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Diary of a Trauma Nurse
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About Me

My name is Cory. I am a mom, a wife, a NaNa, and a critical care nurse that lives in Nashville, TN. I have found my calling in ER/Trauma/ICU. Each day I find myself experiencing life changing events and hope that by reading my posts, you will experience and feel some of what I do. If you read nothing else, please take time to read "The Hardest Question Ever Asked". It's my very first posting. And if for some reason you think you see your story here.....you don't. It's not about you or anyone you know. =)



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Friday, November 23, 2007

Usted será extrañado Noel (You Will Be Missed Noel)


So I got this phone call at 0530 telling me that I was being put on call. I thought it was kind of strange that a coworker was calling rather than the Nursing Supervisor. Her reason for calling? To tell me that a patient I had become very close to had died last night, on Thanksgiving Day. A piece of my heart broke off at that very moment. I cried for two hours before falling asleep. Life is so unfair.

About 3 weeks ago, we got a patient in that was severely emaciated and had a persistent cough, night sweats, fever and chills. He was put on AFB isolation until we could rule out TB which we did. He did not have TB, he had full blown AIDS.

There is so much more to this story than I can even go into.

This patient was Spanish speaking only and I was one of the few in our unit who could communicate with him (without using a language line) so naturally I spent a lot of time caring for him, translating for other nurses and doctors as well as talking to him about Code Status which brings me to a subject that infuriates me. Why in God’s name do some doctor’s insist on discussing code status with patients day after day after day???? If a patient states he wants everything in our power done to help him even knowing that his illness will kill him, why must doctor’s persist until they get the Code Status that they think is right!!!!?? This is so wrong. And it ticks me off! (Noel had a 9 year old son he wanted to get well enough to get home to.)

Regardless, the other things that bothered me regarding this case is the indifference from caregivers I saw at times because of not only his diagnosis, but the communication barrier. We as healthcare professionals tend to be “uncomfortable” in situations where we cannot communicate, I’ve been there myself. But I've also been the patient in a different country that couldn't communicate. We as nurses have taken an oath to care for others, in any circumstance! I saw nurses go in with masks, gloves and gowns (knowing the patient was no longer on isolation), I saw a nurse with the FLU assigned to this patient (his WBC count was 1.2 for Christ’s sake!) It makes me shake my head in wonder at times. Too often we forget that we are still treating human beings. They feel. They hurt. Just like we do.

No, I don’t have AIDS and don’t know how he must have felt but I can imagine, and I imagine it feels awful. I sat for hours on end in those 3 weeks on his bed talking to him, helping him through the horrendous bone and bone marrow biopsies. I bathed him when he said no one had touched him for a week. Before I left on Tuesday evening, I told him I felt “uncomfortable” about being off for two days. I just didn’t have a good feeling. (He told me: "No se preocupe. Así es la vida" which means "Don't worry, that's life". I figured he would rent a vent before I got back but during one of the two days I was off the doctor talked him into a Code Status II which states he does not want intubation or defibrillation. I wasn't naive enough to think that he would beat this disease, but I did hope that we could strengthen him enough so he could see his son again.

I know there are still millions of people out there that are uneducated about HIV and that are scared. Please, if you are one of those people, READ! ASK QUESTIONS! Life is too short not to help others in every way that we can. Here is a wonderful site that gives great, easy to understand information and has an awesome question and answer section. The Body

As always…….thanks for listening!


CoryTraumaRN posted today at 7:33 PM

(3) comments
Flashback: My very first night in Trauma

I was sitting and thinking about the newbies we're getting in our critical care unit where I work now at Southern Hills Medical Center. I thought back to when I was a fairly new nurse and had just started in Trauma and how I felt. My very first night on the unit. I arrived in this very large, scary unit. An intimidating place to say the least. I had worked in the Neonatal Intensive Care Unit (NICU)at Vanderbilt but Trauma was an entirely different world. (Now remind me, WHAT was I doing making THAT transition as a nurse less than a year old?)

I found my preceptor who was very kind and reassuring. Then she is told that 3 nurses called in, we were to be in the "Sand Box" (which I find out later is where the Level II or less critical are admitted). But one thing I did learn, if they are bad enough to be sent to the Trauma Unit at Vanderbilt, they are CRITICAL.

So we start to get report on 5 patients. (Ratio is normally 2 pts: 1 nurse). She then says "these are your two and I'll take these three. Think you can do it?" OMG! My very first patient I got report on was a 24 year old that had shot himself in the face with a shotgun because his girlfriend was breaking up with him. (He had been there for awhile so he was one of the "stable ones".) When I looked at him I was ashamedly horrified. I was silently thankful that I was able to keep my composure although I did not know how. He still had his eyes, his nose was gone, just the orifice where a sound between snoring and a gurgling choke was emitted. Where his mouth had been was tissue that had been sewn up. He had a peg tube where meds as well as nutrition was given. The patient would continue to write notes asking for a mirror. I was told not to give him one. To this day I wonder if that was the right decision. Anyway, in my job now I've learned so much more about suicidal patients and 6404 papers.

I inquired about this patient about 6 months later and was told that when he finally did go home he put antifreeze into his peg tube. He was found dead by his parents.

In all honesty, I can't even remember my other patient.

Throughout the world, about 2000 people kill themselves each day. That's about 80 per hour, three quarters of a million a year. In the U.S., there are more than 80 deaths from suicide every day, 30,000 every year. This is the equivalent of a fully loaded jumbo jet crash every fifth day. From another perspective, you are more likely to kill yourself than be killed by someone else.

CoryTraumaRN posted today at 5:00 PM

(2) comments

Saturday, November 17, 2007

AFFIRMATION

Today I received affirmation that I'm doing what I was meant to do.

Some days I question if I might be better off doing something else. Some days I get tired of fighting doctors to do the right thing or to get things done that need to be done. Some days I hate facing another overdose just trying to "gain attention". Some days I feel like I can't do another 12 hour shift where lunch was a "goal unreached".

Today was different somehow.

I had a patient who'd had a massive stroke. I took care of her for two days. Before I left I had time to help her bathe, put on her own nightgown and put on some makeup and even curl her hair. Things that are typically unheard of in the critical care unit. As I hugged her she kept trying to say something. It took multiple attempts and then she said slowly, "people like me are lucky to have people like you". That is all I needed.

Some days we just need to hear that what we do does make a difference.

(dual post)

CoryTraumaRN posted today at 9:40 PM

(4) comments