So I begin to write.....

  1. 9

    As our responsibilities as nurses increase with education and experience, so do the consequences of our decisions. In a crisis situation, we make decisions for the best possible outcomes and process the "emotional" aspects later. This was one of those days.

    So I begin to write.....

    There is blood on the toe of my right shoe. It is not mine. It does not belong to the patient that is on the table in front of me who was in an automobile accident several hours ago --- surprisingly.

    Although it could have, but I know that it did not because all of his blood is rapidly running out of the blood vessels and into his abdomen. It is compressing his lungs and making it hard for him to breathe; making it hard for his heart to pump blood and carry oxygen to vital organs that so desperately need it.

    There are 8 people in this room and 7 of us are working to keep the 1 alive.

    He is no longer able to tell me where he is. The team works hard to supply volume in the way of IV fluids to keep his heart pumping. We have only one more bag of blood left.......

    Today wasn't supposed to go like this. Not for me and certainly not for him. I am exhausted. I want to cry. Every decision has a consequence. There is no room for what I want; not right now. How did we get here, to this moment?

    Earlier that morning..........

    We walk down the hall. I am talking rapidly to my collaborating physician with every detail --- everything I can recall --- and am struggling to reach the knowledge that may make a difference in this patient's life or his death.

    "What time did he come in?" "Where was the accident?" "What were his vital signs on arrival? On assessment? On admission?" "When did his condition change?" The questions come rapidly; one right after the one before. I realize how much I know ---- how much I have grown as a provider over the past two and 1/2 years, but also how much I do not know. She has an air of confidence and projects that with every word she speaks. I am glad that she is the one by my side.

    When I was in middle school and we played volleyball in gym class, my job (in any position) was to stay out of the way of everyone else so they could get the ball. I never wanted to let my team down by missing the "set" and losing points.

    Today, I am a key team member and "losing the game" means people die. I still don't want to lose and at this moment, the stakes are higher than ever.

    The ambulance crew has arrived. They work beside us. Everyone knows their role and position. Everyone plays their part. Decisions + actions = consequences.

    I look down at the splattered blood on the floor once again. Someone brings in a towel and covers it so that no one will slip in it.

    My patient is now on the stretcher and headed to the ambulance so he can get the surgery he needs that will save his life. Maybe.

    After the ambulance is gone and I have called the patient's spouse, I grab a sheet of paper and step out of the ER. I go to the cafeteria and make some toast.

    I sit down at a table with a pen and my paper. For the first time in a long time (ok, 6 months), I question whether I can do this. I take a deep breath. A tear rolls down my cheek. I wipe it away. There is no room for that today.

    I pick up my pen and poise it over my paper. I stare at the floor right in front of my feet. There is blood on the toe of my right shoe. It is not mine.

    So, I begin to write.........

    ** Details have been changed for privacy.
    Last edit by Joe V on Jun 20
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  2. Poll: What is your level of nursing degree?

    • CNA

      10.00% 1
    • LPN

      20.00% 2
    • ADN/ASN

      10.00% 1
    • BSN

      40.00% 4
    • Advanced Practice

      20.00% 2
    10 Votes / Multiple Choice

  3. Visit bzmom profile page

    About bzmom

    I started my nursing career as an LPN and climbed every rung of that ladder finally becoming a FNP in 2013. My experience as a nurse provided a solid foundation for being a primary care provider. Do what you love - above all.

    Joined: Nov '06; Posts: 54; Likes: 38
    Department of Veterans Affairs - PTSD treatment; from US
    Specialty: 15+ year(s) of experience

    Read My Articles

    4 Comments

  4. by   Axgrinder
    I have to wonder if we all have moments of thinking, "What have I gotten myself into? Can I do this?". Perhaps the question to consider is if we never did, would we be human? After all, we are only mortal - nurses, doctors, advanced practice, respiratory therapy - often assisting Those on a higher level to grant more time in a bad time. We intervene, we try - we save some, we lose some, and we grieve all those in a bad place. We are after all only human.
  5. by   FranEMTnurse
    When I first joined our ambulance corps, I wondered about what I got myself into, but after I became an EMT, I changed my mind. Being an EMT, and eventually a CPR & Basic First Aid instructor, I gained a lot more confidence. I saw many people in trauma situations, and it seasoned me to where I wasn't able to face horrible situations. After being an EMT for 15 years in the ambulance corps and moving to another state, I went to school and became an LPN.
    I wasn't afraid of what I saw in nursing school, and desired to work in the ER (due to my experience) or Labor and Delivery.

    I was a Nurses Aide many years earlier, and loved it, so I knew I was where I belonged.
    However, soon after becoming an LPN, I became a patient and dependent on others to care for me. So I decided to go to plan B and joined the Allnurses.com website where I would be able to connect with nurses in all fields of nursing with all types of experience, and feel most at home here where I am the happiest in the field that is my love.
  6. by   SpankedInPittsburgh
    Proof is in the Pudding. You DID do it and almost certainly will continue to do so!!!! As another ER Nurse I commend you & keep fighting the good fight. We win some & we lose some but we always give what we have.
  7. by   Elfriede
    Writing is an act of compensation. It helps you, to process your impressions. Just follow the terms of data protection. I do it as well.
    Y´s Frieda

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