The traumas of work.

If I told you, I just finished a day at the steel mill, would you believe me? Wearing this denim jumper got me thinking about physical labor, and work.  For the past eight years, I’ve worked as a registered nurse. My career has taken me to New York City, Boulder, Colorado, and the glamorous states of Iowa and Minnesota. I never worried about job security. I’ve always earned a good wage. And, there is a particular satisfaction that comes from supporting people in crisis.

A boyfriend’s father once told me that working in the medical field is like going to war and returning home to loved ones who can never fully understand what you’ve seen. This man was an interventional cardiologist and spent his days with his hands in peoples’ chests. He experienced death, literally at his hands, and had to deliver the worst kind of news to loved ones. In many ways, I think his war analogy is spot on. When I was fresh out of nursing school, I took my first job on a busy medical-surgical unit in a hospital in Iowa. I worked twelve-hour shifts, took 15 minutes for a lunch break and on a good day, I peed once. One week into my orientation period, a patient of mine coded and died unexpectedly in his room. I still remember his name and the way he asked for more apple sauce. As the sun was setting, his intestines burst open, and it wasn’t long before he was on the other side.  Following the code and attempts to save his life, the code team disbanded, machines were turned off, the door to his room was closed. People grabbed their pagers and moved on. My preceptor began answering call lights while I ran into the bathroom, and sobbed. There was no debriefing or time to talk about what happened. Everyone simply moved on. I sat in the parking lot after my shift and cried until I was out of breath.

Years later, at a different clinic, a patient threatened me after I informed him we could not refill his narcotic pain medication. I was asked to explain that we were concerned he was taking too much. In a small office, I calmly delivered the news that he would not be getting a refill. His face got red, his eyes widened and he stood up and said, “fuck!” I was directed to escort him outside the clinic as his behavior escalated. As we stood outside the clinic when he began feverishly digging in his pocket and called me a word that rhymes with “trucking itch.” When he raised his hand to hit me, I ran. Someone called 9-1-1. After the police questioned everyone involved, including me, no one talked more about it. Our medical director asked if I was okay. I said “yes,” as you do when ten people are standing around you. And that was it. I went home later, and I cried.

In my experience as a health care professional, we are expected to be superhuman. In the world of medicine, the stakes are higher. If you give the wrong dose, you could kill someone. If you cut into the wrong limb, you could be sued. This makes sense to me. Expecting that a nurse, or a doctor, or a medical assistant will go through something traumatic and be able to brush it off, pick up the pager and clipboard and move on immediately, is wrong. The medical culture of grin-and-bear-it and do-what-needs-to-be-done are breeding burn out and compassion fatigue. Traumatic events need attention and love. After a close call, a patient dying, or a threat, medical professionals need time to process. Processing is not done in the moment, while adrenaline is still pumping. Staff should have the option to have their feelings witnessed in a peaceful space behind closed doors. Co-workers should have the opportunity to provide support and re-assurance that the right things were done. Debriefings need to happen. When salve is not lovingly applied to these wounds callouses are formed, and providers will walk away from medicine. I’ve seen it. And I’ve felt it.

Nurse’s Week has come and gone. Shout out to all of the amazing medical professionals I know. Your dedication to serving others is what it’s all about. Your hearts are golden and your ability to be present with the pain and suffering of the world is a rare gift. In a lot of ways, healers are super heroes. And, we are also human. We struggle with our own demons. We feel inadequate. We cry with our patients. We bleed.  Our softness is our strength.

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