The most memorable moment for me in the emergency department was unfortunately not a happy one and it haunts me to this day. In fact I avoided writing this for awhile as I just didn’t want to. But it’s a story that needs to be told. Over and over. Because I don’t sweep bad stuff under the rug. I broadcast it.
I was in triage. The panic alarm went off, which meant something was happening with the psychiatric patients. I work in mental health now. I love it. However, it was the reason I left the emergency department. In the ED it’s containment, not treatment. It’s dangerous. I had been kicked in the ribs already, and had friends punched and kicked and bitten. But nothing could have prepared me for that night.
I turned the corner and two nurses who I knew very well, one of them who I had helped train, were bleeding, screaming, crying, in the hallway outside a psychiatric patient’s room. They had been horribly physically assaulted.
I worked in pediatric emergency, but a pediatric patient can still be over two hundred pounds and over 6 ft tall. There were too many people watching, patients, families, staff. I grabbed them and put them in a big walk in closet near by with an Attending who was trying to comfort and assess them.
Then I called a nurse manager I knew was in the office, I told her to go to the ortho closet now. She did. They thanked me later for doing that. Getting them out of the craziness and into a closet. It felt wrong to shove them in there so I was grateful later to learn that they appreciated it.
With my heart pumping I walked into the room of the patient. There were about six security guards holding the patient down. The patient was still straining and fighting. There was blood on the faces of at least two security guards. One had his glasses broken and hanging off his face. These were all people I had worked with for over five years.
With tears brimming in my eyes I used gauze to dab at the blood so it wouldn’t drip down their faces onto the patient. I tried with all my might to ignore the clumps of hair and scalp on the floor from my friends now in the ortho closet. There was blood spatter on the walls.
The worst part. The ultimate horror of that night was seeing the fear in my all of my co-worker’s eyes. Fear and anger and hurt and knowing there was not a damn thing we could do about it.
The patient was under eighteen. And with documented mental health diagnoses. No one would press charges against them. We had been down this road before. This horrific crime that left two nurses injured for months with neck injuries from being thrown around the room by their hair, punched in the neck, and more…it would go unpunished. Forever.
All the nurses that were there that night; we all quit within six months.
It was too brutal. Too real. Too fucked up for us to forgive and forget and brush under the rug. It also showed how the hospital would never have our backs if assaulted in the line of duty. It showed how the system just lets that go.
I can tell you the patient was in their right mind. Not psychotic. I can tell you that though every single person who worked in our department wanted revenge we swallowed our rage and took excellent care of that patient for the next week they were in our department waiting for an inpatient bed.
I never had to wipe the blood off my co-workers before, and while I have unfortunately, had to do it again during my career in inpatient psychiatry it was never quite so traumatizing as that night in the ED.
I returned to work the next day. There was another nurse standing outside the ambulance bay doors. Just standing there staring. She had been there with me last night. We stood there together for several minutes. Not talking. Building up the courage to swipe our badges to go inside. We never spoke. We didn’t need to. Eventually she swiped her badge. We went inside.
I realized in the days following that it reached a point where I was scared to go to work. Every time I heard the panic button I saw the image of them sitting screaming and bleeding. We were all more cautious, more jittery, more likely to give a PRN (as needed medication) for agitation much faster than we ever had before.
Eventually they came back to work and I was incredibly awed by their strength and bravery. Balls of steel was my actual thought. I don’t think I could have done it. Come back from that.
It shouldn’t be this way. Nurses should not be assaulted/attacked/abused. But we are. On a daily basis.
That day should not be my most memorable. I have fantastic memories of so many funny times and good friends and good talks and pranks on night shift and moments of absolute teamwork that can only be done in an acute care setting. Moments when everyone comes together like a well oiled machine to save the lives of children who were dying. Those moments were breathtaking.
I remember when I was new in inpatient psychiatry. There was a medical emergency. I yelled out what I needed and held my hands out and waited…and nothing. I looked up and there were psychiatric nurses staring back at me like I was nuts. I realized then I missed the ED. I wouldn’t have even had to speak in the ED. We all just would have done our thing. It’s a security blanket I didn’t realize I had until it was gone.
Yet the night I remember most wasn’t saving a life. It was watching lives being shattered. Watching my co-workers and friends broken with their blood on my hands. Literally.
When you ask some one what’s the craziest thing they’ve seen as a nurse. They won’t tell you these traumatic memories. But it’s what we are thinking.
I didn’t leave the emergency department because I didn’t love it. I did. I didn’t leave it because I even wanted to. I would have stayed forever. But not after that night. That night changed something inside of me. Changed my perspective of nursing and how our society treats nurses. That night broke me a little.
To all my fellow emergency department nurses out there. I see you. I know you. I value you. You are epic.