I admit as a new ED nurse, I definately have that rush when the EMS call comes over the radio that they are a few minutes out with a good trauma, but one recent call is more than I know how to let go of.
Im not going to go into a lot of details about the incident, but there was a 25 year old kid who was involved with a freak accident with a cement mixer. Needless to say, he did not survive. This was one of those cases where death was so much more merciful than survival would have been, and my saddness and grief are not so much related to his death, but I cant stop thinking about the absolute terror that this poor kid must have felt in the last few seconds of his life. It nearly brings me to tears when I do think about it.
So my question is this; when you have that patient whose story just rips your heart out, how have you dealt with it? How do you learn to let go of the hard cases so you can move on to help the next person who walks through the door? During nursing school, it was always a joke with my clinical group that if there was a trauma somewhere, I was probably near by and standing in the middle of it trying to help. I love what I do, and I honestly feel that the ED is where I am meant to be, but for the past week I havent been able to stop thinking about this patient. I actually had to choke back tears today when I started thinking about it.
I agree that the "worst things" are not what lay people might think- not exciting or (to them maybe) interesting. And when I tried many times, sitting here, to type them out, I started feeling sick and feeling helpless. Because when you think of one, you think of more and more. It's the eyes especially, of so many patients or their parents, that I remember that get to you. The look of fear or hope or so many other emotions. I don't think I'm answering your question though. For me I have to talk it out with others who were there, who I trust. Or write it out, again and again. Usually that helps take the sting out of it or helps it be easier to live with, or something. And even still there is one incident/situation that I still can't stop thinking of and don't think I will ever forget. I think that is the way for all or most of us.
I'm still waiting to become jaded and callous. Meanwhile I take comfort that when someone has the worst day of their lives, I'm there to give them the best possible care (both physical and emotional types of caring) that they were despeately wanting in their last moments. I hope you find the comfort you need, in the meantime if I have the worst day of my life, I hope YOU are there to care for me. You're my idea of a good ER nurse. Thanks for being there. Paul.
A few months ago on the way home I stopped at the scene of an accident where a kid (late teens to early twenties) had been hit by a vehicle while riding his bike without a helmet. Massive brain bleed, and seizing all over the place. A CRNA had stopped to help, and was holding pressure while trying to keep pt from further injuring himself. I saw EMS coming from the distance and left. There was nothing I could do. For weeks I struggled with the feelings and emotions of seeing someone in dire need of help, and not being able to do anything for them despite all my training.
I don't know when, but I filed it away at some point. I remembered only now when reading your post. I think with time we learn to accept things. With experience it may become easier. However, as human beings we will never completely rid ourselves of all feeling.
We all must move to the next world someday. I fear being alone for that. I hope there will be ER nurses who really care and comfort me when I move on. Sometimes all we can do is tell the next world we want this one to stay here, but the final decision is always up to the uppermost management.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
Sounds like you have PTSD. Suggest you get HR to assist you.
Compartmentalization is the way I cope with these ordeals. Over 18 years, there are many I cannot forget...but unless something brings to remember the "ones"....I don't deal....it's my best way of coping....
Maybe you need to not hold back the tears and just let yourself cry. :hug:
One can't expect to move on immediately. You are human. You don't need to be de-sensitized to be a good nurse. I know some people can disconnect their emotions, and others can't. It's okay to be either.
It's okay to feel sad about a situation. To me, empathy is what makes a good nurse. For a person to be able to connect with another person and express honest sympathy about their situation, having never met before, is a beautiful thing. We should embrace it, instead of trying to change who we are.
I would feel the same as you if I were in that situation.
Again, I have to hand it to you ER/PEDS/Paramedics. I am an emotional person by nature, and I don't know if I could cope with what you see and do. Thank God for what you do. I work LTC care, and sure I think some residents suffer needlessly, but usually that is a code status thing, and is up to family and resident. Either way, most of my residents live a long, happy life. I can easily handle them passing with normal grieving.
ER Jen, I feel for you. I really do. I would be thinking the same way you do. I would always be thinking of the terror/pain these poor people go through knowing they are going to die. You said you love trauma, this doesn't mean you aren't cut out for it. This one just hit you hard. Is there someone at your hospital to help you through your grief?
Just some *hugs* for ya, Jen. I take comfort in knowing I do my very best to be there for all my patients on the worst day they can imagine. If they survive, even better. If they don't, it's an honor to be there when they transition to wherever they're going next. There are some I'll never forget.
What I've had to remind myself of is that emotions are not a light switch that can be turned off/on. Whether it's children burning alive in front of their parents or a family's patriarch that suddenly experiences a massive head bleed and progresses from normal mentation to a GCS of 3 in less than an hour, these experiences take an emotional toll. If one is to have any emotional connection when away from work, they cannot simply numb themselves out emotionally. Grieving is normal and becoming "desensitized" can create problems of it's own. I will allow myself to greive after the shift ends, grieve appropriately and move on.
I feel for you..you sound a lot like me in that I have a problem with thinking about people's last few moments anytime something tragic happens. I tend to cry, then I eventually have to just file it away, push it down, or whatever..anything to stop thinking about it because it will literally take hold of my life if I let it. Just know you are not alone feeling like this..you too will figure out a way to deal with these things and what works for me may not work for you
Maybe we should start a therapy group (or thread) for the ones we can't forget?
All I can tell you is to seek help IMMEDIATELY! I'm sure your employer has an Employee Assitance Program or something similar. Hate to say it but "been there, done that" all too many times. I can still remember the one trauma that lead to a major meltdown that cost me my job and almost caused me to leave nursing altogether. Sit down with your director, get the kleenex, loose the hard outer shell and admit to yourself that first, your human and have emotions, second, you have a problem and you need help. You may even need to take a short leave of absence. Prayers and hopes go to you from me and I'm willing to bet most of the community.
There are going to be those events in your career that will affect you profoundly. I have three. I remember every single detail of what happened. Sometimes the memories pop up at the most inconvenient times. I can tell you though that even though the memories remain, the powerful emotions that go along with them really do fade. At some point in time you will be able to think about the situation and your gut won't clench. You will become more objective and less emotional. I think these memories are important to hold on to. They are what shaped me as a nurse.
perfectbluebuildings, BSN, RN
1,016 Posts
I agree that the "worst things" are not what lay people might think- not exciting or (to them maybe) interesting. And when I tried many times, sitting here, to type them out, I started feeling sick and feeling helpless. Because when you think of one, you think of more and more. It's the eyes especially, of so many patients or their parents, that I remember that get to you. The look of fear or hope or so many other emotions. I don't think I'm answering your question though. For me I have to talk it out with others who were there, who I trust. Or write it out, again and again. Usually that helps take the sting out of it or helps it be easier to live with, or something. And even still there is one incident/situation that I still can't stop thinking of and don't think I will ever forget. I think that is the way for all or most of us.