Neuro is the most tragic

[FireStarterRN]

I have decided that neuro is the most tragic and that I basically hate it. It makes me too sad to see young people devastated by brain injuries in the prime of life.

I had another young patient yesterday, a 20 yr old Mexican woman. Social history was that she had snuck into the United States in order to follow the father of her now 4 yr old child. She got pregnant again by him, he dumped her so she went to live with relatives here.

She had a normal, healthy delivery, but the next day the OB nurse noticed ataxia on ambulation. CT scan revealed a large brain tumor. She went for surgery, and now she's been in the hospital for a month and a half, has required a shunt, and is neurologically compromised. Her baby is fortunately being raised by her uncle's wife who seemed very loving and has other small children.

Her prospects are poor. Her older child is in the hands of a friend of its father because he took off to California. The pt's own father has now snuck across the border in order to get the child into the hands of their side of the family. Because of these people's illegal status they have to handle their own affairs outside of the rule of law.

It's so sad. Life is so uncertain and every day is a gift.

[kenny b]

Have you had to make such a choice? I don't think so. Even people in third world countries don't come across such scenarios, leave alone a country like America.

Your tax dollars will not be less if you don't treat illegals. They will keep climbing up no matter what. I don't think you will get a rebate if you don't treat illegals--just a thought.

I agree we won't get a rebate. In fact our taxes don't even pay the interest on the debt. It is our children who will pay the cost of government spending in the form of a devalued dollar. And I agree that reduction in spending on illegal aliens will not solve the problem.

Regards,

Kenny B.

[pagandeva2000, LPN]

I agree, brain injuries are tragic and such a loss and waste of a life.

Some people would be upset that US taxpayers are footing the bill for the medical care for an illegal alien as you describe.

It seems that there are a lot more motorcycle accidents in the news this year, probably due to the price of gas.

I for one don't care if my tax money goes to help domestic citizens or illegal aliens! A life is a life and it is disgusting to even hear such bias coming from a health care professional.

Somehow, I don't think that this poster meant this to say that he/she believed that illegals deserve less treatment than domestics, it could have been mentioned as an observation. I say this because I have seen in my hospital that many of the administrators and even physicians hold similar sentiments and that shocked me. Most of the nurses I know don't look at it this way, but unfortunately, there are many that do take on such opinions and many of the nurses share views on this often (saying that everyone should be treated, regardless of their ability to pay).

[ayla2004, ASN, RN]

I agree and after working on a spinal cord injury unit I learned to adjust my ideals as to what a miracle actually is, the smallest things become huge accomplishments.

working in a spinal ward with elective spinal surgery and trauma patients

chronic pain and nerve damage isn't always cured by spinal surgery's

and young spinal cord injuries are heart breaking as people slowly come to understand that there is no cure with regaining control of their bladder and bowels or when assessment shows that they aren't rehab able

very sad. also worked in neuro with patients with trauma injuries, cancers and saw some really good come backs.

[kenny b]

I'm curious about all of these stories we hear about people who are told that they'll never walk again . . . and they do!

I have a friend who was hit by a bullet, and although he was told he'd never regain use of the right side of his body, he managed to regrow nerve fiber for everything but his thumb (and he's working on that now).

Has anyone seen patients recover after spinal or neural injuries after they are told that they cannot?

Thanks in advance!

Rgds,

Kenny B.

[ayla2004, ASN, RN]

not done spinal/nuero rehab have seen some good acute recovery on patients who had good prognosis after trauma and who had prolonged stays with good therapy inputs while on acute wards.

however have seen spinal injures due to tramua and cancer that lost anal and bladder tone and below waist paralysis

[SharonH, RN]

I knew that som people were going to make this a debate about her residency status. That is the most inhumane of all when you cannot see a person in this tragic situation but her citizenship status.

[SharonH, RN]

And I detest neuro also. It is a very hard specialty to deal with.

[Jules A, MSN]

I hate the unpredicability of neuro injuries. I am totally inexperienced when it comes to neuro pts, but it seems that I can never tell which ones are going to get better and which ones we should never have tried to save.

A patient I saw once was a teenage boy who was found semi-conscious in the bedroom; it was assumed that he had OD'd. In ED he had 3(!) VF arrests and 3 times got a return of output. He was found to have had a significant bleed near the cerebellum from a massive AVM which they could not coil.

He's alive. He will have surgery some time soon to chop out a section of his cerebellum to make room for the AVM, reducing pressure on it. He has a 75% chance of surviving the surgery, and if he does, he'll be disabled.

Aren't you glad we worked so hard to 'save' him?

You make really good points and the way I looked at it was that by the time I got them they had already been "saved" so it was kind of moot point and also a very personal choice. For me, no way do I think I would be happy or mentally stable as a quad but that is just my opinion. It came down to what we had left to work with and we just tried to get them as much practical function as possible. Tough topic.

[leslie :-D]

although us healthy individuals cannot understand anyone wanting to live as a quad, there are some who have rediscovered and embraced a new and improved quality of life.

it seems to go way beyond physical incapacity...

more like a spiritual replenishment.

i've watched/read stories about suicide survivors who became mangled and mutilated as a result of their attempts, yet were grateful they survived, despite their permanent handicaps.

one girl actually got run over by a train and it chopped her legs off...

in her interview, she was very happy at her 2nd chance.

you just never know.

and it's something we can't decide for others.

leslie

[dld, ASN, RN]

I have taken care of so many pts who were comatose and came out of it, got rehab and went home. Many with a poor prognosis. Our body parts and our mind is not all that we are. Look at Steven Hawkins. Quads often use what they have left to really improve their lives, and who they are. They have many lessons to learn, and many to teach us about what life is all about.