Finding Peace Here

MCR_TraumaRM_A

I watched four people die this weekend, four people. Sounds horrifying right? Well, it is.

Surely these people must have been sweet little 90 year olds, who lived long happy lives, drifting quietly off into the night surrounded by family they love. Well, that is not my story, in fact, that’s never my story. My story is filled with people who woke up, got dressed, and started their day, just like you and I, having no idea that it would be their last.

The room above looks so benign, shiny and new, full of promise and cutting edge medical equipment, ready for whatever may roll through the doors. Exactly what you would want if you were the one lying in the bed. But, there is much more here than meets the eye. So many things, things that can’t be seen by those who haven’t stood in this place time and time again.

You may wonder what could hide here, what could be lurking behind the glass doors and freshly painted walls. Just what do I see when I look at this place? I see so many things. I see countless hours of hard work, sweat, and tears. I see a floor covered in blood, trash, gloves, and whatever else may land there in the middle of the mess. I hear gut wrenching screams, the indescribable sound of a weeping mother, and the words “time of death” many more times than I care to admit. I hear the pumping of the level one, the hum of a ventilator, slamming drawers, alarming monitors, and the loud sigh of relief when we “get them back.” I see gowns, trauma surgeons, confused patients, ET tubes, code carts, flushed faces, shaking hands, and countless lives, both saved and lost. You see, I have been on both sides of this bed, and I can tell you they are equally terrifying.

You may think that there is no way anyone could find peace here, or that there is any way to see beauty in this mess. To tell you the truth, some days I’m not sure either. Some days I leave defeated, I let the dark win, and I am certain there is no way I can work one more shift. Then, just when I know I can’t step back in that room, something amazing happens. We save a life, one, that’s all it takes, and you know you can pick up the pieces and carry on. I recently cared for a patient with dissecting AAA, scary shit, I don’t care how many times you’ve done it. This man drove himself to the hospital and arrested walking through the triage doors. Incredible timing right? Not only did he regain consciousness in the ED before going to the OR, he walked out of the hospital a week later, that’s right, walked out. AMAZING! How does that even happen? That shiny room worked its ass off that day and won, we won! I can’t describe the feeling. Nothing can compare to saving a life.

In the middle of the chaos it’s hard to see the significance of the work we do. We just power through whatever the task is at hand. Lines, labs, intubation, compressions, chest tubes, splints, the list goes on and on. It isn’t until after the event that we can step back and look at what we have done. What went well, what could have gone better, and come to grips with the fact that the person we just cared for was in fact a person, not a job, not a task, but a human being. Someone with a life, and a story of their own. For me, it’s in that very moment I find strength and peace in what we do. There is always something beautiful, even in the worst of situations. The pure will to fight, to live, and to carry on, even when it hurts to breathe, is what keeps me coming back for more.

So yes, that room can be a horrific place. It can be scary and lonely, but it can also be amazing and inspirational, a place of love and triumph. Each day, each patient, brings a new chance to fight, to win, and to find beauty in unthinkable circumstances. Behind those glass doors are many hidden things. Many things that most people will never see or feel. Things that have made me laugh, made me cry, built me up, and knocked me down. Most of these things can’t be shared, and that’s ok, they don’t really need to be. If you live it you understand why, and you also understand how it’s possible, to find peace here.

-Melina

Photo credit: MCR trauma room in Loveland, Colorado

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148 thoughts on “Finding Peace Here

    1. My son is a RN in PICU and I never understood how it can do what he does, i know what a wonderfully sensitive sweet human being he is but I’m his mother. Thanks for helping me understand a little more.

  1. As a former EMT,I can relate to this. You get tunnel vision, then when it’s all over, you wonder “how do
    we do this?”

  2. We on this side of your job have had no clue what you face as your job everyday. But I think it’s more of a God call on your life so He can use you to repair and heal those lives you come in contact with. Those you lose are in His hands. Thank you seems so lame. But we do thank you for saying yes to your choice of duty we call a job, to be courageous enough to keep going day after day. It’s not much coming from me but I commend you and all those who do what you do and we will be lifting this profession up to The Lord Jesus Christ in prayer thank you for in lightening us to the other side of this. May The Lord bless you all in everything you put your hands to and the peace of God be with you always. Amen

  3. Thank God for all you do, never regret a patient you lost because God was present and he needed that soul. I’m 82 and when it’s my time, I hope I have someone like you helping but never regret the lost as I’m ready.

  4. After having my husband go through 3 surgeries in 4 months, I am humbled and so appreciative of the challenges you face every day. Thank you so much for this insight into your side of the story and thank you for what you do. I echo the last poster…God bless you and all the nurses and doctors who work to save lives.

  5. AFTER HAVING BEEN AN ER/TRAUMA NURSE FOR 41 YEARS, I CAN IDENTIFY WITH EVERY HIGH AND LOW ‘MELINA’ EXPERIENCED. MY HOSPITAL ER WAS A LEVEL 1 TRAUMA DEPT. FOR THE SOUTHEASTERN PART OF NEW ENGLAND, WHICH. MEANS WE GOT THE WORST OF THE WORST CASES……..BURNS, MVAS, GUN SHOTS, STABBINGS. EVEN AFTER 41 YRS. I WANTED TO ‘SAVE’ EVERYONE, BUT ESPECIALLY THE CHILDREN. I WOULD AGONIZE AFTER A DEATH, WHO IS YOUR MOTHER, FATHER, LOVER, FRIEND? WHO’S HEART WILL WE BREAK IF OUR INFORMATION IS BAD? IS THERE A HEAVEN AND IS THERE A PLACE FOR YOU……OR WERE YOU GRANTED A REPRIVE THIS TIME? I NEVER GOT ‘USE TO DEATH’ AND I NEVER WANT TO.
    G,DEFUSCO, RN, CEN

  6. After being a Volunteer for over 5 years in the hospital I have watched the wonderful Doctors and Nurses. When the code is called and they rush to do what they can for the patient..the loved one…I am always so proud. But there cames a time when there is maybe just one or two Doctors or Nurses that do not do as trained and then your loved one dies from attitudes and not proper care as my husband did. I did not write this to hurt anyone but “bless those who care” everyday and Thank You for caring.

    1. I’m so sorry for the loss of your husband, Bonnie. But as a former ER nurse and a recently retired nurse anesthetist, I feel compelled to point out that sometimes even when everyone does everything just right people do die. We do much to sway the tide but in the end, we don’t call the shots.

  7. I give anesthesia in a Level 1 Trauma Center and I think this best describes all our jobs to outsiders. We have several dedicated trauma ORs where I often picture an imaginary hole to the other side and where we pull people back to the living side by hangnails. It is ALL a true team effort. Thank you for writing this. It makes me cry.

  8. As a retired RN that worked in the ER and mucus,sicu,and Neuron ICU, I felt just like it was written! Great blog! I retired after 32 years

  9. Bill, Jill, Avril, and soon Justin…..I could NEVER do the job you have. It takes a WONDERFULLY SPECIAL person like YOU GUYS to be a nurse and deal with the bad with the good. You four are BLESSED for the caring awesome individuals you are. I love you!..Mom

  10. This is a beautiful homage to all the healthcare workers in emergency departments, intensive care units, coronary care units, OR and Recovery units, and all those who work on the “floor.” I would like to point out that there are only three kinds of healthcare givers who are at the patient’s bedside 24 hours a day, 7 days a week, and they are: doctors, nurses, and RESPIRATORY THERAPISTS. Respiratory therapists must go to every code blue and go directly to the head of the patient’s bed to establish and maintain an airway. They do chest compressions just like the nurses and doctors do. They are responsible for the mechanical ventilators that keep many patients alive. They treat patients and save their lives. Most patients and their families don’t realize the critical role respiratory therapists have in a patient’s care. And, sadly, they don’t even get respect or recognition from their fellow healthcare colleagues. It’s a beautifully written piece, but it is true for EMTs, nurses, doctors, AND respiratory therapists.

    1. Thank you for that, my son is a respiratory therapist and I have seen the stress take a toll on him at times because he cares so much.

    2. Thank you for acknowledging the Respiratory Therapist. it is often an invisible job, and we are often managing our patients in the varied units and floors at the same time. I have been practicing for 20 years now, and I don’t ever remember saying when I was young “when I grow up, I want to be a Respiratory Therapist”. lol But I am so proud to be one, even invisibly so. I have found many times that Doctors and Nurses don’t realize the responsibilities that we carry in our position, but I have always appreciated their need for our input in many cases. That recognition, even if not so intended, speaks loudly of how important our job is, especially in acute care settings. The mainstream public just doesn’t realize that there are so many team members other than Doctors and Nurses, I know that I never knew there were so many different practices in healthcare growing up. There is no way that one practice can possibly do all that we do as a team; not without each other and the skills that we each bring to the case in hand. This blog is definitely one of the best written that I have read for non-health professionals to have some understanding of what health professionals deal with daily. We are constantly reminded how lucky we are when we get to go home after a long shift.

      1. My Husband is a RRT has been working at the same hospital for 36 years. The same place we met…2 1/2 weeks ago he had his most difficult patient…our son, he asked to be the one to remove the vent when He passed. No one should ever discount any member of the team from the docs to the housekeepers all are important. I worked as a RN for 25 years.

      2. Libby, many nurses and doctors rely on respiratory therapists for critical care assessments and treatment plans. They know how valuable their skills and experience are. RRTs have never banded together the way physical therapists have to toot their own horn. We need to do that. We need to educate the public so they stop saying “hey nurse” to get our attention. We need to educate Congress on what it is we do and just how important it is. They need to choose who they want to operate their ventilators when they have to be placed on one.

        Bev, I cannot imagine what it was like for your husband to remove his child from life support, or for you as the patient’s mother as well as a nurse. It’s a true testament to what RRTs, nurses, and doctors face every day. I’m so sorry for the loss of your son, and I hope you have a strong and caring support system surrounding you and your husband. Grief can be all-consuming. I know this because I lost my own son to suicide in September. God bless.

    3. Pam Bordean Cook , I am an RN . In our rural Regional Hospital we did not have Resp Tech’s on 24 hrs /day or the weekend. We nurses that worked the 24 hrs/ 7 days a week in Emerg were the ones did CPR , Defib, meds , Iv everything until Doctor came from home to intubate . Then we continued bagging and even following the patient to OR at times to assist the OR staff . It was a team from nurses that came down from the floors once a code was called . An RT would of been greatly appreciated . Rural hospitals have the same type of trauma coming to the ERas the Urban hospitals. Yes I agree RT are valuable and should be recognized but someplaces also have to work with who is there . We worked as a team !

    4. Thanks for mentioning us respiratory therapists. It’s always the doctors and the nurses that get the accolades from patients and their families, but it’s the respiratory therapists that the docs and nurses call when THEY need help with a patient.

  11. While reading your blog I had flashes of many of the people that I cared for in trauma rooms. My first was a 10 year old literally run over by a car. I can see the boy, I can hear the father screaming hi name, and I can remember how it felt to loose the boy. Literally hundreds of situations later I finally burned out. I am proud to have done all that I could for over 25 years in several ER’s in Vermont. And I continue to have the deepest respect for all who continue. Well done and well said,

  12. After moving to Bardstown KY and being in the healthcare field myself…..I had my own near death experience with a perforated bowel that then made me septic I was sent to a small hospital that I hadn’t heard very nice things about. The care I received from the ED all the way through my 17 days in the ICU was beyond exceptional! If it weren’t for those dedicated healthcare workers this wife, mother of four boys ( one being special needs) would no longer be walking this earth. I am so thankful for the dedication, compassion, love and caring I received, I will make sure to pay it forward! Thanks Flaget Hospital and all the doctors, nurses and staff that took such great care of me!!

  13. What a wonderful glimpse into the life of Er Personel, so enlightening to us who have never been there nordone that. I too have a Son living this life, works many hours and goes to the bedside of those dying or to those who will make it through the night to another day of living on this planet earth. Thanks to all of you that work long hard hours and God bless.

  14. This is so beautifully said! Thank you for sharing this. My daughter is an ICU nurse (for 7 years now), and I only sometimes hear some of her experiences from there. Nurses are some of the most wonderful people in the universe…especially when dealing with such horrific experiences. Thanks again for your powerful words!

  15. My mom spent her last hours in an ER along with my dad, my sisters, and several other family members. The staff were kind and gave them time and space to sing and pray and say goodbye to her as her heart gave out. I’m sure it was more pleasant all around than the usual ER death.

  16. Working in the ICU somedays was like that a patient you were just talking to getting ready to transfer to the floor crashes, you rush around getting the doctor who intubates the patient puts in a central line and you just get it done bc you know that patients life depends on it and when its done you step back look at the mess in the room and get cleaning bc you don’t want the family who is in the waiting room to see the mess….then you have to break the news to them as you walk them back to their loved ones room and see the grief and tears and then it hits you how did we do that? You do it because you love your job and that one save or the day you get to wheel that patient out to the floor laughing and talking makes it all worthwhile

  17. We care. We help. We share. We say ‘that’s just not fare.’ We at times just stare. We care. We help. We are always aware. Life is balance. We care. We help. We share. We hope. Through our efforts, when the scales of life tip and become unbalanced, we might have the privilage to restore that balance. We have been given this gift. We care. We help. We share. That which has been given to us we extend to others. With hope. With determination. With love.

  18. My husband is a paramedic and usually tries had not to bring those sad, traumatic stories home from work. Thank you for all the work you do, for blessing others in whatever ways you can, large or small.

  19. I have been an RN for 37 years and while there are some totally draining days where all you can do at the end of your shift is to try not to fall asleep when driving home, I am very glad that I am a nurse.

  20. I’ve been there so many times as a ED nurse. My worse day was when I was charging….6 deaths in my 12 hour shift. One of the 6 was a 18/19 week fetus. I still remember it like it was yesterday even thou it’s been at least 5 years. I just went home & loved on my newborn.

  21. Having been a nurse and nurse practitioner in critical care for 40yrs I can appreciate all the thoughts and experiences. Especially in health care today, we have to remember why we got into this field. With all the changes in health care: EMR, cost cuts and pt satisfaction surveys driving our hospital administrators, it makes it harder and harder to do our job and keep our focus on high standards of care and self preservation. It would be nice if all the people we came in touch with were very nice and understanding and catered to us, but I would much rather have someone care for me that was knowledgable, very good, gave attention to details and cared about me. It is very hard to get good pt surveys when cost cuts are made and staffing is affected so much that you can’t care for patients effectively and are attentive to their every need. It is a vicious cycle: less staff-less attention- worse pt and family surveys. The only people that suffer are the people in the trenches. Bedside staff and practitioners dwindle and high level administrators keep finding ways to cut cost. I have an idea, how about cutting some of their salary and positions !! Hang in there and as hard as it gets remember why we do this. Maybe someday soon we will see the pendulum swing and health care will get back to what it should be-focusing on high standards of care and paying attention to detail and caring about the patients more than the bottom line. We can only pray……

    1. Thank you so much for your honest story Maria…yes, I agree that the government has really put a stress on all of you that work in the hospital. We the family put you in a position that is not fair, not once did I put blame on you but I spent every day, some days 24 hours beside my loved one until he passed. I watched the care that was given. Love all of you and I know you do all you can. My daughter-in-law was one of you for over 25 years. When she came to the hospital she was able to assist my husband and did more than the nurses had done or were allowed. All of you are angels but you are human and so much is put on you. God will reward you for giving your loving care. I worked in the hospital was put on a committee patient safety and care. It was with the Doctors and Nurses and after spending so many hours with them I was able to see and made suggestions which was well accepted. Being a large hospital there were two major changes made after those meetings. This is not to say that I am so special but was able to help the patients and the staff for more time for the help of saving the lives that you all worked so hard giving back life.

  22. After some 30+rs in MedSurg nursing, now retired for three yrs. You have said it with such feeling ,that even those in other lines of work can identify with all that goes on ,
    how we can quickly switch into high gear and what needs to be done for the life of others, we find comfort knowing
    we had a chance of helping any way possible the patients
    and their families.

    “Once a nurse always a nurse”
    I am not really retired ,I do two days a week,
    it seems I cannot let it go, I love my nursing

  23. As a 15 year veteran of a level 1 trauma ER I can honestly say, “been there, done that.” Dope days you’re the windshield, some days you’re the bug. God bless.

  24. Melina, this is a beautiful recounting of your experience. I am a Clinical Writer for Medline Industries, and I’d love to be able to repost this on our blog with you as a guest blogger for National Nurses Week (May 6 – 12). Please let me know as soon as possible if you are interested!

  25. I am a retired nurse and you have definitely hit the nail on the head with this.! Those of us who have lived this every day can appreciate the feelings you so graciously described. Thank you!!

  26. I was a nurse for 35.years so I too Know what you are talking about its hard to describe but you did it well thank you .

  27. Great read Melina,
    God put’s all of us in healthcare where we are suppose to be, I have felt every possible emotion you can imagine working in these sacred places, in the rooms of the E.R., ICU, CVSU, CCU, NICU, in the back of the truck, (ambulance) in the middle of the interstate. I have cried in defeat, and I have cried with answered whispered prayers. I have had a wonderful career of 28 years in Respiratory Care as an RRT, and as a Paramedic for 10 years. Some of the kindest, loving, sweetest people you will ever met are those you find in health care, They see you at your best and worst. People say it takes a special person to do what we do, and you know what, it so true, God picks each one of us to do what we do. Thank you Melina for this wonderful well written piece ,which gives so much incite for the general public into the working life of our emergency health care providers, it make me proud to have been one of them.
    Jeffrey D. Aytes, RRT, EMT-P
    Retired, but always ready.

  28. My daughter is a critical care RN in the ICU/CCU department. This is her life 12 hours a day for sometimes 5-6 days a week. I admire the individuals who work these units more than I have in my life since I have lived it though my child’s eyes! It is amazing the work these RN’s do and the very little credit given to them by families, patients, doctors and yes, other nurses who do not work critical care and simply do not understand. This story made me cry and smile too. I cried at the feelings I felt behind the words and I smile at my pride as a parent of a critical care RN.

  29. It is hard sometimes for people to understand what happens behind those closed door or curtain. As a member of a great team that has to deal with the good and bad…..I wouldn’t trade it for the world! Yes it is hard, I have broke down and watch my fellow staff break down, the thought of someone else having to be there on this patients/family’s worst day is what drives me to come back, not in a morbid way, but a sincere caring way. I truly did not find myself until I got into emergency medicine, it has cost me a lot but I have gained and experienced things that I will never forget, the look of a family member that has lost a loved one and the gratitude for your team has done is something I…..lets just say its emotional.

    To the Good Sam’s team I work with and the partners on the bus, thank you!

  30. I began my nursing career in 1973 in the ED where I remained for 9 years, moving to ICU afterwards. I find that this blog completely represents the life of a nurse, RT, Nurse’s Aide, Anethetist, and all the others who work to save lives on a daily basis.

    For the last 17 years of my active practice, I worked as a geriatric Nurse Practitioner. We must remember that in addition to saving lives and restoring health, we must also be the caring bedside presence at the time of death, whether in the hospital, nursing home, hospice, or personal home. Assisting those whose time has come to leave their earthly existence is one of the blessings of being a nurse. Not only can you see the peace of the departing one, but assist the families and loved ones in their acceptance of the passing. It is hard for family members to “let go” and frequently need the assistance of a caring healthcare provider to make bearable the decisions that must be made at the end of life. I have just gone through this with my mother, a month ago and my dad 2 1/2 years ago. I am so glad that I had the courage to talk to them over the last several years of their lives to understand what they wanted and did not want to happen during a “terminal” illness. Unfortunately circumstances did not allow them to be at home in their final days, but, as they wished, CPR was not performed, ventilators were not used, and medical interventions were kept to a minimum. Wishes for their remains were fulfilled.

    I am at peace with the decisions that were left to me, as an only child. Perhaps being a nurse better prepared me to be in the place I am in now. My husband and I have discussed our advance directives extensively, even though we consider ourselves to be “young” for such talks and we know that our decisions now may change over the years. We should learn to accept death as a part of living and not be afraid of it. Yes, we will all miss our loved one, but the more we know that their wishes have been carried out in their final days, hours, and minutes, even after their death, we should grieve in a more confident, comforted way.

    I understand that unexpected, traumatic deaths are always going to happen and it is heartbreaking to so many when it does, especially to a child or young adult. That is the subject of another time and place. I hope that you take away from all the previous posts that is nurse IS always a nurse and that the patient is not always the “sick” one and that dying can be as joyful as birth.

  31. As an ER nurse, this article is very appreciated. I remember that room very well. We do our best to save patients and Most of us have cried our hearts out when we couldn’t bring a person back. It takes a special heart to be a health care worker. Thanks to my fellow nurses, the doctors, paramedics, techs, respiratory therapists, radiology staff, secretaries, housekeeping, volunteers and all the wonderful people that help save lives everyday.

  32. Omg it takes special kind of person to handle this I am so very proud of you maleah ty for posting as I fight back the teaars I am greatful for the experience of reading this which has enlightene me to all that the medicaal. Stff in the ERs everywhere go through and go jome with each day. Some outhere ghink theyve had a bad day need to read this .

  33. This truly is a great testament to what emergency healthcare workers go through. When I started as an RT many years ago, I was the only one on nights in a small rural hospital. So I learned to work with Drs., nurses, radiology, EMS…we truly were a team. At first I was like I can’t do this and then a wise old Doctor told me to always look at it this way….You know, you know your job and who would you rather have doing your job besides yourself. Believe in you and your abilities but always work as a team. I loved the ER and yes there were days I wondered why but the days of how did we do that always made me continue on.

  34. I am an RN ..but this past December 2014 …,I had a role reversal ..on a quiet Tuesday evening I became the victim …I was ejected from back seat of truck…after it flipped ..I had traumatic brain injuries …. Bilateral collapsed lungs.. ORIF femur…bi-lateral radial fx.. C and T vertebrae fx..
    Multiple facial lacerations put together with staples and sutures… Knocked out a tooth and broke several ribs… Needless to say I was not stable enough before a few days to even take me to surgery … It was a waiting game..my family was there 24/7 to keep updated… The staff in the ICU at Wake Forest were amazing…they went about and beyond to assure my kids, parents, sister, , friends and coworkers were kept informed!!!
    They shaved my legs per my daughters request … They went above and beyond to help keep my family informed and active in my care.. I– being the patient don’t remember much …but their remarks about how happy they were with the nursing care they received were amazing!!!!’ Made me proud!!! Some people are good nurse and some are people are exceptional !!!! I spent 38 days …Was ventilated for 18 of those… .. Missed Christmas And New Years , before I was discharged… From Stitch center…,
    I left the stitch center with wheelchairs/ walkers/ neck brace/ bilateral arm Braces/ casts… I
    Attended outpatient Rehab 2x week and I am please to say… I am now device free… Walk with only a slight limp And I am going back to work on May 1. 2015!! The staff at wake was phenomenal!!! I salute you and your or profession .. Keep up the good service you are offering… I was one of those who was not expected to live…,and here I am 4 months post discharge getting stronger everyday!!! Thank you!!!!!!!!

    1. Traci….It is wonderful that you had such special people both in your family and the hospital. I will keep you in my prayers for a complete healing and bless you for helping others. Bonnie Moffitt

  35. Just lovely. My husband died in the ER here in my hometown and I will never forget the ER nurses who took the time to hug me as I left, express their condolences and give me just a peek of “good” that had happened that day (he made jokes with them most of the day) before it turned so terribly tragic. Thank you thank you thank you.

  36. Love this! I work in hospital not a nurse but part of the team. I post positive stuff on my fb wall because of what I see in hospital. It helps me deal with all I see. And I hope that it will make others think of what they do and say to loved ones even when they don’t get along. Thanks for the blog , I will share on my page as well! Thanks again part of team hospital!

  37. I’ve cried many tears over patients old and young, taking them to the OR , telling mothers I will care for their children as my own , praying on my way to work , praying inside over my patients, praying with my patients when they need it, holding hands, giving hugs, lessening pain, and sometimes giving it all in the wake of death. This job cuts to the core , because I am a family member ,I’ve been the patient, and I am an Anesthesia provider. I know the feeling of loss and I know the feeling of doing all to prevent someone from experiencing loss, but sometimes we do all we can and ultimately it’s in Gods hands, not our own , we are only the instruments in a larger plan .

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