Friday, January 30, 2009

Those who wander are not always lost

I graduated from nursing school the Spring of 1999 working my first 2 years on medical surgical units and the last 8 I have been primarily based out of the Emergency department along with several side jobs. The first 3 years I worked exclusively in the ED 32 hour day shifts. I was VERY naive when I first started in the ED but it did not take much time to realize that you cannot always be Mr. Nice Guy, drug seekers are AMAZING actors, people with personality disorders are masters of manipulation, people really DO fake seizures, NEVER trust a drunk, and a good portion of the population should have had their children taken from them at birth. This list truly could go on and on........

After being an ER nurse for a short time I experienced a tragedy that will forever be sketched in my brain. It was toward the end of a 12 hour shift when paramedics came rolling in with a young woman in her late 20's. She had been in a MVC (motor vehicle crash) while driving to a local Fair with her 2 young children. She was pale and unresponsive on arrival without a blood pressure. Not a scratch on her. Before long a surgeon determined she had an aortic dissection.
Within minutes he cut her chest open then proceeded to manually crack her ribs. He used his fingers to clear the blood that was pooling in her heart chamber. In awe I watched her heart beat after beat. We all work so hard to save her life. As blood, fluids, and medications poured into her we rushed her to the operating room leaving a trail of blood from one department to another. The surgeon and the OR staff did all they could but were unable to save her. The surgeon, OR & ER staff weeped as they told her family of her demise. Her oldest boy (I think he was 8) wanted to say goodbye so along with his family they went into the OR. The boy thought she was merely sleeping and tried to wake her. As he stood beside his Mother a tear came down her face. This would be the last memory of his Momma.

Little did I know how MANY more traumatic injuries, experiences, and deaths I would be encounter over the next several years.

You never forget the sadness of parent after the loss of a child from SIDS. The memory of a mother and father rocking their baby for the last time before handing their precious bundle over to the nurse who has the dreaded task of delivering the baby to the morgue. We had 2 of these cases in the ED when I was pregnant with Leah.

You never forget the reaction of a parent when they think you are coming out to tell them their toddler did not survive. I can vividly remember walking out into the ambulance doors to update a family on a child's condition. (10 month old near drowning in a bucket of water) The mother dropped to the ground crying and screaming unable to comprehend that he was still alive after she found him lifeless after getting distracted for a moment while washing her floor.

You never forget the blood curdling scream of a parent when they find out their teenage son was killed in a car accident while his sister was driving home from the methadone clinic and fell asleep at the wheel.

Again this list could continue on and on. As you can imagine it is the illness and death of a child deeply affects health care providers most.

When you work in the ED for any amount of time there are so many stories to tell, not just sad.

There are funny ones, the guy with an "object" stuck up his behind that does not want to share the information with the triage nurse for fear that everyone will find out. Well honey when you have to go to endoscopy to have something so deep removed the word is gonna get around.

Then there are sick ones, like the middle age man that is caught having "relations" with the families Golden Retriever. Then there was disturbed teenage boy that was caught sodomizing 2 dogs with a broom stick, his grandfather was a convicted serial killer.

These lists too could go on but these are just a few blips of the last 8 years that pop into my mind as I type. I always said I could write a book about the experiences of being an ER nurse. I journaled a bit about it but that was far as I went.

While working in the ED I was actively involved in education, attending seminars, a member of Emergency Nurses professional association, and one of the few that tested and became a Board Certified Emergency Nurse.

After a few years as a positioned staff nurse I went per diem so I could spread my wings looking for new horizons. I worked at a trauma center in the ER, as a critical care transport nurse, a critical care nurse, and as a college health nurse. Despite all my endeavors nothing quite did it for me. I always returned to working mainly in the ED until I started working in Radiology as an Interventional Nurse. It did not take me long to realize this is where I wanted to be.

It is hard to describe our role in Radiology and nobody else really knows either. It is a unit like no other. It is a combination of working in day surgery, the OR, PACU/recovery. In addition we respond to all emergencies in our department and we care for critically ill patients and our patients become critically ill after some high risk procedures which sometimes lead complications. In a nutshell that is what it is! I explain this because I have recently had to answer some annoying questions from others that do not know what goes on radiology. Like, "what do you do, take pictures all day?" or "aren't you bored". NO, actually it is a pretty busy place, always something to do!

We do TONS of procedures! Just a few examples: nephrostomy tubes, embolizations, arteriograms with stenting and arthroplasty, portacaths, thoracentisis, biopsies, peg tubes, VCUG's (yuk, we have to cath kids), bronchoscopies........and on and on.....

And NO I won't "loose my skills" working in Radiology. (excuse my sarcasm) We start LOTS of IV's, insert catheters, place chest tubes, sedate patients (that is a major role of ours), and cardiac monitoring......

Ok, so we try not to defibrillate our patients unless needed and if someone is having an MI (myocardial infarction) we do not TNK (clot buster) them in our department. But there are SO many of the skills that I have learned in the ED that I use on a daily basis and I am SO thankful to have had such a solid foundation.

I have enjoyed working in the ED and have learned SO much both professionally and on a personal level.


I will miss the acute MI's, the trauma patient, the adrenalin rush of a code, and the successful resuscitation of a patient but I will not miss all the BS that goes along with it nor will I miss working nights, weekends, and holidays! :)

I now enjoy working in a department when EVERY ONE of your patients is appreciative and thankful for your care.

I love the people I work with: the techs, radiologists, secretaries, and of course the AWESOME nurses I work with.

Lastly, I am SO THANKFUL I have this job and despite the failing economy I pray I am not on the chopping block for upcoming layoff's that are said to happen at our hospital in the next 2 weeks because I'll be back working in the ED and that will be a whole other post;)

I apologize for the long drawn out post but these are a few things I had on my mind and wanted to get out.
Anyway, with 10 feet of snow and freezing temps there is not much farm activity to report.



Judy T said...

I work on a Behavioral health unit- I bet we could swap some great stories!!!

Don said...

my hat (blaze orange stocking cap that I wear to check on the chickens) is off to you for your dedication to life. My favorite cousin is an ER nurse and I imagine that you and Cheryl would be great friends. I don't know how you insulate yourself from the tragic things you see. You must have a sense of balance from when you are involved in miracles.

Thank you for what you do!

I like your farm stuff too!

Throwback at Trapper Creek said...

Everyone should hope they get a caregiver like you. I worked at a community hospital for 15 years in fiscal services, but many of my friends were/are nurses.

Thanks for sharing, this is your place to vent, share, and give us all a peek at Kim.

Stay warm, and good luck with the cutbacks. :)

Erica said...

Emergency Medicine is not for me, I could not handle what you went through. I much preferred working in a ICF/MR before I had Jack. Everyone in the medical field, definetly has their own special calling :) I hope there are no layoffs and you are able to stay where you are happiest :)

Anonymous said...

Wow. Absolutely no need to apologize for the post, it is something that I got a lot out of reading - plus, it is your blog to express your thoughts! I hope that you can keep going in the field that you enjoy - each area is very valuable, and while ED might be more outwardly dramatic, I'm sure you have many experiences still that are emblazoned in your mind and effect your patients.

Joanna@BooneDocksWilcox said...

Is ED, the emergency dept? Oh, I hate hearing about layoff's at various places each day, I'm thankful to have a job too as a Secretary for a public transportation authority. Those of us in public transportation have a few tales to tell too. :-)

San Diego Farmgirl said...

Don't know how you do it. I tend to get frustrated with people who don't take care of their bodies.

Phill said...

It's nice to be reminded of the good work that comes from your profession. And interesting to hear a viewpoint firsthand. Just wanted to stop and say hello - I found my may over here from Moon&Stars. We're just starting our homesteading plans, and it's wonderful to read about what you have been able to achieve. I added myself to your follow list so I can come back often!

Country Girl said...

FF, I bet you have some good ones. My girlfriend use to work on a BH unit as well. I couldn't do it.

Don, thanks you always have the nicest comments.

Nita, thanks for your kind words!

Erica, you are right we all have our place. My heart goes out to all that are going through cutbacks and layoffs, scary times!

LC, thanks you are right this is my blog. I think my positions secure you just never know these days.

Joanna, your right it is the emergency deppartment. I bet you do have some stories to tell!

SD FG, I hear you. So many people use and abuse their bodies then they wonder why they are ill.

CM, thanks for stopping in and say hello. I will be over to visit your blog as well!

Anonymous said...

Hey Kim:

Great post, explaining the stresses that your serving in various occupations/departments exposes you and others like you to. It takes a very special person to do what you do/have done and still keep going and keep remain sane. The patients you serve are so fortunate to to have you (and those like you) touching their lives in such a critical, positive way. Even though I don't have all your training, experience and knowledge, I do feel a kinship with you, and am so glad that there are folks like you to receive our patients direct from a ditch or smashed vehicle or bed in their home.

God Bless you, my friend!

Your ditch doc buddy.

citygirl said...

Your post strikes a cord. It left me weeping for all those many traumas and the few highlights (so many stories that could be shared) of working in the Critical Care Unit for most of a decade. I, too, finally found a new "home" in day surgery and recovery room. I, too, am grateful for the professionals who demonstrate a fantastic blend of competence, compassion and humor. You are definitely on that could take care of me or my family anytime!

Amy said...

Nursing is definitely a job that chooses you, not vice versa. My mom and my MIL are both nurses and I grew up around people in the medical field. And boy do they have stories to tell, much like yours. Thanks for sharing!

Lynnie said...

Wow! You have really given us a window in to a nurse's world! My heart was beating so fast reading down that list of stories from your nursing life. I definitely have a new appreciation for your field!

YD, sometimes with ♥June and ♥Angel Samantha said...

In my mind, it takes a rare breed(I meant it in a good way) to do what you do. I don't think I can do that job.

Anonymous said...

Awww....Kim, I wish I could give ya hug after reading that one. I am in awe of your ability to handle your chosen field. I worked in an Elderly Care Facility for a bit over a year and it was the longest time period in my life. (And I wasn't even responsible for the patients themselves.) I'm not emotionally equiped for such a job. But I sooo appreciate those of you who are. xoxo

VisionaryRN said...

Oh My God Kim! That was a blast from the past....all the high/low moments in the ED. I think I was there for every one accept one or two. Wow, we had seen and done so much over the past few years. I am so glad I had you with me to get through all those trying times. We just do what we gotta do! Thanks for the walk down memory lane. It brought back a lot of pain, but it made me realize how lucky we are to have the opportunity to help our patients and families get through the worst of the worst!

Danni said...

Wow. wow. I started reading and couldn't stop. My eyes filled as I read the story about the woman that was lost in the car accident and her son saying goodbye. You are amazing - to have the skills you do and the strength to use them. Great post.

Sarah said...

It was into the arms of a woman like you that I literally threw my four month old son last summer when I jumped from our truck at the emergency room doors. He couldn't breathe because of a burst cyst under the floor of his mouth that was causing such swelling that his tongue was pushed up and back. I was terrified.

Thank god for ER nurses.

And I'm glad you're happy where you are now. lol I remember one Radiology tech in particular who was *so* kind and understanding when I was so worried about my baby going 'under' for the MRI. Ugh.