I had a real moment of shame at work the other day. Not just your everyday shame, either, but a searing flash that made me feel a little sick and disgusted with myself. It hasn't lessened in hindsight either, which really sucks. I try awfully hard to be a good person, and have to figure out a way to never let this happen again. The problem is - I don't know how.
It had been an uncharacteristically slow day. I mean slow. So slow that I voluntarily spent most of my day in Triage, which will eat you alive if it's busy, but on this particular day meant that I sat in a quiet room alone and played word games on-line. This is a double-edged sword, however, because when it's not busy the time seems to crawl. Most days I barely look up and my twelve hour shift is over. Not this one. The minutes dragged.
We all work twelve hour shifts, but we start around the clock. I had been there for hours when one of the older nurses came on duty. And before you knew it, before she had finished drinking her first cup of coffee, she got our first high-acuity patient of the day, who came in talking and nervously attempting to make jokes, and then proceeded to code on her within ten minutes. She coded once. They got her back. Twice. Back again. Three times. This was not good.
Her family was there, and growing in number by the minute. We called in the chaplain, who took them to the family room down the hall - the room you never want to be in - and tried to keep them up to date on what was going on. Her husband sat numbly in a chair, staring at the wall.
In the trauma room things were hopping. There were a ton of people in there - respiratory therapists, pharmacy, my boss, the nursing supervisor, two doctors, a physicians assistant, untold numbers of nurses and several students who were on the unit that day. The ER rotations almost always come at the end of a nursing program, right before the student is going to graduate. It's an anticipated rotation for all but a few. And this was exactly the kind of action they wanted to be in on.
I wasn't needed in the room, but I kept going in to see what was going on. And when I ran into the primary nurse who had that patient, I made some sort of comment about how all the rest of us had been sitting on our asses all day and then they came in and got the action, while we were all half-asleep. I went back in the room - because I was bored - and finally got something constructive to do to help. One of our nurses had dragged all the students to an out of the way corner and was walking them through the code. One of the doctors stood in the middle of the room and walked us through his thought process step by step, inviting questions and feedback. One by one, we let the students do the chest compressions, so they could learn how on a real person and not a rubber demonstration dummy.
A real person.
This was not a teaching moment. This was not something to keep me awake for the last two hours of my shift. This was not television. This was a woman who was going to die, no matter what we did or how well we did it. The family at the end of the hall who kept glancing fearfully at the closed curtains were not amused in the slightest, nor should they have been. The look on their faces as the doctor came out of the room and walked down that long hall toward them was a look I've come to know and dread. It was raw terror. As the doctor reached them and put a hand on her husband's shoulder...he knew. He knew before he said a word. And he slowly collapsed weeping into his son's arms as the rest of the family stood in varying degrees of stunned shock and vocal grief.
You have to walk a line. There has to be objectivity there or none of us could do our jobs effectively. You have to teach people how to handle situations like this. In nursing school, it's a badge of honor. "I was in on a code during my ER rotation" is right up there with actually seeing a baby being born during your time in OB. (Which I hated, by the way, just to add one more black mark to my name. OB, not babies).
And god knows if we didn't have some way of distancing ourselves, we'd never get through the day. And god knows that it takes a cold human being to not feel a family's agony. And god knows that I may never make it to that point. But even though I was not alone that day in my attitude, I still feel like a schmuck. From a medical and professional standpoint we were beyond reproach.
But as humans?