I spent ten years in EDs and Level 1 trauma centers. I’ve seen horrific accidents, gunshot wounds, amputations, and worse. I’ve seen grown men three times my size scream and cry. It was often my job to stop the bleeding, ease the trauma, and prepare people for major surgery and an uncertain future. It was, and continues to be, such a privilege.
As nurses, beyond caring for illnesses and wounds, we care for people in totality. With each patient, I have to remember that this isn’t an isolated event. This person existed before they came into my ED. Who are they? How did it come to this? The person standing in front of me was somebody yesterday, and tomorrow they’re going to be someone completely different, mentally and physically. Tomorrow they may have a permanent scar. They may be missing a finger, or a leg. Maybe we had to shave their head to address a head injury. Ten years from now, they’ll remember this moment, hopefully healed by then and telling the story to their friends over a beer. But right now, they are standing in front of me, pouring their heart out. Literally. The blood’s getting all over my scrubs. The symbolism isn’t lost on me. And it’s a privilege.
In the ED, it’s rare that someone comes in alone. Sometimes it’s a family, or even strangers who happened to be there at the time the trauma happened. This is the first time I’m meeting all of them – a brand new cast of characters who may or may not have a history. Maybe they’re in a strained relationship. Maybe this was domestic violence and the person who caused it is asking you to fix it. Maybe it’s the patient and her mother, or the patient and his child. It’s my job to honor each situation and the vulnerability that comes with it. It’s such a privilege.
Being a nurse in the ED means looking traumatized people in the eyes without any fear or hesitation, and saying, “I’m here. We’re in this together. I’m going to help you. We got this.” And it needs to be authentic. I need to give that person dignity and respect, and to give a little bit of myself each time. It’s a unique human interaction. Patients always say, “Why me? Why did this happen to me?” and I say to them, “Because you’re one of the strong ones. Think of what you’re learning right now that you can take with you. This event does not define you. It prepares you for great things.”
Families would pull out pictures and show me what the patient looked like before they came in. They were already mourning the person the patient used to be. But instead of saying, “Aw, your son used to be so handsome” or “Wow, your spouse used to have two arms,” I’d always say, “Yeah, but he’s got a cool scar now,” or “I don’t know, I think she looks pretty great with my stitches. Don’t you like my handiwork?” You’re preparing them for the new person that patient is becoming. You’re making a connection and learning about another person for a moment. It’s a true calling. And of course, it’s a privilege.
I’d try to make them laugh. Nurses need to have a sense of humor. The people in front of you are in shock. They’ve been in an accident or an altercation and they’re in a totally unique state. Sometimes it’s hard to do, but I’d try to put a smile on their faces to shift the focus from the trauma and just focus on the positive – they’re here. They’re getting help. It could be worse. Maybe they’re going to lose a limb or a finger, so I’d tell them, “You’re fine. You still have nine other fingers. Nine! Who even needs ten fingers? They just get in the way.”
One time I had a husband and wife come in, and the husband was making a big fuss, probably nervously chattering on and on. The wife joked and said, “Hey, can you stitch his mouth shut while you’re at it?” I made a joke about leaving him a little straw so he could breathe. Or maybe you know that your patient works in an office, so you joke with them that unfortunately their illustrious cello career is over. It puts things in perspective to them. You might even see a smile, and that, in addition to being a huge compliment, is a privilege.
Even while writing this piece, so many memories crept back and made me smile, even though those memories were messy. People lost blood. People lost sanity. People lost people. But I was there for them. I did my best to make them feel like it was going to be okay, even if it wasn’t. They trusted me, a total stranger, in their time of need. My days in the ED are over, but I still carry those lessons. We’re not always at our best. Our colleagues aren’t always at their best. But we are all a collection of the traumas and victories we’ve had and are having each moment. We bring our scars and our stitches to work every day. And for nurses like me, we thrive on that. Because human connection, empathy, and of course nursing, is such a privilege.