Veterans Day

When I started my nursing career I took care of many WW2 vets. I loved and appreciated every one of them. They are truly a great generation of men. They fought evil and won. They avenged America from a terrible loss and they rescued thousands from persecution and ethnic cleansing. They were labeled, the Greatest Generation and rightly so. They were solid and stoic. They buried their trauma so deep that it rarely surfaced. They walked into the face of evil and they won. The ones lucky enough to come home from war went back to work, raised their families, and built a wall between soldier and civilian life. As they aged healthcare providers like myself began to see that wall crumble. Age and dementia quickly broke a hole in the wall so carefully constructed. For these precious ones we hold their hands and offer comforting words in the night. Their war was never truly over.

As the WW2 and Korean War generation ages and dies I’m faced with a new group of soldiers in the ER age related medical problems. The Vietnam Vets of the 60s and 70s are now frequenting ERs like mine with heart disease, chest pain, COPD, cancer, liver and kidney failure and every other age related malady known to man. They also have emotional scars but this generation was expected to cover it up and move on like their fathers. Some used drugs and alcohol others used food, reckless behavior and other vices. They went for years trying to cover their trauma before there was even a name for what they experienced. A Vietnam vet once in the ER for chest pain told me he still suffered from “that PTSD.” He told me that the VA put him on a couple of pills for it. He said the pills helped him sleep. I told him I could not begin to imagine what he had lived through. He shrugged and told me that he would have done it all again even though no one threw him a parade when he came back home. He seemed embarrassed to talk about why he was on an antidepressant but at the same time he wears his veterans cap proudly. He carried on after his tour in Vietnam to retire from the army. I told him that I believed any service in the name of our country is admirable in my opinion. When he was discharged from my care I thanked him for all he has done and sacrificed. He shook my hand and looked me in the eyes and thanked me for thanking him. He thanked me. I still don’t understand but my heart was warmed with the gesture.

I see another group of veterans in the ER from time to time. These men and women are my peers. I look at their birthdays and am astonished that they are the same age as me because they seem older due to the emotional weight they carry. I see men and women that were in high school the same time I was. Our generation had not seen evil up close. We were sheltered and protected. When our country was attacked my friends along with men and woman our age across the nation were called to action. Some were already enlisted but so many went to recruitment centers just like our grandfathers did in the 40s.

The difference with those eager enlistees from the ones two generations before was that the nations love for them and the war they fought was flippant. We were totally dedicated to the cause one minute but before the mission was accomplished we at home had lost interest. Our passion for eradicating evil was quickly replaced with a passion for reality TV and the latest tech devices. When these men and women returned they weren’t met with ticker tape parades. They were met by a few family members in a lonely airport and expected to go back to life as they knew it before. How could we who have lived every day with every convenience offered in the first world begin to comprehend how these soldiers felt the first time they walked down the cereal aisle at a supermarket again?

The younger vets that I see in emergency situations are the ones that have been crippled by addiction or mental health crisis. They, like the embattled Vietnam Vets before them, were under appreciated and mistreated when they returned from combat. They couldn’t get the career placement or emotional counseling that they needed. Their country had moved on while they were fighting and wasn’t there for them when they returned. I respect and honor these vets just as I do the ones that are healthy. I respect these just as much as I do the ones who came home to a proud family and work environment. The ones who came home alone just as much as I do the ones that came home with their whole unit intact.

When your life is on the line there is no “level” of service. You all count. You all play a vital job. You all keep us safe. You are loved and valued by me. Thank you, Veterans. And God Bless the USA.

A Good Physician

Today I was reminded about the struggle of selecting a pediatrician. I haven’t had to worry about which one I wanted since Sam was a baby. His pediatrician pretty much chose me.

When Sam was a baby he had Medicaid. I was a teen mother married but with very limited income. I had been a patient At the Greater Meridian Health Clinic for all of my pregnancy and his medicaid approved physician was there as well. He was very sick one day and we took him to the public clinic that he was assigned to and they were closed for some reason. Sam was listless and his fever was very high and not relieved by Tylenol or Motrin. I didn’t know what else to do so I took him to Dr McEachin’s clinic at Medical Arts Pediatrics. Dr. McEachin was my pediatrician when I was a kid and I trusted him. They saw Sam immediately. Dr. McEachin saw on his x-ray that Sam had pneumonia and he called us to his office. He told us that our insurance wouldn’t cover an admission from his office. He told us that Sam was very sick and that we needed to be in the hospital. He put his notes and x-rays in an envelope and sent it with us to GMHC (Sams Medicaid preferred provider) and told us to tell his preferred provider to admit him to the hospital.

 We went to the clinic he was assigned to and spoke with the triage nurse. On triage his O2 sat was 84 and his HR was 184, his resp rate was 40 and she couldn’t get his bp. (I wasn’t a nurse at this point and I had no idea how serious these vital signs were) We gave her dr McEachin’s notes and all the labs and x-rays. She told us it would be at least 2 hrs before he could get back to see the dr. While she was telling us this our cell rang and it was Dr McEachin telling us to come straight to the Er at Anderson’s and that we could be admitted under our coverage if we went through the ER. We arrived at the ER and Nurses were waiting for us because he had called ahead. They put sam on breathing treatments immediately. He stayed in the hospital for 12 days. We saw Dr McEachin a few times during that stay. We saw his colleagues the other times. I later found out that Dr McEachin waived his physician fee and allowed us to be admitted to him for free despite our Medicaid. We were admitted under the ER and he saw us for free as a pediatric consult. He didn’t do this because he had to. He did this because he saw a child in need and he wanted to help. He loved his patients. He didn’t see medicine as a dollar sign he saw it as a calling. 

God bless Dr. John McEachin. God bless the doctors that follow in his foot steps. 

Notes on Loving an ER Nurse

I've been back to nursing for a little over a year now after a five year break. During my time home I spent invaluable time with my children and my husband. I learned how to be a housewife. I was at the beckon call of my four people. It was a golden time. I loved every minute of it. 

A side effect of all this time off to be in the brilliant white light of my family was that I lost the cynicism and dark humor that is common of nurses in my field. I was away from it. I didn't see the tragedy or the horror of first line emergency nursing on a daily basis anymore. I didn't have to compensate with humor or a refined coolness of emotion. I was free. 

But now I'm back and just as cynical and dark as I ever was before and I want to take this time to give you a few words of advice for living with an emergency room nurse...

1. Listen to us. We are tired and we are emotionally frazzled. We need you to listen. We don't need you to be the advocate for the patient, doctor, respiratory therapist, family member, lab tech, x-ray tech, paramedic, or receiving nurse. At this point, one or all of those are butt holes and we just need you to listen to us rant and be on our side. In fact ALWAYS take our side. 

2. If we say that something is "cool" or "awesome" or even "badass" please accept that this is a way to compensate or compartmentalize some emotional things...Unless it's something lodged into a living human body... that's usually bad ass awesome and we aren't scared to tell you.

3. Be prepared for us to be acutely and expertly familiar with the genitalia of the opposite sex. It's part of the job. If I need to tell you about a penis that I couldn't find, a vagina that was especially malodorous, or a scrotum that was bigger than any scrotum in the history of scrotums. Just accept that I need to get this information out of my head and be my sponge.

4. When I come home, and I don't want to talk, leave me alone. It isn't you. I'm tired of people and I don't have words. I need quiet. Leave me alone.

5. When I come home and I look like crap and I ask you to give me a hug... hug me until I tell you to stop.

6. If I talk in medical talk over your level of understanding and don't stop to explain just smile and nod... this talk isn't for you it's probably for me and you probably need to refer to rule number one. 

7. I'm not going to sleep with a coworker, police officer, fire fighter, medic, or anyone else at the hospital. Hospitals are gross and at any point of the night I may be sweaty, dirty, smelly or wearing someone else's body fluids. It's not grey's anatomy, believe me. Also, give me some freaking credit.

8. Anything that you say to me after my 12 hour shift is probably going to be forgotten. Don't be a douche when you have to tell me the same thing again after I've had some sleep. I'm still mentally checking to make sure I gave my third patient his script at discharge. If you need me to pick up something at the grocery on my day off please put it in writing or send me a text.

9. Let me sleep. Don't wake me up. I am tired. Please. Let. Me. Sleep.

10. If I tell you a dark twisty nursing story please don't hold it against me. Laugh like you enjoy it. I need you to make me feel sane. 

11. If I ask  you if my scrubs look too tight the answer is NO

12. If I cry when I tell you about my patient that didn't make it, just listen and let me cry. Don't minimalize my grief by telling me that he was "old" or that there was nothing that I could have done. Lots of times there are a million things in my head that I think i should have done and I feel guilty for not doing them faster or sooner. Just let me grieve. 

13. Last one.... If I'm living this life with you, I love you. I want to be with you and I wouldn't spend 36 hours a week cleaning up other people's crap (literal and metaphorical) unless I was doing it for you. 

Bottom line, we do a terribly tragic and mostly disgusting job. We do it because we love it and we do it because someone must.... but we do it for you too. We wouldn't be the person you loved unless we rocked our scrubs once in a while. We wouldn't be the one you fell in love with if we didn't stop at the wreck scene on the way to our vacation or rush the field when a kid was hurt at a football game. You love that about us. And we love you for loving us.