I don't often write about work. I feel as though no one would understand what it's like anyway, so I tend not to bother. You really have no idea until you've worked in an emergency department, and have DEALT with emergency situations. But I will try and describe my shift yesterday afternoon. We arrived to a fairly quiet department. About five kids inside, and only a few waiting outside to be seen - a very rare occasion. The first call came at around 3pm. I took it - from the Ambulance control centre, advising that there was a four year old boy who'd been hit by a car coming to us. CPR was already in progress. Once we heard that, we pretty much knew it wasn't going to be successful. Childrens' hearts are the last thing to go. They're young and healthy, and will keep going for as long as they can. Once their heart has stopped, it's pretty much not going to be started again 99% of the time. So we went out to our resus room with trepidation and prepared ourselves. I was the airway nurse - meaning that when this child came in, I would be the one in charge of 'bagging' - ie, holding the mask over the child with a pressure bag attached, doing the breathing for him. We waited, and waited, and he didn't arrive. Finally we got told that it had been called at the scene - the child was pronounced dead and would not be coming to us. We walked out silently, each dealing with our own thoughts. Sometimes it's worse when it happens this way, because we get the adrenaline rush, knowing we have to save a life, and then there's no resolution. We have no chance to DO anything to make it better. You don't let yourself think too much. Not about the families, or the drivers of the car - about how their lives are ruined in just one second. We'd just finished restocking the resus room (after throwing away everything we didn't end up using), when I took a second call. A 13 year old girl was in the passenger side of the car that hit a telegraph pole. I passed the phone to the senior doctor nearby, and hovered to hear details. All we were told was that she had a broken leg, but was otherwise okay. So we didn't set up resus again. Except when she arrived, she was in a bad way, and we took one look at her and raced her through the doors. We were in resus for four hours. I was crouched over, protecting her spine. For four hours straight. I was at her head, and was the only one she could see. She screamed and moaned, and tried to sit up, and begged me for water (a sure sign of severe blood loss). For four hours I stroked her forehead and tried to calm her down, telling her exactly what was happening, and why she couldn't drink, and when she was calmer at times, talking to her about school, family, boys. Her injuries included: a compound fracture to her femur (thigh bone) - on X ray, the bones were actually in an X shape. Both her tibia and fibula (shin bones) were broken (this is all on her right leg). Her left side of her pelvis was broken. Her left radius and ulna (forearm bones) were broken, as well as her right thumb and nose. She had a 20cm (8inch) by 10cm (4inch) laceration down to her bone on her right shin. She had massive bruising over her breast from her seatbelt. The inside of her lip was completely sliced up. She was covered head to toe in glass and blood. We gave her as much pain relief as we could, but she was in agony. She was so agitated about the neck collar, and wanting a drink. For four hours I calmed her and at the same time, explained everything that was happening to her father and grandparents standing beside her. Her mother came in eventually, and I will not go into this, because I am still angry. I realise this is a public diary and therefor cannot really say too much incase it ever got back to someone involved. But people's self absorption astounds me. Why they cannot leave marital problems alone to deal with their child angers me so much. This poor girl had to comfort her mother, not the other way around. I hadn't eaten a single thing all day, and I was still standing, huddled over, at 8pm. I was emotionally drained and physically exhausted by the time we got her to theatre. Today my back is killing me, and I'm still exhausted. Last night was the first time in the year I've been in emergency, that we were able to have a debrief afterwards. Usually it's just infeasible with all the other patients we need to see to. After I got her to theatre, I still had 3 hours of my shift to go, with patients to look after. Somehow you just find the energy to start again. I wish, sometimes, that I could have a video camera in that room, so people could understand what exactly it is that we do for people. Those who do not respect the role of nurses have no IDEA of what on earth we go through for our patients. Don't get me wrong - the doctors are amazing. But it's a cliche` - it's a team effort. We ARE a team in that department. And now, tonight, I'm going to watch television and forget reality for a while....
