Been a rough couple of weeks. Young trauma patient's with bad outcomes, right before prom and graduation. It just seems so "busy" here lately, more than the norm. I just want to thank all the Docs, nurses, ED Techs, lab, Xray, and RT. Even Environmental Services (for turning rooms over so quickly). They too have to deal with the aftermath, and we don't think about them much. My ED has a lot of new nurses, but they've handled things pretty well. And we'll go back to work tomorrow.
Bad Stretch Of Bad Shifts.
- Thread starter TXEMC344
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Been there. We all have. Hang in there.
One of the cases, probably the worst (had a bad run)....a bunch of kids really, high school age, partying at the lake before prom. It's been raining a bit and of course they got stuck in the mud. Boyfriend hooked up a chain to his buddies truck, girlfriend in the front passenger side, and the chain broke.....you all can guess the rest. Arrived in our ambulance bay POV.
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I don't want to guess.
Because I know.
God bless. We're all in it together.
Because I know.
God bless. We're all in it together.
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I don't think you can teach emotional resiliency in the face of seeing terrible cases. Some people are better than others at this. But what you can do is pick up your colleagues when they have awful cases and model this behavior, and when the time comes that you have an awful case, they pick you up as well. It totally sucks seeing something that grinds your shift to a halt and makes it hard to press forward, but when your colleagues can help pick up your slack when it happens, it makes a big difference.
And another whole issue, we use Cerner and Dragon dictation, which has been down. So 12 hours of dictation to catch up on, my Critical Access ER of 9 beds, now has 16 patients, and 5 waiting for a bed. Post call day ruined.
Thank you for your response. Just new attendings, new nurses, and staff....it's just been hard. And frankly in a small hospital like mine, everyone wears many hats, and things just get covered up.
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I've been there. It's tough, very tough at times. But thank you for what you do. It's God's work.
And don't forget to take care of yourself (Luke 4:23)
Just want to pop in as a student and thank you for the thread. Had a really terrible peds outcome on one of my subIs last summer and one of the attendings from another pod took me aside for a few mins afterwards. Really meant a lot and helped me deal with it to see the people I looked up to be human about it
Thanks for all the replies. Feel a lot better this morning. Going to get a good workout in, and then I think sleep...I think a good sleep will be good. Again, thanks guys & girls who go to work everyday and do what we do. Underpaid, overworked, unappreciated, but we all still taking care of folks who need us (in some way), and we show up to our shift everyday or night and do it all over again.
Also, like I said in my original post....caught a housekeeper cleaning up & mopping the trauma bay after another particularly bad case. She was crying. They see the carnage & aftermath of these cases day in and day out and yet aren't thought of much. Maybe think about saying a simple "Thank You" to them as well. I'm going to. It'll go a long way.
Also, like I said in my original post....caught a housekeeper cleaning up & mopping the trauma bay after another particularly bad case. She was crying. They see the carnage & aftermath of these cases day in and day out and yet aren't thought of much. Maybe think about saying a simple "Thank You" to them as well. I'm going to. It'll go a long way.
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deleted92121
Perimortem C section a shift or two ago. No survivors. Informed I’ll likely never be part of one again.
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I think this is a hard question. I am just a resident but I have talked about this with attendings. I have talked with them about their lows during residency or after. That really helped me during hard shifts. Difficult patients, bad outcomes, traumatic events, and the like.
I had a shift recently that started and ended with a code. I was running the code of a young guy (40s) who likely had a drug OD. We ran it for an hour waiting for family. After running it for an hour and the wife was 20 minutes away 20 minutes ago but still another 20 minutes away I decided to call it. We got the wife on a cell speaker phone to say her last words to her husband. All of the staff was appropriately upset to hear her final words to her husband and then call time of death. They all felt that it was the kind thing to do. The final code of the day, a prolonged resuscitation in a very sick old man, was one where the nurse felt that I was not listening to her and that thus we didn't save the patient in her mind. Her emotions tore me up.
In the end, I reached back to what I learned from the attendings I respect. Also, I received a very kind letter from an attending about the first case later in the week commending me for my treatment of the situation.
I am not trying to toot my own horn, just offer an experience. One thing I realized is that my experience is similar yet different and in parallel with my friends. We are each on our own journey but share similar independent experiences. By sharing experiences, triumphs, and failures we help with the catharsis of our job. My residency has recently developed something to serve as an optional group catharsis with a residency story telling event. I know that it isn't applicable to our post-residency people but might be an idea for program leadership. One problem is I don't think a lot of people have a way to share their stories.
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They would have to pay me big bucks to work at a critical access ER with 9 beds which I assume is likely One docs coverage with Maybe a midlevel shift.
I have worked at Busy accepting hospitals, Level 1 trauma, critical access ERs.
I would take a metropolitan referral center anytime over a BFE critical access with farm equipment all over the place. These critical access may have lower volumes but being the only doc in the hospital sucks.
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I imagine that what happened is that they're rare enough that with luck, dxu won't ever have to be a part of one again. I ran a CISD for the staff after one of my hospitals had one, it was so traumatic. (Not my case, just got pulled in as med director)
There's an old thread around here entitled "Medicine Sucks." It's a multipage cathartic outpouring of some of the worst this board has ever seen, and helped me through some terrible cases. Just realize that it's pages and pages of PTSD going in...
There's an old thread around here entitled "Medicine Sucks." It's a multipage cathartic outpouring of some of the worst this board has ever seen, and helped me through some terrible cases. Just realize that it's pages and pages of PTSD going in...
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They'll have to pry my 5 bed rural ED shifts from my cold, dead hands.
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I tried to bump it (medicine sucks) recently but couldn't find it.
Medicine Sucks
Had to tell a family "Yeah, the reason your 8 yo daughter has been having those headaches is because she's got a big old brain tumor." Medicine sucks. :(
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deleted92121
Med Director said it’s a unicorn. They don’t happen often and the likelihood of witnessing or participating is exceedingly rare.
Background: 30ish G7P4 at 39 weeks. Found down. Resus 30 min prehospital. Arrived in ED asystolic. 2 mins to get baby out but looks like they’d been gone for a few days. Mom gets ROSC. Tx to ICU. Dies that night.
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We deal with so much suffering, it’s routine. Occasionally you get punched in the gut, and you feel more human, but I don’t know how many times I’ve had the “you’ve got cancer” or “yeah, So maybe we shouldn’t do chest compressions and prolong the suffering”.
Ps: hour long codes? Your staff needs to set you straight or be set straight.
