A Note on CPR ***Triggering re- CPR and death.

I don’t watch football. It irks me for many reasons. 1- Doctors and nurses save lives every day and we will never make millions of dollars per shift. While I do not fault pro players for working hard and pursuing something incredibly difficult, I do no think it is worth the millions they are paid. 2- When I see people riding motorcycles without helmets I have a visceral response because I think wow. You just want to die don’t you? And/or you are a complete idiot. Playing football…sort of the same reaction. I worked in a pedi-ED for 7 years and the worst injuries were football, hockey, and skiing/snowboarding, and the surprising fourth place would be cheerleading. These were kids. Sustaining serious injuries. The fact that we KNOW that long term head injuries causes chronic traumatic encephalopathy and yet people still PAY to see these men literally cause brain damage to themselves…well it’s sick and fucking twisted in my opinion.

So when I heard about a football player falling down cold and requiring CPR mid-field and the subsequent fallout. I’ve had a lot of feelings about that. I think people having the most feelings are people who have performed CPR. You can’t see me, but I’m raising my hand. I’m that person. I’ve performed CPR. And honestly, I lost count of how many times I have done it.

The feelings I’ve seen from my fellow critical care healthcare providers on social media are a mix of things including but not limited to: we are not paid enough for what we do and it’s ironic that the million dollar employees on that football field had no ability to save their teammate and it was the 20$/hour EMT’s who saved him. The NFL and the world has taken a pause after being traumatized by watching CPR performed. There is acknowledgement that watching and performing CPR is traumatic. I can tell you, of the several times I performed CPR or rescue breaths I never got a break afterward. In fact I would be reprimanded if I tried to take one because “Everyone is feeling it and they are all back covering patients. Pull it together.” Was said to me when I was found crying in the med room after the unsuccessful resuscitation of an 11 year old. Unsuccessful resuscitation sounds too pretty though. This is what really happened.

I straddled a kid and pushed in and out on his chest with sweat pouring off of me, no gloves, no mask, no idea why he was here, he was carried in by screaming parents and me and another nurse threw him on the stretcher. She started breaths. I started compressions. She and I passed glances as the rest of the team surrounded the bed. I could feel his ribs bend under my hands, and I had to keep a fast pace. It was the end of night shift and we were all fucking beat. We were also short staffed. I also had three patients who were freaking ill that I knew needed me but here I was. Pushing on a chest praying this heart would start. But there’s a particular smell of a dead body. You learn it after working critical care. We all knew it. We all smelled it. He wasn’t long dead, and young enough we may get a heartbeat back, but he was gone. The heart beat would be so the parents could have time to wrap their minds around organ donation and brain death. I knew it. The nurse at the head knew it. The doc knew it. But there I sat. Pushing on his ribs, hearing the parents scream and cry, and after fifteen minutes, three rounds of epinephrine the doc called it. You ever hear parents when a doc calls their kid dead? It’s about as awful as you can possibly imagine. There was a thud as the Dad fell to the floor. The mom keened a sound like a horribly wounded and dying animal. And I slowly climbed down trying not to look at the kid because I knew I had three more waiting for me outside the door.

I wiped a stray tear and walked past the dead child and the grief stricken parents. I walked into a room with a kid with pneumonia. I looked at her chest. Rolled my eyes and said “Fuck.”

Grabbed the bag and started pushing air into her lungs. She was on the monitor but for some reason it didn’t pick up that she wasn’t breathing. Her oxygen level was still perfect so it must have just happened. She was warm and pink, but definitely not breathing. The doc walked by saw me bagging and said “Oh!” and helped me roll them into our resuscitation room. I bagged her until she was intubated and brought up to the ICU. Then I went to try and give report to the day shift nurse who was pissed I hadn’t hung the antibiotics for the other patient.

I could barely even speak. I remember just rubbing my head and saying I’m sorry and going to get the antibiotics and hanging them and going home. That night was Christmas Eve.

I went to my family’s traditional get together and pasted on a happy face and pretended I hadn’t had a horrendous shift that involved CPR.

So you see. That was one time. One time out of many. Healthcare professionals are not given the support, the time, the space, or any ability to not be traumatized doing our work. I didn’t get a bonus when I saved people’s lives. In fact my clinical skills had absolutely no bearing on my raise each year. It was based on patient reviews and emergency department numbers and benchmarks. So if anything comes from this very public display of CPR I hope it’s 1- Respect for the goddamn skill that critical care healthcare workers possess. Because I’ll say it- we are a fucked up little bunch of people- but damn we know how to save lives. 2- Acknowledge that football is fucked up. 3- Healthcare providers NEED and should be REQUIRED to have access to the time, space, and resources to heal after a traumatic work event which SHOULD include any and every time we perform CPR.

To any Healthcare Providers reading this- for your own knowledge- after I left the ED I saw a therapist for about two years and did a lot of EMDR therapy with him. It changed my life and allowed me to heal from all the trauma of the ED. Our focus was on my memories from working in the emergency department as those were quite traumatic for me, but I did not even realize it until after I left how messed up I was. When you are functioning in chaos it’s hard to see how heavy it is until you are out of it. Exposure therapy and I think any kind of therapy can be scary for critical care workers- I know we are a tight little bunch who don’t trust outsiders to be able to hold our shit. Because it’s heavy. But I promise you there are mental health providers out there (Myself included!) who treat first responders and are not intimidated by our shit. Do not let yourself go untreated because you think we can’t handle it. We can. Hospitals will never prioritize your mental health- you’re going to have to take the steps on your own. And for that I am sorry. I am sorry we work within systems designed to demoralize us. But I see you, and I appreciate you, because I am you.