Coping with a wide-scale trauma..

[Dempather, RN]

We had a patient come to us a while ago who was injured after a particularly gruesome accident. After the incident, word got out and people have called me about it, including well-intentioned family members of mine. What makes this wider-scale for me was that it made it's way out of the hospital and into the community. Even a close friend called in a mild hysteria stating she knew the patient well and wanted to know if I was there and if the patient was okay. I was able to handle the situation well and maintain the patient's privacy.. but I think my friend knew I was holding back information she knew I couldn't share (which hurt more).

I think I can handle a lot, and I'm proud to be an emergency room nurse, but this floored me. I've been a little hazy since it happened. Can I call myself a good ER nurse if I don't let this brush off my shoulders and forget about it? Are we all supposed to be indestructible?

I don't necessarily want to talk to co-workers because I don't want them to think I can't handle tough situations. An example here: One of my co-workers afterwards cried out, "WOW, I wish I was there.. that would've been AWESOME.. what a great learning experience!!!". I felt like reaching over and smacking her. But I caught myself wondering whether that "I'm hardcore" enthusiasm makes a person a better ER nurse? Or better ER doctor? Is that how we're supposed to be wired?

Traumas are exciting. And it rushes the adrenaline. Mine was definitely rushing during the whole event, but I would never call myself enthusiastic. I would never leave a situation like this and call it COOL. I did well .... I know that's what matters. But is it enough?

[Altra, BSN, RN]

Every well-seasoned ER/trauma vet, paramedic, EMT, police officer & firefighter I know has plenty of stories that they tell with great gusto ... and a story or two that they tell with some measure of anguish. I could recall any number of traumas & codes and tell you, yes, what was "cool" about the case. But occasionally some aspect or detail regarding the patient -- their injuries/condition, their age or physical resemblence to someone else I have known, some component of what happened to them, or simply one more trauma at the end of a grueling day -- gets under your skin and it becomes much harder to separate the clinical presentation from the human situation.

As long as you performed well while the patient was in your care, you have no reason to feel inadequate. Not every trauma ends in high-fives all around. After a little time & distance, I would bet that you will be able to identify something new that you learned during that case.

{{{{Hugs}}}}

[Aneroo, LPN]

There is a piece of flair on facebook about trauma nursing that says: "It's not that I want you to get hurt. I just want to be there when you do". I think that fits well with most patients.

If it was an unusual case, someone close to you, someone big in the community (cop, fireman), a child, or just something very traumatic, I would check with your nurse manager about a critical incident debriefing. It would provide a chance for all involved (from the field with EMS to ER to OR or floor) to debrief- talk about the incident, get counseling if needed. If it was a good educational case, see if you can have a meeting with those involved to talk about what could be changed to improve outcomes/pt care for the next similar case.

:heartbeat to you!

[flightnurse2b, LPN]

you need to talk about it with someone.

of course you are still a great nurse.... none of us are indestructable. we're human.

i was a critical care paramedic before i became a nurse. i used to call my paramedic self the chameleon. i was totally different when i was in that ambulance and in that ER... i felt like sometimes i had lost my emotion and turned into a rock... but then when i clocked out... i was allison again. many other ER nurses/paramedics/firefighters have also told me that they have a trauma "alter-ego".

i had a very hard personal tragedy that put that all on tailspin for me and ever since that day i have not been able to put the mask back on fully. i have become more empathetic and more empathetic. sure, when i work a code, the chameleon comes back out, and i'm in the zone. and afterwards... when i have to break bad news, i am less cold, and less detached. i felt like always putting my game face on.... was making me lose myself.

like altra said... i have my cases of triumph, where i've helped do an awesome auto extrication and the lives were saved. those are great moments. i always have my cases of heartache and extreme defeat.... and those, unfortunately, are the ones that stand out the most.

we had our time at the fire dept and also in the ER that we debreifed and talked about whatever was weighing on anyone's mind. you'd be surprised to see how many ER docs, nurses and fire-medics break down and cry. you just have to sometimes.

sometimes there are times for awesome learning experiences--this may have been one of them. but it won't be useful to you in that sense unless you are able to express your feelings about it and are able to first and foremost allow the human side of you to come out before being super ER nurse.

sending you hugs!!

[traumaRUs, MSN, APRN]

Not one of us is indestructable! Like others have said, we all have the coolest stories that we can laugh at and watch our audience turn green! However, we all have some stories that have shaken us to our core and those we don't laugh and talk about.

Please talk this over with someone you trust...if you let it fester, it will get worse. Take care.