gromit - Yikes!
Y'know what? Even with experiences like these, sometimes I wonder why the devil do I want to get into EMT/ER/OR nursing.
But on the other hand, I really can't think of a more "exciting" field to be in...
By the by: The name Gromit wouldn't be from "Walalce & Gromit", would it? :)

GOOD CATCH :yeah: You're only the second person who has caught onto that. My wife introduced the series to me -and I was hooked immediately (even more amazingly, I have NEVER liked claymation. This was just a cut above) I'm waiting for the next movie.

Well, I wanted the EMT (and then on to paramedic (EMT-P)) and firefighter because of the adrenaline rush (grin), and I had a friend who was doing it and loved it. Of course, my sanity could be in question (who would willingly get into hazardous situations for no pay, just the fun? -most of my 'career' (16yrs) was as a volunteer -only 4 years of it did I ALSO work in it for pay))

My reasons for being a nurse are varied, but not really in topic here (grin).

-Jessica, I never thought about emotional theray (what exactly IS that?) -my doc diagnosed and began treating me for depression back before I burned out and left the field for a number of years -welbutrin is my rx now, but I'm still prone to occasional emotional outbursts that are difficult to control -just severe, almost debilitating sadness/sorrow (whatever) -tough to understand if you never had to deal with it, I guess. But either way, its not acceptable behavior (not for a niceguy biker-dude like myself, hahaha).

Back to our topic, though, I do wholeheartedly endorse CISD, EAP, and not least of all, understanding friends. The former two, if implemented properly, can help stave-off a problem, possibly fix it, or at the very least, refer you to someone who can.

The CISD in Hillsborough County, FL is staffed with firefighters, EMT/Paramedics, and professional Psychs (not sure if its 'ologists' or 'iatrists') none of these people work in this county -so the fear of hindering ones' advancement (and other worries) is lessened.

Our respective fields are tough, demanding, and often rewarding. We DO have help available, if we recognize it, and avail ourselves of it.

renerian, BSN, RN · Jul 2, 2005

My ex father in law was a firefighter/paramedic/volunteer and went to a car vs. train accident and saw a woman, alive split from groin to waist......he quit the next day after almost 20 years. Horiffic........

I have had good luck by either watching something funny before bed or listening to my ocean sounds tape with guided imagery to get through things like that....

Hugs,

renerian

Gromit · Jul 3, 2005

Karen, I like the idea of watching something funny before going to bed (I watch cartoons (sometimes old ones on my vhs tapes) when I go to bed, never thought about it, but yeah, I guess it is a good thing. Listening to wave sounds would probably drive me nuts, tho.

Roy, I forgot to add that Gromit is also (for the same reason) the name of one of my dogs (a Boston Terrier -only one I've ever had, my wife wanted one. Ugly little dog, but cute as well, and very adventurous -so she is MY kinda dog! btw, she also rides on the tank of my motorcycle (grin)).

-train. Never saw a train accident myself, and cant even imagine the horror of seeing what what your ex-father in law saw. wow. Thats chilling.

One of our ex-firefighters (he left right as I was joining, so I only met him a few times) had seen his fiance' dead in an accident, but offered up no details. It was kind of odd, but the hazing of the newbies (me, in this case) involved traumatic stories (almost as if they were making efforts to scare us away) but my friend had warned me they were going to do this, and I took it in stride. I will say that I did not join in such efforts when newbies came after I was a member. I didn't want to discourage anyone from being a volunteer.

Well, its late (relatively) -been home a couple of hours, and have to go back on shift tonight. Off for the fourth, then two more shifts. (hate those 'one-day-off, two day on' schedules. But then I'll be gone for 6 days, and I like that! :) )

happy fourth! for everyone if I don't make it online tomorrow!