Confessions of a Trauma Junkie: My Life as a Nurse Paramedic, 2nd Edition
236
Confessions of a Trauma Junkie: My Life as a Nurse Paramedic, 2nd Edition
236Paperback(2nd ed.)
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Overview
Ride in the back of the ambulance with Sherry Lynn Jones Share the innermost feelings of emergency services workers as they encounter trauma, tragedy, redemption, and even a little humor. Sherry Lynn Jones has been an Emergency Medical Technician, Emergency Room Nurse, prison healthcare practitioner, and an on-scene critical incident debriefer. Most people who have observed or experienced physical, mental or emotional crisis have single perspectives. This book allows readers to stand on both sides of the gurney; it details a progression from innocence to enlightened caregiver to burnout, glimpsing into each stage personally and professionally.
"Corrections": the third realm of emergency care behind layers of concrete and barbed wire. Join in the dangers, challenges, and truth-is-stranger-than-fiction humor of this updated and revised second edition of Confessions of a Trauma Junkie. In addition to stories from the streets and ERs, medics, nurses, and corrections officers share perceptions and coping skills from the other side of prisons’ cuffs and clanging metal doors.
Emergency Service Professionals Praise Confessions of a Trauma Junkie "A must read for those who choose to subject themselves to life at its best and at its worst. Sherry offers insight in the Emergency Response business that most people cannot imagine." --Maj Gen Richard L. Bowling, former Commanding General, USAF Auxiliary (CAP) "Sherry Lynn Jones shares experiences and unique personal insights of first responders. Told with poetry, sensitivity and a touch of humor at times, all are real, providing views into realities EMTs, Nurses, and other first responders encounter. Recommended reading for anyone working with trauma, crises, critical incidents in any profession." -- George W. Doherty, MS, LPC, President Rocky Mountain Region Disaster Mental Health Institute "Sherry has captured the essence of working with people who have witnessed trauma. It made me cry, it made me laugh, it helped me to understand differently the work of our Emergency Services Personnel. I consider this a ‘must read’ for all of us who wish to be helpful to those who work in these professions." --Dennis Potter, LMSW, CAADC, CCS, FAAETS, ICISF Faculty "Confessions of a Trauma Junkie is an honest, powerful, and moving account of the emotional realities of helping others! Sherry Lynn Jones gives us a privileged look into the healing professions she knows firsthand. The importance of peer support is beautifully illustrated. This book will deepen the readers respect for those who serve." --Victor Welzant, PsyD, Director of Education and Training, The International Critical Incident Stress Foundation, Inc (ICISF) Learn more at www.SherryLynnJones.com
Biography & Autobiography : Medical - General
Product Details
| ISBN-13: | 9781615993413 |
|---|---|
| Publisher: | Loving Healing Press |
| Publication date: | 04/03/2017 |
| Edition description: | 2nd ed. |
| Pages: | 236 |
| Product dimensions: | 6.14(w) x 9.21(h) x 0.50(d) |
About the Author
Victor Welzant, PsyD, is the Director of Education and Training and past member of the Board of Directors of the International Critical Incident Stress Foundation, based in Ellicott City, MD. Victor previously served as Director of Acute Trauma Services for the Sheppard Pratt Health System and as a consultant to the State of Maryland, Department of Health and Mental Hygiene in the area of disaster behavioral health. Victor maintains a private consulting and clinical practice in Towson MD, where he specializes in the treatment of Trauma and Stress related conditions, organizational training, and program development. Victor is the Clinical Director for the Anne Arundel Fire Dept. Critical Incident Stress Management team in MD, as well as a supervisor for the Sheppard Pratt Health Care CISM team development. He is a consultant to the Harford County Maryland Sheriff's Department's Crisis Negotiation, and Peer Support teams and serves on the adjunct faculty of Towson University in Psychology, Nursing, and Homeland Security. Victor currently serves on the editorial board of the International Journal of Emergency Mental Health. Victor lectures and consults internationally on the topics Crisis Intervention, Critical Incident Stress Management, Suicide, Disaster Behavioral Health and the impact and treatment of trauma.
Read an Excerpt
CHAPTER 1
On the Road Again
Stories from Emergency Services Workers
When least expected, an Emergency Services (ES) worker might get the call that will change his life. Critical Incident Stress Management (CISM) is the standard of care in handling these emotionally traumatic circumstances and experiences, but CISM is not practiced or appropriately applied everywhere. Some folks are emotionally lost after a call so soul-stirring they cannot mentally escape. The worker can become a secondary victim of trauma. No one is immune.
This essay is about a medic who carries an ambulance call clearly in her mind, heart, and soul. Although the emotional wounds have mostly healed, the memory remains, and she is forever changed. Angel is now 33-years-old with several years' experience as a trauma center ER Tech. The medic became an ER RN who worked in the trauma center with her daughter; apple does not fall far from the tree. What a legacy.
Sweet Dreams, Angel
The telephone's ringing was an unwelcome intrusion into the night, breaking our silence into a thousand shards reflecting bits of dreams and pieces of reality mixing into an unreachable moment.
"Station nine, Cheryl,*" I mumbled, feigning coherence and attempting to ground myself at the moment and comprehend the directions I was about to be given.
"Priority one," said Ronda,* the EMS dispatcher. "I need you on the air right away."
I shook off the last remnants of sleep and called out to my partner in the bunk beside me. "Bob*: priority one. Ronda sounds a little edgy — we'd better move it."
Sometimes the dispatchers have to use creative management skills when the crews on 24- hour shifts rebel at sporadic and interrupted sleep. Working a double, this had been one of those shifts. We were trying to grab a quick nap and had missed lunch and dinner.
Company policy dictated that we had three minutes to get into the ambulance and report on the air after contact with dispatch. Instead of using our time to freshen up, we each popped a piece of chewing gum into our mouths and immediately headed out the door. We assumed that Ronda was in a mood and did not want to incur further wrath. We still had 10 of the 48 hours left to work and alienating the affections of a dispatcher can never result in anything positive for EMS crewmembers.
"Alpha 255 is on the air."
"255, priority one for Dearborn Park. Make northbound Southfield ramp to I-94 westbound. Child hit by a van. Your D-card number is 3472, time of call 2209h."
"Alpha 255 copies."
We understood the edginess in Ronda's formerly calm voice. The big three in dreaded EMS calls are those involving family members, friends, and children. Normally I drove and Bob navigated, but this was a race against time. Bob jumped in the driver's seat, and I hopped into the back of the rig to set up the advanced life support equipment. We had known before we pulled the ambulance out of the bay that when a pedestrian takes on a motor vehicle, the vehicle usually wins.
"Spike two lines, normal saline and lactated ringers," yelled Bob over his shoulder, straining above the screaming sirens. I knew what to do, but Bob calling out orders and my responding as I completed each step began the process of communication that was vital to our success as a team. "Pull out the drug box and set up the (cardiac) monitor. Don't prepare the paddles or leads until we see how big this kid is."
I hung the bags, though it seemed to take an interminable time. My hands felt big and especially clumsy as I tried to pull the packaging open and bleed the IV lines. The overhead strobe lights cast eerie red intermittent bursts inside the patient compartment, ticking off the seconds in our patient's Golden Hour.
It triggered an almost comical mental image of a wino, sitting in a cheap hotel room, and chain-smoking cigarettes with eyes transfixed on a small black-and-white TV screen. In this image, a red hotel sign flashed just outside his window, giving momentary peeks into the red, smoky glow of his reality. At that particular moment, my reality was just as undesirable. I tried to free myself of those images to accomplish my tasks, taking a deep breath to reduce my anxiety and approaching panic.
"Both bags are hung, the tape is ripped and hanging on the overhead bar. Catheters are in a box on the bench seat with the pulse oximeter, and the oxygen is on. Do you want the intubation kit left in the jump kit or opened and set up back here?"
"Leave it in the jump kit," said Bob. "We might have to tube him on the ground."
It was hard for me to monitor the radio communications from the back of the rig, so I asked Bob if the fire department was on the scene: his response was a brusque, "Affirmative." We knew that if fire-rescue workers were already there, they would stabilize our patient and perform whatever basic life support measures necessary. The fire trucks were a welcome sight as we rounded the curve toward the scene of the accident. My anxiety reduced slightly as I mentally checked off items in the victim stabilization process. Firefighters on scene completing primary steps permitted us to leap into advanced trauma and life support measures that could increase our patient's chances for survival.
At that moment before stopping the rig and beginning our tasks as paramedics, I switched to a more emotional appraisal of the situation. It is not our job to judge patients or their circumstances, but maintaining that particular level of professionalism is extremely difficult when you see severe trauma to a child. You cannot help wondering what prompted the child to be in such a dangerous place, especially at night.
And where were his parents? Did they not care enough to monitor his whereabouts or bear any concern for his safety? Did they just assume that he had the appropriate judgment at his age to take care of himself?
Somehow, I switched into an empathetic mode for the child and anticipated grief and loss. In my denial, I allowed a moment of anger before I saw the boy's face or condition. Inwardly, I prayed for this to be a salvageable situation. We stopped the rig. The doors, pulled open by the firefighters, revealed a scene I had hoped not to see.
Looking at our patient, it did not seem like anyone would ever have the opportunity to question his judgment, or take away some privilege as punishment for his playing in traffic. The boy was obviously paying the price for what was probably an impulsive act. Instead of worrying about things that normally concern kids — like cool clothes, catching something awesome on the tube or getting the latest computer gadgetry — this kid was struggling to breathe.
The fire department rescue crew had already applied MAST pants to stabilize lower extremity fractures and secured our patient to a long backboard. He appeared about 10-11 years old, blonde hair, about 5 feet tall, maybe 95 pounds. There were multiple abrasions on his head and face, matting his blonde hair into bloody clumps, with bruising around both eyes. Blood oozed out of the boy's nose and mouth, staining the cervical collar placed around his neck by the firefighters. He was in labored, agonal respirations as we approached him.
Bob checked for pulses and found a faint radial pulse at a non-life-sustaining rate of about 30. The boy's pupils were fixed and dilated, his skin cool and pale, and his lungs were already filling with fluid. We popped an airway in his mouth and began bagging with 100% oxygen. Lifting him onto our stretcher, we welcomed him into our world: a guaranteed, miracle-making, emergency room on wheels, prayers administered copiously at no extra charge.
Come one, come all, see the happy ending, just like on TV. No one dies, and no one is permanently impaired. Somehow, just before the final scene, the heavens open, music sounds, and all are well.
After loading, we again checked for a heartbeat. Confirming that the boy was pulseless and not breathing, Bob muttered an expletive and called for CPR. A firefighter jumped in the front seat of the ambulance to drive. While the firefighters on board continued compressions and bag-valve-mask ventilations, we got the intubation equipment ready.
A quick-look on the cardiac monitor showed an AMF rhythm (Adios, Mother F — r), also known as asystole — flatline. Firefighters continued CPR with hyperventilation while Bob intubated and I looked for a site to gain IV (intravenous) access. We knew the prognosis was not good, but neither of us was good at accepting failure or seeing a situation as impossible. We had the skills and the toys. Somehow, we would make it work. We had to, as defeat and loss were not acceptable options.
The firefighters already cut the boy's thick left coat sleeve. I assumed they had prepared an opening for me to start the IV line and I grabbed the boy's arm with both hands to look for a good vein. The upper left arm bent quickly in half like a rag doll, mid-shaft. Apparently, his humerus had sustained a complete fracture, and the arm bent grotesquely and flopped off to the side.
I shuddered, took a deep breath to decrease my nausea, grabbed my medic shears, and cut away the thick coat sleeve on the other arm. Finding an acceptable vein, I muttered an audible and brief prayer, something like, "Dear God, please let me get this first try," and popped a needle into his right antecubital vein. I taped the line down as Bob secured his endotracheal tube, and started preparing the drugs while Bob established a second line in the boy's external jugular vein.
Things moved smoothly and efficiently, like a well-rehearsed movie scene. It felt like an aberration of time to me as sounds and movements achieved a slowing distortion. Our on-scene and en route times would later prove exceptionally brief, but as we performed our duties, it felt as though we were there for eons.
Every thought and movement jumbled together, feeling thick and expanded as one might view the world through the feverish eyes of illness. Despite perceptual conflicts, we managed to get weak pulses back after pushing the epinephrine and atropine, which gave us momentary hope to pull this child out of death's clutches and back into his mother's arms. As we worked against time and mortality, the monitor showed an ever-hopeful sinus tachycardia at a rate of 120, but it did not last.
During the call, we pushed all of the appropriate drugs and performed our protocols flawlessly but the boy, whose name we later learned was Scott,* died at the hospital. His skull exhibited profound crepitation and his abdomen was rigid and distended with spilled blood. My partner wrote the report as I cleaned our rig with Big Orange, a delightfully fresh aroma designed to replace the smell of blood and other spilled bodily fluids with a more socially acceptable citrus scent.
When we finished, I went back into the ER and held onto Scott's cold foot. Our training concentrates on producing positive results and saving lives. Nobody ever told us what to do when our advanced skills and expensive toys do not work.
No one ever explained that you could be completely successful in applying your talents and still come out with the worst result. No one ever walked us through how to handle it emotionally when a child dies. No one seemed to be there for the medic feeling lost, hopeless, and helpless, watching the spirit of a child fade into the universe.
Bob and I did not talk about Scott, or the call, except to review the procedures. There was nothing we could have done differently, but the boy died. I reminded myself that God performs miracles in His time and on whom He decides to confer them. Scott was not to be a recipient. My partner and I finished our shift and without another word, went home.
I spent the next several hours cuddled up with my daughter. I phoned my son and told him I loved and missed him. The ambulance call, every detail perfectly preserved — a video without end — played itself continuously in my head like a promotional loop. It was a song that keeps repeating itself in your consciousness, getting louder and louder and you cannot escape from it. My heart raced, and I could not take one of those deep, cleansing breaths that reduce stress to offer some measure of relief. There was no relief. There was no return to normalcy.
Sometimes, in a hidden corner of the mind, there exists a place removed from reality. Darkness and the images that saturate the senses reaffirm an individual's powerlessness. These images are beyond the point of chosen exposure or experience.
I spent the next 48 hours unable to eat or sleep, reliving the recent violation with its unrelenting intrusive thoughts following the trauma. As the second night filled with darkness devoid of mercy, the line between rational and irrational thought became a chasm leading to an emotional abyss. I reached out for help.
Mark D. is a good friend who holds a degree in psychology. When I called him, a friend of his answered the phone, telling me that Mark had just stepped out. "This is Cheryl. It's nothing important, really, not a matter of life and death. Well, I guess it is about life and death, but it's no big deal. Just tell Mark I said hi."
He called back within minutes.
"What's going on?"
"I had a bad call. We picked up a kid who had been FUBAR'd (F — d Up Beyond All Recognition) by a van. I don't know what the deal is because I've been doing this for years, and nothing has ever really bothered me before, but I can't eat or sleep or turn it off, and it just keeps rolling around in my head."
"All right. First of all, I have a lot of respect for what you do. I could never do it. What you do and what you see out there are not the normal things that people see, or should see. Tell me what happened."
Quickly relating the call in elaborate detail with the images so firmly imprinted in my mind and heart that I could effortlessly rattle them off without stopping to breathe, I told Mark what happened. I could not catch my breath, and the room seemed to swim as I visited that place. My senses relived their experience: the smell of exhaust and blood, the bits of glass crunching under my boots, the controlled panic in the eyes of the emergency workers as they fought so desperately against death.
Feelings of inadequacy mounted, accompanied by the urgent desire to quit my job. I did not want to face parents handing me dead babies or have to wonder, racing against time to a scene, what I might find. There was a wave of understanding beginning to flow over me.
The medics with whom I have worked told, in their most private moments, of a desire to have the power of God, just once, to re-inflate a soul with life in the middle of senseless tragedy. I had yearned for that power even if it meant just giving Scott's parents the time to hold him and say goodbye before his body grew cold and lifeless. I had far more questions than answers, but could not identify or speak them as my heart ached with this loss.
Mark listened patiently. After I had answered all of his questions, he asked the one that opened the door of my prison. "What was different about this call?"
It took a few minutes to understand what he was asking. I had seen people in pieces, handled drowning victims, offered comfort and understanding to those who faced a loss of dignity and sanity. I had been the recipient of projectile vomitus, perceived as a hero, and then scorned, all on the same day. What was different about this call was not the call itself.
I was in the middle of some demanding personal problems. That same day, my (now) ex-husband had stormed out of the house, refusing to watch our 10-year-old daughter and leaving her to fend for herself. At work and away from home I was powerless to care for her and hoped that the neighbor she was visiting, Lynn, would see to her safety.
I had assumed she was safe as she rode her bike with her friends down our quiet streets, but I could not justify that assumption. There is no safe place. There is no place where the boogeyman is forbidden, where pain, sorrow, and loss will not enter and change everything we know in ways we could never imagine.
The anger at my situation and the realization of the parallel between the family of the dead child and my own became clear. Scott's mother left him with relatives trusting that he would be safe. I was with this other mother's child as he took his last breath and died.
Where was my child during this time?
I remembered suppressing a horrible fear as I fought for Scott's life. What if another medic was cutting my daughter's coat sleeve, looking for a good vein, trying to instill life into her lifeless form? Would they mourn her loss? Or would they be callous and marvel simply at how physical trauma can pull apart a human body without giving a thought to the soul?
Would they know my daughter was a beautiful little girl who excelled in gymnastics and played trumpet? Would they suspect she decorated cakes and was a whiz at reciting Bible verses? Would they know what she would miss, what I would miss, in a future now denied her?
(Continues…)
Excerpted from "Confessions of a Trauma Junkie"
by .
Copyright © 2017 Sherry Lynn Jones.
Excerpted by permission of Loving Healing Press, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Foreword by Victor Wlezant, Psy.D.,
Preface: The Healer Within,
Preface to the 2nd Edition,
Part I – On the Road Again: Stories from Emergency Services Workers,
Part II – The Other Side of the Gurney: The Mortal Side of Emergency Service,
Part III – ER Short Stuff: The Day to Day Life of Emergency Room Personnel,
Part IV – Corrections: Prison Health Care Stories from Nurses, COs, and Staff,
Part V – After the Call: When it Isn't Really Over,
About the Author,
Glossary,
Index,