Topics About 'Trauma'.

Amidst the havoc created by the pandemic, nurses have been a steady influence for good. Our profession continues to represent caring and compassion, ministering to the sick in difficult circumstances, and doing our best to preserve dignity and respect for those who suffer and for their loved ones. Nurses have risen to the occasion and led the way in compassionate care. But, at what cost? As the pandemic abates, we begin to see co-workers facing and processing the trauma of this year of COVID-19. Hopeful signs The pandemic is certainly not behind us but there are hopeful signs that the increases are abating and that mass vaccinations are taking hold to break the grip of the virus on our nation. Worldwide, the situation remains perilous and we simply hope that the vaccine will continue to be effective and give the global community relief. Slow Process of Recovery The deleterious effects of the pandemic are well-known: death and disaster all around. The USA alone mourns the loss of 550 thousand people, each a person who leaves a space to be filled with grief. With known cases at 30 million (possibly many more undiagnosed), we have a sizable portion of our population directly affected by the virus. Currently, about 10% of the total adult population in this country is fully vaccinated with about 1/3 having received at least one shot. We see signs of progress but aligned against these words of hope are the threatening presence of variants and the risks of letting our guard down too quickly. The Trauma of the Pandemic Nurses experienced a variety of traumas from the pandemic. Losing patients even with the best care possible Being overworked and having to push through intense fatigue Facing political and social upheaval with our country and communities divided on how to approach the virus How to treat it and how to prevent it On all fronts, nurses were right there at Ground Zero, dealing with all of it in the best way they could, all the time keeping to focus on advocating for and doing our very best to provide exceptional care every time to every patient. Back to Normal? How? As we see glimmers of "normalcy" we begin to process the trauma of the past few months. Sleeplessness, general anxiety, and disruption of routines contribute to many mental health issues. How do we best cope? Acknowledge it was hard We cannot move on and dismiss. Sometimes we have to sit with our troubles and turn them over and analyze them a bit to find a way to process. To deal effectively, we might need to first offer each other the space to say it was hard. How can you and those around you feel safe in discussing the difficult times of treating patients with COVID-19? Talk about it There may be one particular death or story or time that keeps going through your mind. Talking about it with a professional or a trained listener can help in dealing with a troubling time. Mental health professionals acknowledge that verbalization can help consolidate and reconcile disparate memories. Who might you enlist for a confidential conversation about specific traumas of the pandemic? Notice if you are having trouble Are you sleeping as well as you used to? Are you struggling with difficulty concentrating? Are you feeling low or "blue"? Sometimes we need to permit ourselves to not be OK. And to get help. When we go through traumatic times in our lives, the trauma doesn't go away afterward. It is still there, living in our minds. We have to find ways to work with it and to talk about it and incorporate it into our new, post-pandemic selves. We may need to seek out professional treatment and encourage each other to do so. Revisit old routines This may be a time to take back some parts of life that were disrupted: revisiting exercise routines by going back to the gym (if safe), or resuming evening walks, or volunteering at the animal shelter. What is the old routine that you want to restart? Re-engage You may be depleted professionally after the pandemic. The weariness may be making you wonder about moving on to a different line of work. While it may be time to explore further, it may also be a good time to take stock, to re-build professional interest, and to re-connect professionally. This could be the perfect time to engage in a learning activity online. Learning can rejuvenate and re-ignite our passion for our profession. How can you re-engage with nursing in a meaningful way? Whether you work in a COVID ICU, a health department, an ED, a school, a testing site, a mass vaccination location, every nurse has experienced the pandemic as it approached, surged, and now subsides. We have all dealt with our version of trauma. As we acknowledge and process our trauma we can take hold of lessons learned and move forward, even better professionals than before. What is Your Experience? How are you dealing with your experience during COVID-19? Can you share some of your experiences and how you are processing your trauma?

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Jessica Kensky and her husband of 7 months, Patrick Downes had both run in the marathon in 2005, before they even knew each other. On this Patriots Day, they were going to be onlookers. They found a spot on Boylston Street near the finish line. They were watching runners cross the finish line and were about to leave, when at approximately 2:49 PM, with more than 5,600 runners still in the race, the first bomb went off. Twelve seconds later, a second bomb exploded. All around them, windows were shattered and people were battered by flying debris from the explosions. In an instant, the explosions turned what had been a sun-filled afternoon into a gruesome scene of bloodshed, destruction, and chaos, killing three spectators and injuring more than 264 others, including 16 who lost limbs. Many lives were forever changed that day. Jessica and Patrick were among the victims of the senseless act of terror, losing 3 limbs between them. As part of the allnurses team, I was honored and inspired to be able to sit down and talk with Jessica at the 2018 AACN-NTI Chapter Presidents Luncheon sponsored by Medtronic. Jessica shared painful memories of that day as well as the days and months to follow. Immediately after the blasts, Jessica instinctively switched into nurse mode trying to fashion a tourniquet out of her purse strap to attach to Patrick's lower leg. As they lay there on the sidewalk, she noticed his nearly detached foot, alerting her to the seriousness of the situation as he was losing a dangerous amount of blood. She did not even realize the extent of her own injuries. She and Patrick were separated and sent to different hospitals. While she was fully alert when she arrived in the ER, Patrick was unconscious and without any form of identification other than his wedding ring with PB&J inscribed on the inside. Upon arrival in the ER, the sounds, smells, terminology that rolled around her were all known yet jarring at the same time. She had to go from calling out orders regarding lab values, medications, to being a patient on the other side of the bedrails. She realized that she would not be playing the role of the nurse in this situation. Her devastating injuries caused by burns and bomb debris had to be attended to promptly with expertise. While she is very thankful for how she was treated, what she remembers most is the human side of nursing care that she received - the way that her ICU nurses continually cared for her mental health with their acts of gentleness, kindness and compassionate care. Rubbing a cool cloth on her back. They brought lightness while also acknowledging how sad this was and what a difficult situation she was in. A few things she learned as an ICU patient as opposed to an ICU nurse, many of which drew laughter from the nursing audience. It is really scary to leave the ICU and go to the floor. It is a world away from the people you have grown to love and trust. You can have a foley and still have the sensation to urinate. PICC line insertions are NOT painless. Sometimes we just need to see the daylight. Pain management is not a joke It's possible to be delirious and embarrassed at the same time Multiple surgeries, plus narcotics, plus immobility equals excruciating constipation. Once someone sees you needing a cervical collar, it's really hard to find someone else who will take it off. Out of all the pain drugs she was given, her drug of choice was Benadryl Never let a member of the surgical team touch the patient without a nurse being in the room Jessica received a very special gift that has become an integral part of her life. A black Labrador, so aptly named Rescue, has indeed rescued Jessica and allowed her not only survive but to live life with a purpose. Jessica and Patrick realized how important it is for children to be able to comfortably talk about their injuries when they spotted them out in public. They wrote a book which was very therapeutic for them and also informative for children and parents alike. They used their therapy dog who has been a very important addition to their family, Rescue, as a gateway in their book, Rescue and Jessica: A Life-Changing Friendship. I treasure the copy I received that was "pawtographed" by Rescue. Jessica and Patrick did not succumb to their devastating injuries physically or mentally. After hundreds of extensive surgeries and many long and grueling hours of physical therapy and rehabilitation, Jessica has survived and become a beacon of hope for others. Her determination, strength, optimism and knowlege have allowed hers to be a story of triumph over tragedy. What she learned on the other side of the bedside has allowed her to move beyond the bedside and share many important lessons she learned. She has become a shining example and reminder to nurses of the important things that lie at the heart of nursing. We should never forget the important part that humanness plays in the care we provide. I hope you are as inspired by Jessica's story as I am.

The entrance seemed dull with the light from the building, "and they call this good light," I thought to myself as I looked back once more at the glistening of the sun on the dew-filled grass. Must hurry, can't be late. Morning report was fast for me. Covering the ER made my work assignment not as heavy as it could've been, even possibly extra minutes to sneak outside the ER door for a few more moments of the beauty that would soon fall into noon. The day moved slowly along with only a few calls to the dreaded ER. They can work a "sista" to death, if you know what I mean. Anyway, the hopes of a slow day, at least in the ER remained, and if so, I would finish on time and be able to enjoy the evening sun. Beep, beep, beep, not the long beep! Please, not the long beep, not today it's too beautiful today. I rushed to the stairs as they called Respiratory stat to the ER. The code room was open, and Dr. Thong asked me to get another therapist and gather extra equipment, and a ventilator, the standby for our patient would be 8 minutes. Through the doors he came, covered with emergency workers around him, their faces blank and fearful. The smell of autumn followed, with leaves and debris covering their clothing. He's been down for 10 minutes someone yells. I then saw his face for the first time; he was young, maybe 25 I thought. What could have happened? His face, ears, and scalp were a deep purple, no wounds, no blood to be seen. The report began, 26 year old gentleman digging a ditch at a construction site, trapped by a backhoe that slipped from its port. The race began; Dr. Thong said, "let's move people." The endotracheal tube slid down his throat with no resistance. With each press of the Ambu Resuscitator bag his chest rose. Blood flowed from the central line placed in his groin. The hue as I remembered resembled weak coffee. And with each thrust of the chest compressions, his chest gave in like dough being kneaded for bread. The drugs being pushed gave no indication they were on board, not one frazzle was noted on the heart monitor. After 20 minutes the room became crowded as the operating room staff arrived from the called made to them. The equipment they brought took up space throughout each corner as they prepared for the thoracic surgery plan. As they took their place at the bedside my mind floated to what would be as I was given the heavy blue gown to put over my scrubs. The first pass of the scalpel opened his chest as if it were a zipper. I could not believe how easy it was to distinguish fatty tissue from muscle. The yellow hue sat there in small clumps as if it were popcorn kernels. Just as fast as the yellow and pink tissue was parted, blood would fill the cavity as if a race were being run. More equipment was pulled from the cart and then the smell of burning flesh filled the air, as well as the sound of the saw as it opened his chest for us. The view of the pulseless pink and blue organ didn't last long. Hands began their job, massage, massage and more massaging as if this would bring life back into it. "I need another set of hands," yelled the surgeon through all the chatter in the room, and at that very moment without any thought of what was happening; I reached out with my hands and began my first open heart massage. We did not save his life that October day, but the beauty of nature and man became as one for me. It became an ordinary day in my journey as a RT/RN...........