The Last Place I Want to Be...

I wake up each morning and plan to go to the ER for work. This is normal for me. For the hundreds of other people that come through our doors each day, it is the last place they anticipated spending their day, and sometimes I forget this. What I see as a problem with a simple solution is often to the patient a devastating and sometimes life-changing event. 

Traumas had been rolling in and out all day and this was yet another. The patient was stable, but confused, and the CT scan was indicative of bleeding in the brain. I was concerned for the patient's prognosis and unsure of if he would return to baseline metal status after inpatient treatment. When family walks into the room the one thing you want to be able to convey is a message of hope, and sometimes there is not enough certainty to do so. This is hard. 

Is he going to be okay? That is the loaded question that every family member wants to know and I cannot always give the answers. What I can assure them is that the patient is stable and that he or she will be in excellent hands upon admission. This family member tried to communicate with the patient, and became tearful and pale. She sat down and stated I think I'm going to be sick. I grabbed her an emesis bag and sat down next to her rubbing her back. I assured her that right now, he was ok, and further treatment would help us understand more. I gave her permission to go outside and take a walk a take a breath. In that moment and looking at her face, I realized the weight of the situation. Not only was his world turned upside down, but so was hers. A simple outing out turned into a life-altering trip to the ER.

I think so often in emergency medicine, with critical patients, we have trained ourselves to just see the patient and focus on stabilization, treatment, and transfer. It is only when family enters into the room that this bubble is broken to recognize the person in the bed and the implications of the medical condition on the patient and family. There is a safety wall up to prevent personal feelings from clouding perspective during stabilization. I find that after the event I am able to step back and see the big picture. 

Every day I fear that someone I know will roll through the door of my ER. This particular trauma was a good reminder to me to remember what it means to go to the ER...that each and every time I enter a patient's room they hadn't planned it in part of their day. It is important to listen, empathize, and take a moment to put myself in their shoes. If my loved one was in the ER, what would I want to know? What would I want the nurse to do? How can I be a comfort to the family in addition to the patient I am caring for?

I work in the last place someone wants to be in a day, so how can I make that day a little better for all involved?