I Should Be in Jail

[allnurses]

This article was written by a member of allnurses. Due to the delicate and emotionally charged nature of the article as well as details, the member wanted the topic posted anonymously. If other readers have articles they would like published anonymously, please contact allnurses.com.

My First Encounter As A Paramedic: Shaken Baby Syndrome

Let's start out with my first encounter with a parent. I was a paramedic (a newbie..a rookie..an innocent) called to a home of a 4 month old that rolled off of a couch. The baby is seizing and the father is talking about how he was making the baby a bottle. He was alone with the kid and the mom was at work. He claimed to put the baby on the couch and the baby rolled off the couch. A short couch...onto carpet. The story didn't add up. The baby seized the entire 30 minutes it took us to get to the nearest hospital, and then later died from massive head trauma. Shaken baby syndrome. That was some fall.

This was my induction into real life. I was out of my protective cocoon and my rose colored glasses cracked in the truth of real life. I have scraped children off of the highway who were unrestrained; I have whisked children out of homes that were besieged with fighting under the protection of cops; and I have taken children to the ED scared to be touched by anyone.

The pressure of being a paramedic became too much, so I chose a new profession...pediatric nursing! (insert snarkiness here).

My Many Encounters As A Pediatric Nurse

Mom Brought 13 Year Old to ED Both Afraid Of Dad

Mom did not have custody, and the dad was not happy the kid was in the ED. Dad, I am sure after meeting him, is in a gang. The cops were brought in, the mom asked to leave, the dad was cursing up a storm and I confronted him. "We will absolutely not tolerate that type of behavior in the hospital, in a CHILDREN'S HOSPITAL. If you don't sit down and be quiet, you will be escorted out." Nicer than a punch, and I kept my job.

I myself was escorted by security to my car after work....fearing what may await me.

15 Year Old On Life Support OD'd To See If Mom Loved Her

She did not want to die, she wrote me in a note when she was intubated, she just wanted to see if her mom cared. The child took a turn for the worst with multi-system organ failure. As we strived to make her comfortable and keep her body in a hypothermic state, the mom was mad at ME because the room was too cold. She tried to fire me from being her daughters nurse. This after she so nonchalantly said, "pull the plug". I stayed at the bedside and held her hand as she passed away, mom went to go eat.

13 Year Old Dying From HIV/AIDS

The dad wanting to be at her side, the step-mom wanting to go do stuff. The dad confided in me once, when he was irritated with his wife, that his daughter was never treated fairly by his wife. He wanted to bring his daughter home to hospice and wanted to redo her room - a makeover - just how she would have loved it. The wife would not hear of it, since the girl was 'gonna die anyway'. And she did, in the hospital room with nursing staff at her side.

18 Month Old Beaten By Mom's Boyfriend

The mother of an 18 month old who was beaten by the mom's boyfriend. The grandmother had unofficial custody since the day the child was born. She had unofficial custody of 3 of the children because the mom was always partying and never had time for the kids. When the family decided to remove the child from life support after the baby was declared to have brain death, the mother banned the grandmother from the room. That was the only time I did not let a parent help me bathe a patient after the patient died....and I gave them a time limit for grieving as well. The fact that the mother was holding her dead child and talking about going to Chili's and a movie later in the day sort of made up my mind, along with her acting like this was a party and yelling at her brother to "go get me a coke, hey, my baby just died and you need to be nice to me", and "hey, you know that **** was going to go get a new car today?" Absolutely no feeling at all about the loss of a child, but enough bitterness in her to block the one true person who cared for the baby from being at his side.

4 Year Old Who Was NPO For Surgery

As usual, the patient did not go to OR before lunch and she became fussy and..hungry...I walked past her room to hear her father yell at her to "Shut up!" as she was crying. I went in right away and she was reaching for his lunch. His McDonald's fries and burger he was munching down on. I absolutely kicked him out of the room (sans roundhouse kick to the face).

Absence Of Grief

I know that people deal with grief in unusual ways. I have seen grief, I have seen the absolute absence of grief, and I have seen those who pretend to have grief. For me, the people who have not one ounce of compassion for the child who most needs their love are the ones who I cannot and will not ever understand. I know that people don't think beyond their own needs, even when a child is crying and does not understand what is happening.

But it doesn't mean I agree with it, or have to like it.

As a nurse, the hardest part of my job is to not say and do what I really think and feel. Or I would have been in jail a LONG time ago.

What have you seen that makes you want to commit an assault?

[Nightshade1972]

About 30 years ago, I read an article about emotional child abuse. Two of the stories which stuck with me:

An elementary schoolteacher found one of her students crying silently in a corner, after recess. The child ended up at the hospital with a broken arm. The teacher wondered why the girl hadn't said anything--until the girl's mother showed up at the hospital. Rather than expressing any concern about her child, the mother's first priority was to get a hot cup of coffee for herself, all the while complaining about how being at the hospital was impacting her workday.

The boy who had a prolonged hospitalization (I forget what for), who seemed unusually withdrawn when his mother was around, even more so when she wasn't. The mother nonchalantly said "I told him never to talk to strangers, that's probably why he won't talk to you." The medical professionals thought there was more to it than that, so they pressed the mother a little further, and it turned out that she had actually told her son that he would *die* if he talked to strangers!

[8&$$]

I am a recent graduate. I have three beautiful children that I protect with all my strength. I could never do pediatric nursing. It would drive me to kill someone and I am no talking about the children, but those terrible caregivers(memories from my own childhood comes to mind)that shouldn't have children or be near them.

[FurBabyMom, MSN, RN]

I work in the OR, our facility is a level 1 trauma center. You see a lot of things that are just not right. Sometimes it's kids, sometimes it's adults, sometimes it's truly accidental sometimes it's not at all an accident.

Luckily, in the OR - sometimes we never get to meet the families. Sometimes we get patients transferred to us for a higher level of care that come to the OR straight from the helipad. We may or may not know a name - we may assign them a "fake" or "disaster" name while they are unidentified. Other times patient arrive through our ED and are brought up to the OR for surgery, or go from ED to ICU then OR. In our facility ED staff bring patients to PACU if they're coming to the OR, anesthesia gets report in PACU, and for ICU patients the anesthesia staff get report/pick up in ICU and transport back to ICU. Occasionally we transport to/from ICU with anesthesia, but not commonly (generally these instances are when there's a lot of equipment).

It's easy (easier) when you don't get details. Commonly, all we get is what the trauma pager displays: age/estimated age, gender, mechanism of injury, most obvious serious injury, GCS (if applicable), vitals, estimated time before arrival, method of transport (ground or air). Sometimes we'll get additional updates, but generally we don't get more updates until we send a nurse to the ED trauma bay to scope out what is going on, and likelihood of coming to the OR. We generally get called if the plan is to bypass the ED and go straight to the OR but sometimes it's about 2 minutes notice.

It's worse when we get the frequently fliers. The patients (especially kiddos) who are severely hurt and cling to life through multiple surgeries. The folks you take care of time and time again, and they get a little better, then a little bit better still, and it breaks your heart that they might go home to the same environment where they were hurt.

Then you get the patients where you know it was not an accident, knowing no details about the situation. You document everything you can on arrival, and document why you omit something. Sometimes I do not have time to fully assess a patient's skin condition...they need surgery too much, are barely alive - a skin assessment is important but trying to control the hemorrhage from their GSW is more important. You page the social work on call, and may or may not have to answer police or children's services questions. You know you may or may not get called as a witness in a criminal trial.

It's very depressing sometimes.

[katierobin23]

I'm starting in the PICU at a large children's hospital on Monday and these cases are what scare me the most. I can only hope I am able to handle myself as you have.

[~PedsRN~, BSN, RN]

Great post, OP. You really hit the nail on the head....

I hear a lot on here that to be a really effective nurse, you have to set aside the emotions of it all to really do your job.

But there will never be a time where taking care of an infant who is now non verbal, blind, deaf, neurologically devastated, etc due to abuse from his own parents - the people who are put on earth to love and protect him - becomes routine.

[Hoosier_RN, MSN]

I work with the elderly. Some of the abuses committed against them would make your stomach crawl, and make you pray for your future. I can't even begin to tell some of the stories (atrocities). That was the last ltc that I worked at. I now work at at a facility that is private pay and is selective about who they take. We don't see these kinds of things there, thank goodness. But that last facility had stories that were almost beyond belief...

[ruthrowe]

I too work with the neonatal and peds. population. When I hear people say that we should just all love each other and the world would be fine, I think to myself that not every human is capable of love so it will never happen. The world is full of broken people.

[agiboma, BSN, MSN, NP]

thank you for sharing your experiences!

[Txldy]

I have seen my fair share of tragedy during my 30 years of nursing. At one time I sought counselling, which helped deal with the grief from all that insanity.

I learned to be the person on my shift that my patients could trust. I was on time with my meds and made sure they were as comfortable as I could possibly make them.I traveled as a nurse, and worked many different specialities. I had skills, that I lost to a stroke.

When you walk in to a room and see a happy little smile, you know your job is mostly done. When your little one needs blood work in the pre dawn hours, you can use the least restraint if you sing or hum them a little tune.

The thing is, when you know you have done the best that you can, when you have shown love and compassion and calm in a crisis, you have given a child a little bit of hope and happiness, and you can allow yourself to grieve after they are gone. You would get a hug from me, and a nice cup of tea. You need to just sit down and talk about it. Ya gotta do that for each other.

[WondeRNurse]

It makes me cringe to read , "What have you seen that makes you want to commit assault? " The very question seems to hold within it the essence of violence. I would suggest using a different means of conveying the same question, such as, "What have you seen that makes you anrgy?" or, "...that breaks your heart?"

To incite the very thought of violence as a response to the horricities we witness as nurses will plant a seed deep within the subconscious mind, with no positive outcome.

This being said, I can only share that never, ever, ever have I wanted to harm anyone. I wanted to legally detain the father who molested his 19 lb 3 year old daughter....who was being returned home -where "daddy" lived- for the 3rd time. And I DID ask Social Services, "Why?!"

I was VERY upset when I witnessed a lab tech tell an uncooperative patient, "I hope you die!" (I persued corrective action in that event.) But the thought to physically harm anyone never entered my mind.

What HAS entered my mind is questions I have regarding the limitations I have as a person to change what is happening in this world, and the amazing tools I have at my disposal to make a difference. It is the ol' Serenity Prayer at its best: to know what I can do and to accept what is beyond my abilities. Do what you can. Then (or, maybe even before step 1), pray for the person who is failing to be anything much above an animal. To be truly human involves the heart, involves caring. And THAT is what you described as lacking in each of these scenerios. One doesn't have to be religious to know the power of the heart, backed by thought, has transformative capabilities! (Check into Heartmath! ) When you think you want to act violently in response to these events, you are contributing to the overall problem, in a global sense.

As nurses, we are much more than a pair of hands with bandages and a pair of ears and a stethoscope. We each have a heart. Granted, some nurses have closed their hearts, and perform tasks with the grace of a robot, BUT each one of us, at any and every given moment, can make a thought that the person whom is less than caring will have a transformative moment, an awakening of their heart. After all, we are all on a journey called life, all at different levels of awareness.

I dare say, it is this very act, this intentional thinking, that has given me a transformational experience! I have more compassion. I have more acceptance for the little bit that I can do. And I feel good, instead of frustrated.

I am making the thought that all nurses, doctors...PEOPLE!.... come to have this level of awareness.

[lovinglife_rn]

This was such a great article! I recently completed my first year of nursing in October on a Acute Rehab Unit... But my first love was pediatrics. After reading this article I guess I never really understand all dimensions of pediatric nursing. I truly commend you on all the wonderful work you do. In the midst of everything all the stress and craziness, just remember to take care of you as well!

[debionken]

I didn't read all the comments so not sure if this was mentioned or not already. But as a geriatric NP I can absolutely tell you that similar horror stories can be told about abuse of the elderly. Abuse - physical, mental, emotional and financial - perpetrated by "children" (usually well into their 40's, 50's and sometimes older), grandchildren (also adults), or caregivers. Or "friends" who happen to spot a vulnerable and lonely elder and prey on them. It is cruel and devastating. And the horror of it is that there are far fewer social supports and protective programs for these elderly than for children. It can be quite difficult to advocate for them. Often their choices are simply between the frying pan and the fire.