basric: (Basric Bee)
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WHEN YOU PRAY, MOVE YOUR FEET


I am a Trauma nurse for a Level 1 Trauma Unit covering Middle Tennessee. The word through our medical center is a Trauma nurse is almost as arrogant as a Cardio-Thoracic nurse. It’s probably true. It irritates me to no end to be called an E.R. nurse. Our Emergency Room is where you go when you are sick, break your arm or have a heart attack (also known as a myocardial infraction or M.I.)

If you are in trauma there’s a one in three chance that you will die (the E.R.'s statistics are much better). That’s why dressed in Vanderbilt's colors of Black and gold we are called the Death Squad. I know my job, I don’t have the God complex MOST surgeons possess but I’m good at what I do. What I do is everything humanly possible and sometimes seemingly impossible to keep you alive when you are pushed through those automatic air-compression double doors into my triage so you don't end up in that one out of three.

I work nights, a difficult shift for trauma, especially weekends. Nurses who can handle it are even more difficult to find and keep. Tara was hired for nights; a ten year Trauma nurse from St. Barnabas Level 1 Trauma Center in the Bronx, NY. I’ve done travel nursing to NYC and a Wednesday night there is a weekend night in Nashville. Their weekends are a nightmare. Tara knew what to do when and where. This, for those of you who’ve read my entries before, was a relief.

Tara had one little problem. She had been recently touched by the Lord. Now, I am not saying this is a bad thing for Tara, but when you’re a nurse, you leave your personal life at the door. Tara couldn’t. She blessed everything--have a blessed day, here's your blessed pills. Did she think she was the Pope? She reviled any of us who did not attend church regularly reminding us we were damning our souls, refused to work Sunday condemned those of us who did (hospitals should close on Sunday?)—yadda . . . yadda. . . yadda. I ignored her until that faithful night that seems always fated to come when I’m in charge.

(Once again I throw it out there for your edification especially to those in their teens and twenties and those who just get their jollies cutting off tractor trailer trucks—your car may stop on a dime but an 18-wheeler takes double its length. So, you cut them off and slam on your brakes and they RUN OVER YOU and you end up under the trailer after the cab has RUN OVER you. Then there is the guy behind him who isn’t quite focused on his driving for whatever reason. That car ends up under the back of the trailer.)

This night we were forewarned of an incoming three car motor vehicle accident (MVA), three males in their twenties from the front car, a male in his thirties and his wife also in her thirties from the back. The truck driver was sent to the E.R. with minor injuries. We were prepared, our residents, Paula, Tara, two other nurses pulled from the floor and me.

I gave Tara the thirty year old male with head injuries and a strip of metal that pierced his thigh and was pulled out as he was removed from the wreckage, luckily the EMT reached him immediately after, since it had nicked the femoral artery.

I had the wife with head trauma and a crushing leg injury. I had just finished assisting my resident to stabilize our patient for surgery when Tara’s Resident yelled for me. I glanced back at Paula and the three patients in the bays. The charge nurse in me automatically noted two had been pronounced and they were working furiously to save the third. I turned back to the front.

It’s amazing how quickly you can DE-gown, DE-glove and replace them walking only a few feet. As I passed the patient I stopped; blood was pooled between his legs the bandage saturated, the patient was bleeding out. I folded an ABD pad (abdominal) pressed it against the leaking bandage and placed a stretched bandage tourniquet around it and checked his foot for a pulse. At the gurney head the resident thumbed toward Tara who stood holding the patient’s hand and praying. (FYI: we move patients from EMT gurney to our gurney instead of a bed because the patients either head for surgery or the morgue as they are stabilized.)

The resident's anger was evident, "Deal with her. I can't get her to move."

“Tara!”

“Hush! I’m praying with the patient. Please don’t intrude.”

HUSH. She did not just tell ME to hush.“TARA. Come here now.” Oh yes, I wanted to drag her to the bottom of the gurney.

She patted the patient, “I’ll be right back, Hon. Really, can’t you see I’m doing the Lord’s work.”

“Here, we let the Lord do his own work. Your work is to keep pressure on that artery and you were impeding the doctor from placing the central line and intubating.”

“The patient asked me to pray with him. His soul takes precedence over the body.”

I have admitted to having a raging temper due in part to my Comanche blood but I managed not to strangle her, barely, “The chaplain’s job is to pray with the patients; yours is to keep the patient ALIVE. No, be quiet. While you’re NOT doing YOUR job the patient is bleeding out. So you are praying him to death, literally. And blood can NOT be infused to replace the loss without a line. Look, already there is blood on the pressure dressing I just applied. Get another dressing and keep pressure until the doctor has him stabilized to go to surgery.”

“But. . .”

“Do your job or I will have you escorted out of triage and replace you with someone who can. You can pray for him to yourself while you hold pressure.”

(For those wondering, as soon as the line was placed, the patient was intubated and sedated.)

I was dealing with processing the three front crash Trauma patients for the morgue when the husband was wheeled out by the surgical techs.

Tara flew at me backing me up against a wall screeching, “You barbaric heathen, denying a man with what may have been his dying wish of prayers to our Lord.” (A note I only backed up because touching her during a verbal assault would have me arrested for assault & battery.)

“If you’d have kept praying, he would have died.”

“You can’t know that.”

“I know if blood comes out and none is put back in pretty soon the heart stops and the brain dies."

“You have no heart, no feelings what so ever. You are one of the living damned. These people are nothing but slabs of meat to you.”

I stopped those around me from defending me though they tried. I kicked her out of triage. She wrote me up. The resident wrote her up. She ended up on another floor.

Did she hurt my feelings? Hey, according to her I don’t have any. But there are mornings when I get home and reach for coffee or juice and some other mornings a wine cooler or two. And sometimes that little locked box in my head springs open and all the past pleas come rushing out. Eighteen to eighty, male and female, preacher to gang-banger -- begging me not to let them die, not to let their loved ones with them die; to pray with them, for them and sometimes knowing there was nothing I could do to help save them. So, in triage I guess I have no feelings. I can’t afford feelings or prayers when I need to be assessing, assisting, and moving. I’m going to try to help keep you alive.
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Date: 2011-10-24 06:24 pm (UTC)
From: [identity profile] ktdid525.livejournal.com
Amazing story.I see a lot of people fall into a trap of thinking Jesus is going to step in and save them, but he gives us the option to help ourselves too. Since he has given us that option I assume he would like us to use it ;-)

Date: 2011-10-24 06:41 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks for reading and taking time to comment.

(no subject)

From: [identity profile] ktdid525.livejournal.com - Date: 2011-10-24 06:48 pm (UTC) - Expand

(no subject)

From: [identity profile] basric.livejournal.com - Date: 2011-10-24 07:09 pm (UTC) - Expand

Date: 2011-10-24 07:52 pm (UTC)
From: [identity profile] myrna-bird.livejournal.com
Oh, it is so good to have you back! You haven't lost your edge for telling it like it is. Another great trauma tale.

Date: 2011-10-24 08:00 pm (UTC)
From: [identity profile] basric.livejournal.com
Thank you so much. I appreciate it.

Date: 2011-10-24 07:57 pm (UTC)
From: [identity profile] faerie-spark.livejournal.com
*boggle* Whether or not prayer is powerful is not the point! I don't know what I believe in, but I do believe that if we were created by something, that we were given intelligence, the ability to create, invent, gain knowledge. I'm very happy to kno that at least some folks use their knowledge in the trauma unit.

Glad to have you back with your stories.

Date: 2011-10-24 07:59 pm (UTC)
From: [identity profile] basric.livejournal.com
Thank you, you are very kind.

Date: 2011-10-24 09:10 pm (UTC)
From: [identity profile] ladyjudithanne.livejournal.com
This was amazing...how you did'nt slap her is beyond me.

Date: 2011-10-24 11:57 pm (UTC)
From: [identity profile] basric.livejournal.com
Not wanting to spend the night in jail helped. Thanks for reading & commenting,

Date: 2011-10-24 09:33 pm (UTC)
From: [identity profile] muchtooarrogant.livejournal.com
Great entry.

"Did she think she was the Pope?"

You made me laugh outloud, so it's good that I'm working from home today.

Thank you for doing what you do every day/night. No worries, if an agnostic like me ever finds God, I'll be sure to take care of the praying on my own if I'm ever in your unit. *grin*

Dan

Date: 2011-10-24 11:46 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks for taking the time to read and comment.

Date: 2011-10-24 09:57 pm (UTC)
From: [identity profile] amempress.livejournal.com
Wow. Incredible story.

These people are nothing but slabs of meat to you

Um, no. The one neglecting the basic needs of a body to survive would be the one viewing people as slabs of meat.

Date: 2011-10-24 11:56 pm (UTC)
From: [identity profile] basric.livejournal.com
Appreciate the comment.

Date: 2011-10-25 03:27 am (UTC)
shadowwolf13: (Default)
From: [personal profile] shadowwolf13
Omg, I am so glad you're back this season! As always you sweep me away into your story.

I don't understand people like that nurse. There's times for prayer and times for action ... and they seem to never see it.

Date: 2011-10-26 08:53 pm (UTC)
From: [identity profile] basric.livejournal.com
She was definitely overzealous. Thanks for commenting.

Date: 2011-10-25 05:05 am (UTC)
From: [identity profile] whipchick.livejournal.com
Fascinating. Such an interesting window into your world. Here's the part that's most interesting to me - near the end, in your last paragraph, I actually question a little bit whether Tara has a point about prayer ("begging me...to pray with them"). And even though I don't think that's actually your intention, that moment of doubt makes your piece more compelling and less "I'm right and here's why." Might be worth exploring further.

Date: 2011-10-25 06:01 pm (UTC)
From: [identity profile] basric.livejournal.com
I have no regrets from walking away from a dying patient asking me to stay and pray when the next victim needs me to live. But I admit having worked a cancer unit that no one should die alone, if possible, so I try to call a floor nurse or care partner and once grabbed a lab tech to be with a patient until they passed.

Date: 2011-10-25 05:23 am (UTC)
From: [identity profile] rabid1st.livejournal.com
I can't tell you how many times I've explained the simple law of physics involved in driving huge vehicles at high speeds to family and friends who considered themselves "good drivers." I take the safe distance thing very seriously. I don't know if that was my early medical training or the fact that Mad Max was based on George Miller's experience as a doctor in a trauma unit in Australia. I think it goes further back though, because I remember wondering about those cliche motorcycle gang pictures that used to run on very basic cable when I was a wee Rabid. I used to think, "Dude, that truck will crush you like a bug. You aren't menacing. You need to be wearing a helmet. Stop being an ass." :grin:

All that is just my rambling thoughts as I was reading this very gripping story of a night under pressure. Go you for dealing with that night after night. This certainly is a great illustration of the topic. And I admire your restraint with the zealot.

Date: 2011-10-25 05:53 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks for letting me know at least one person actually soaked in car versus tractor trailer the car and it inhabitants lose. I remember the Mad Max and I remember the gang terrorizing just a car and thinking--woman serve and hit the SOB--he has no protection you're in a car, much less the 18 wheelers. (=

Date: 2011-10-25 08:46 am (UTC)
From: [identity profile] kehlen-crow.livejournal.com
Amazing, as always.

And also, your writing has become noticeably better since last year :-).

Date: 2011-10-25 05:48 pm (UTC)
From: [identity profile] basric.livejournal.com
Very kind of you tis say. Thanks for the comment.

Date: 2011-10-25 01:14 pm (UTC)
From: [identity profile] imafarmgirl.livejournal.com
Wow she really sounds like a freak. It's great to see you back in idol.

Date: 2011-10-25 05:45 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks for taking time to read and comment. I appreciate it.

Date: 2011-10-25 02:00 pm (UTC)
From: [identity profile] bewize.livejournal.com
You brought tears to my eyes with this and I'm not even sure why. Well done.

Date: 2011-10-25 05:45 pm (UTC)
From: [identity profile] basric.livejournal.com
Appreciate you taking time to comment.

Date: 2011-10-25 04:28 pm (UTC)
From: [identity profile] phoenixsansfyr.livejournal.com
As a medic who changed from a busy system to a significantly less busy system, I know where you're coming from with this. I have the occasional hospice call (we also do interfacility) where I do have the time to give family a hug, tell a patient or family (after I've been asked) to pray for them (I am not of the Christian faith by any stretch of the imagination, but I can grant them ten seconds of my time to hope they pass easily and quietly), and I sincerely tell them I will.

If I'm in the middle of working someone, get the fuck out of my way. My job is to try and save a life of someone who hasn't yet said they want to die, try my absolute hardest knowing the odds are so very against me, and if I do what Tara did... Oh dear lord, I'd no longer have a patch. And I'd accept that. My job is not to pray for the dying or their families in the middle of something. My job is to do what the art we practice can: try and SAVE a life.

I hope she ended up in med/surg, where she'd perhaps be a bit better placed. Or hospice.

Date: 2011-10-25 04:30 pm (UTC)
From: [identity profile] phoenixsansfyr.livejournal.com
That I will pray for them*. Typically they'll say "pray for me, please" and my response is simple: absolutely.

(I have a brain when commenting)

(no subject)

From: [identity profile] basric.livejournal.com - Date: 2011-10-25 05:38 pm (UTC) - Expand

Date: 2011-10-25 04:32 pm (UTC)
From: [identity profile] sarcasmoqueen.livejournal.com
I am flabbergasted. That was truly amazing from beginning to end. You had me from the first line all the way to the end. Thank you for sharing. Is it wrong that I wish you HADN'T edited for the gentler readers out there?

Date: 2011-10-25 05:29 pm (UTC)
From: [identity profile] basric.livejournal.com
If I hang around there will be ones with warnings. It's hard to write sometimes because I write it first like I think in the Lingo we speak so I have to decipher that. And what takes seconds to happen takes paragraphs to write so that is part of the editing also. And no, I take it as a compliment you would like to have the unedited version. Thanks for reading and the kind compliment.

Date: 2011-10-25 05:23 pm (UTC)
From: [identity profile] ariesathena.livejournal.com
Wow. This is an amazing, frightening story. I honestly applaud your restraint because I would have had a very hard time resisting the urge to smack that woman. And I don't think you don't have feelings! Personally if I were ever in a trauma situation, I would much rather my nurses be working to keep me alive than praying for me.

Date: 2011-10-25 05:31 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks for the kind words. Appreciate your taking time to comment.
Edited Date: 2011-10-25 05:32 pm (UTC)

Date: 2011-10-25 06:19 pm (UTC)
From: [identity profile] roadnotes.livejournal.com
And you start this season off with an amazing post, putting us right into the scene, with energy and emotion. I look forward to what your future entries will be like.

Date: 2011-10-26 08:55 pm (UTC)
From: [identity profile] basric.livejournal.com
You are very kind, thank you.

Date: 2011-10-25 07:39 pm (UTC)
From: [identity profile] sipman.livejournal.com
So good to be reading you again!! Super well done bb

Date: 2011-10-25 08:38 pm (UTC)
From: [identity profile] basric.livejournal.com
You are so kind as usual.

Date: 2011-10-25 08:28 pm (UTC)
From: [identity profile] zeitgeistic.livejournal.com
Oh my! You're certainly more patient than I would have been.

Date: 2011-10-25 08:36 pm (UTC)
From: [identity profile] basric.livejournal.com
Patience comes with time. For myself at least.

Date: 2011-10-25 08:50 pm (UTC)
From: [identity profile] locknkey.livejournal.com
As awlays I find your writing draws me in and engages me. <3

Date: 2011-10-26 08:56 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks, Appreciate the comment.

Date: 2011-10-25 10:29 pm (UTC)
From: [identity profile] majesticarky.livejournal.com
Whoa so intense! I'm so happy you're here another season with your ER stories. They always fascinate me so much!

Date: 2011-10-26 12:33 am (UTC)
From: [identity profile] basric.livejournal.com
You are very kind. Thanks for commenting

Date: 2011-10-25 10:30 pm (UTC)
From: [identity profile] lawchicky.livejournal.com
Actually, if you're in trauma, there's a 100% chance you will die, just like everyone else.

;)

Date: 2011-10-25 11:40 pm (UTC)
From: [identity profile] basric.livejournal.com
Not 100% chance, we save two out of three so its around 33%. 100% would mean everyone dies.But thanks for the comment.

(no subject)

From: [identity profile] lawchicky.livejournal.com - Date: 2011-10-26 12:03 am (UTC) - Expand

(no subject)

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Date: 2011-10-25 11:08 pm (UTC)
From: [identity profile] achromaticlight.livejournal.com
Wow, what a great entry. I applaud what you do and your rationality.

Date: 2011-10-25 11:36 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks so much for reading and taking time to comment.

Date: 2011-10-26 12:16 am (UTC)
From: [identity profile] n3m3sis42.livejournal.com
Ohhhh, Tara. Here in the South, we'd say "Bless her heart." Sounds sweet but it really means we're shaking our heads.

Great story!

Date: 2011-10-26 12:35 am (UTC)
From: [identity profile] basric.livejournal.com
You're right. Thanks
Edited Date: 2011-10-26 08:58 pm (UTC)

Date: 2011-10-26 12:35 am (UTC)
From: [identity profile] imagemirror.livejournal.com
extremely vivid fascinating look into your world well done looking forward to your future posts

Date: 2011-10-26 12:37 am (UTC)
From: [identity profile] basric.livejournal.com
You are very kind, thank you.

Date: 2011-10-26 02:09 am (UTC)
From: [identity profile] wolfden.livejournal.com
I think I could not work trauma. I also think I would have been arrested dealing with Tara. You do a great job telling this story.

Date: 2011-10-26 02:38 am (UTC)
From: [identity profile] basric.livejournal.com
You are very kind, thank you.
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