Even the Stoic Have a Breaking Point

Today was not a day I loved my job. In fact, in my years as a nurse, this is the first day where I cried openly, in front of my colleagues, and with those colleagues.

Even the Stoic Have a Breaking Point

The day started out normally enough: come into work, get my assignment, and start preparing my OR. I didn't need to move in right away; while we normally move patients into the OR around 0700, my patient wouldn't be moving in until 0800. And so, when the trauma code was called overhead at 0654, I was called upon to scope out the trauma bay.

I headed down to the ER, expecting the usual car accident, stabbing, or shooting. Well, it was a car accident all right, but certainly not the usual. A young woman, on her way to work, struck head on by a drunk driver. Yes, before 7a.m. But the heartbreaking part was that this woman arrived with the CPR device compressing away, her obviously pregnant belly bouncing in sync with the compressions. The baby was in obvious distress, and there was no time for transfer to the OR or to wait for an OB to arrive from maternity, four floors away. The trauma surgeon did an emergency C-section, right there in the trauma bay. Suddenly, we had not one but two trauma patients. And both were coding.

Baby boy was intubated and gradually his color improved, although respiratory function, heart rate, and pulse ox remained well below norm. He was sent to a nearby children's hospital NICU, with many crossing their fingers and saying a prayer that he would make it.

We never did get mom back. We tried drugs, we tried external pacing, we tried every trick in the book. All without success. We did what we could to get her incision closed and cleaned up for family to see.

We all heard the husband/father arrive. The wails as he was told his wife didn't make it, the sobs as he was walked into the trauma bay and sank to his knees. Every single person in that trauma bay was crying right along with him, even those known as the crusty old battle-axes who have never openly shed a tear.

I've cried over patient situations and deaths before, but always privately and usually in my shower at home after a hard day at work. But this was a situation where I couldn't hold it together, and I was certainly not alone. This was one of those traumas that will likely haunt many involved for the years to come.

Many healthcare employees are involved in events in the workplace that can lead to traumatic stress brought about by strong emotional responses (Vaithiligam, Jain, & Davies, 2008). In light of these events, hospitals should provide support to involved employees. Many offer an Employee Assistance Program (EAP), but is an EAP always enough? Employees may be reluctant to contact the EAP if they fear their employer will find out they have sought mental health help.

My facility goes beyond the EAP and provides critical incident debriefings when deemed warranted or if staff request a debriefing. The most recent was after a sudden onslaught of more than a dozen heroin overdoses that led to poor survival rates and several becoming organ donors. I am sure there will be one to follow today's events.

Debriefing allows those involved in a traumatic event to process it, vent emotions, and address potential physical or emotion harm that may result from the experience (Davis, 2013; Vaithiligam, Jain, & Davies, 2008). A timely debriefing that occurs within 72 hours of the precipitating event can reduce short- and long-term crisis reactions and psychological trauma (Davis, 2013). Healthcare employees can greatly benefit from the option to attend a critical incident debriefing. Does your facility provide this crucial support?

References

Davis, J. A. (2013). Critical Incident Stress Debriefing From a Traumatic Event. Psychology Today. Retrieved from Critical Incident Stress Debriefing From a Traumatic Event | Psychology Today

Vaithiligam, N., Jain, S., & Davies, D. (2008). Helping the helpers: Debriefing following and adverse incident. The Obstetrician & Gynaecologist, 10, 251-256. doi: 10.1576/toag.10.4.251.27442

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Rose_Queen

About Rose_Queen, BSN, MSN, RN

(Editorial Team / Admin)

Rose_Queen started her nursing career over a decade ago in the OR as a new grad. She has experience in multiple surgical specialties and currently works in cardiothoracic surgery.

6 Articles   11,935 Posts

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I'm so sorry my friend. ((((Rosie))))

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Specializes in critical care.

I am so, so sorry!

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I cried as reading this. I am sorry you had to witness this. At least you and your team did your best to save her.

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I am so sorry Rose_Queen. I'm sorry you had to go through this, and I'm sorry that human lives can end so quickly and unfairly. You and your team did what you could and the rest was out of your control.

I completely agree that team debriefings should be done after traumatic events.

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Specializes in Emergency Medicine.

I was an active duty military nurse for six years, have been to war, have basically, seen it all. We always debriefed after every mission, traumatic to staff or not. However, your situation is something I dread seeing everyday I'm in the trauma bay- I have yet to see it; perhaps it is the only thing I have not seen. Regardless of the horrific things I've seen and experienced, literally hell on earth, I would have been standing there crying like you.

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Ugh. (((Hugs))) to you, Rose_Queen. I hope all involved can make peace with having been witness to such a tragedy.

My employer does debriefings after particularly difficult cases such as this one. The few times I have felt the need (or been asked) to participate, I did find it helpful.

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Specializes in long term care Alzheimers Patients.

I am so sorry Rose Queen. Hugs

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Specializes in Telemetry.

(((hugs))) So sorry this tragedy occurred. You and your colleagues are in my thoughts.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

It's amazing after all I've seen (much while deployed like ED Nurse up there), stuff like this still gets me right in the feels. I am so sorry, how awful. I really hope the baby does well so that someone will survive something so horrific. That poor family. :(

We had a rough pediatric patient in our ED recently, and our hospital chaplain came in to talk to us and bless our hands a couple of days later. I don't have much use for organized religion, but our chaplain is fabulous and I really appreciated what he did in sitting down with the staff who cared for this particular patient. I think we all found it helpful. I hope you and the staff involved can find a way to deal with the incident.

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Specializes in LTC, assisted living, med-surg, psych.

((((Rose Queen))))

Ah, incidents like this are hard to handle and impossible to forget. I wish you the best in processing it and moving forward from it. Good article.

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Specializes in L&D.

I'm so sorry. The debriefing process is so necessary after something so traumatic. I work in labor and delivery and recently found an fetal demise along with the OB. It was awful. We all cried together :(

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