A father comes running into the waiting room with a limp body that is obviously struggling to breath. Those crowding the waiting room observe the pair almost baffled and confused as they recognize an "emergency" but have little idea of what is happening. It is you they all turn to. You are the one who has the training, the license, and that coveted identification badge that suddenly feels much like an anvil dangling from your chest.
The situation is bad. Children compensate well then crash fast. This child is already having mental status changes, is covered in sweat, and his oxygenation reads 75% instead of the comfortable 95-100%. Your heart is in your throat as you gather information and do your best to prioritize the most important questions. Airway obstruction, underlying medical problems, allergies...nursing school doesn't prepare you for these things. Your mind attempts treason as it melts into a confusing state of figuring out what to do next. "A, B, C's" you were always taught. Give that kid some oxygen...but if the airways are constricted what good will it do?
You rush the child back to a room, call for a doctor and a colleague to pull the appropriate medications, and begin preparing to treat this precious little life. The work this little body is doing to breathe is heartbreaking to watch, but your job is to get past the emotions. Those thoughts "what a cute little guy", "He has such beautiful blue eyes and long eyelashes", "Look at his dump truck pj's and sponge-bob slippers"-all of those thoughts are on lock-down. Your mind is in a sort of "skin/body/human" mode where all you can see is the physical and attempt to preserve or prolong the life in front of you. You consider the size of the body for adjustments to treatment, but struggle to not remind yourself "don't screw up-he's just a kid and has a lot of life left!"I have experienced scenarios very similar to this and they have gone many different ways. My most recent was excellent. As the patient was placed in the room, my team descended on him and worked together to correct the problem. The outcome was positive and the little guy recovered well.
When finding out I work in the ER, people frequently react in a combined horror/awe with the obvious "what is the craziest thing you have seen?" It certainly is a crazy place to work and the perfect place for an adrenaline junkie. There is constant stimulation and challenges and you must learn to work with others, be sharp with details, and think on your toes. To me it is a constant reminder of how precious life is and how briefly it lasts. Some shifts make me want to run to the airport and jump on a flight to Missouri in order to give my family one more hug. We all do it. We disagree or get annoyed with those we love. Just remember the next time you get impatient with them-some people don't get that chance anymore. Love those you are blessed to share this journey of life with, especially those whom you
