I'd be interested in knowing other stories about the worst encounter other ER nurses have had. Whether it was a critical patient, trauma patient, staff encounter - what made you lose sleep?
I was the ICU Charge Nurse on 11-7. When multiple multi-traumas came into the ER, I naturally mosey'd down to the department to see what was going on and to lend a hand if I could. A family on their way home from sabbath was walking down a pooly lit street when they were hit by a drunk driver. The mother had her leg separated from the torso at the hip. DOA. The father had a broken arm and head trauma but was GCS15. The kid was OK.
When we were transporting the father over to the units, he kept asking about his wife. To this day, I regret not taking the father into the room where her remains were so he could say farewell to his wife. It was really a horrible tragedy.
Since I started this thread, I thought I should put my worst situations down.
15 month old comes in, in full arrest. Has been in asystole for approx 30 min. Pupils fix and dialated. We managed to get a pulse back, baby pinked up. We don't have Pedi ICU so we had to transport to bigger hospital. We waited 1.5 hours for transport team due to snow storm. Just before transport team arrived, baby begins to bleed from every place we stuck her, from her ET tube and from nearly every oriface. Looks like DIC. Anyway, it was horrible to watch this baby bleeding out before our eyes. The parents were horrified and there was little we could do. We kept her going somehow, transport team arrived - we heard she died several hours later. Mother was a nurse at our hospital. The vision of this baby haunts me still.
Second worst, happend a few days ago. 37 y/o female came in in full arrest, asystolic. We did everything we could, but she remained in asystole. After calling the code, her BF and father of 2 of her children came into room with 1 y/o baby. Baby sat in stroller, cheerfully playing while mother lay dead a few feet away. Obviously, I know the baby had no idea, it was just a haunting thing to see. When patients 11 & 15 y/o girls arrived, it was horrible to see their grief. The worst part was when 11 y/o asked me "Will my mom ever come back?" I just started to cry. Those are my two worst. I guess you had to be there for the emotions.
I have never been an er nurse but was a patient after a motorcycle accident. I actually had such faith in the er people that I felt I could go to sleep and they would not let me die. except they wouldn't let me sleep. there was a midget in there kept pulling on my legs to put them in traction, I had the pleasure of seeing this man do cpr with one hand( he was on the ambulance team ) that responded when I was working as an LPN years later. I don't think that I have ever thanked them. also the ambulance people that picked me up off of the roadside helped save my life. There happened to be some one on the ambulance that wouldn't take no for an answer when the hospital was trying to reroute them. I am not sure if I would have survived if I had been taken to the country hospital that was closer. While I am at it the therapist at the rehab center were also unbelievable. How they went out of their way for the patients, not just for therapy but they recognised the psychological aspects of rehab and came in on their days off or took us out to eat. They all helped to inspire me to become a nurse. As I was laying in bed with both legs in skeletal tx I told the student nurse " I am going to become a nurse" she just smiled I don't think she realised how serious I was. Looking back makes me see how lucky I am to be alive. I did my clinicals at this hospital and went and pulled my records the first page read as " Pt. is aware of the great possiblity of losing the right leg on the operating table" no, I was not aware and glad of it. second line " Pt. is aware of the great possibility of death occuring on the operating table" no again. until I read this I didn't appreciate how close I was to death. well I didn't mean to bore you, but all you er nurses just realise that we are grateful.
One of the first worsts that pops into mind is when EMS handed me a dead ~14-month old. It was pallid and waxy and there were these shallow abrasions all over that weren't red, which we realized later were postmortem rat bites. Rigor had begun to set in; it was as if the paramedic had handed me a CPR mannikin. I just stood there and wept; there was nothing to do. Stepdad made an appearance briefly, acting weird--more scared than distraught. After he'd been out of the room for awhile, a police officer came in and told us he'd confessed to smothering the baby with a pillow because he wouldn't stop crying.
Another more recent incident; not quite a worst, but memorable nonetheless: I was working the flight line at New Orleans Int'l Airport, pulling patients and evacuees off helicopters and taking them into a holding area. I was wheeling one little wheelchair-bound lady down the tarmac when I stopped and turned to talk to another nurse on my team. Idiot that I was, I neglected to lock the w/c AND took my hands off the handles, so that when the Blackhawk that was about 30 feet away took off, she went rattling across the pavement. The horrible thing was that, besides scaring her half to death, her foot had gotten caught behind one of the front wheels and abraded about half her big toenail off. She was crying with pain and fear, and I felt like the worst nurse in the history of the profession. It was my ignorance and carelessness that did that to her. At that point in time, the holding area we were putting patients into was way beyond capacity, and we were able to offer only comfort measures if anything at all. I explained the situation to a nurse from another DMAT and he apparently took pity on both of us. Later I saw her in her w/c munching on an MRE with her foot bandaged fit to beat the band. I told her again how sorry I was, but thankfully she didn't seem to recognize me.
I'm glad I don't have any horrible stories like that. J4m13, I wouldn't feel bad about that. At least you were there helping in the situation. I can't imagine...
I do have a story though, that I'm going to tell because it is horrifying and it was on the local news as it happened last night.
We had a HUGE dust storm in Enid, OK yesterday. A cold front moved in and we had at least 20-30 mph winds all day with higher gusts. Since it hadn't rained and people are plowing/discing/whatever, there was a lot of dust.
Two women were on the highway driving and one hit the other. It was nearly zero visibility due to the dust. The women got out and walked up to each other to make sure each was okay (I guess) and right then another car hit them both, sending them flying into the ditch on the right shoulder. Shortly after that, a semi came up and swerved onto the shoulder (correctly) to avoid hitting the three cars. He ran over the two women who were lying in the ditch, still alive at the time.
Can you imagine? You can't see jack, you have a wreck, dazed, you get out to see if the other car is okay....everything is fine...BOOM you both fly into the ditch. You're laying there in shock, but happy to STILL be alive and then you get run over by a semi truck...
Helicopter brings in a 72 yr old lady found in her home bound, gagged and beaten to a pulp- so unrecognizable that one nurse didn't recognize her as his great Aunt, and worked on her for quite a while until we established ehr identity. That was a lot of disturbing...both the thought of hurting a little elderly woman, and the realization that she was hurt beyond recognition.
Second: One day i was in Charge and at shift change I heard this woman screaming "help me" repeatedly in the trauma room. It was disturbing shift change, so I thought I'd pop in and calm the lady down. When I got there, I started to talk to her- thinking she looked pretty ok and was very alert. They she raised up one hand to grab mine and I saw she had absoloutely no skin on the back side of her arm...nothing, shredded to the bone. her entire body was like that. She had tried to jump from a moving car, but got her foot stuck in seat belt and been dragged for some time before police could get the driver to stop. It was really just so horrible, she was in agony- there was barely enough flesh to anchor an IV well (she of course eventually got the central line...she died several days later in our burn unit. None of could really bring ourselves to talk about it, but at the same time, we all found we were thinking about that one for weeks....
Ive been an ER nurse for 13 years now. I could share many "war stories" that kept in a state of PTSD for days at a time. But now what wreaks the msot havoc with me is an understaffed ER where a charge nurse had to take an assignment, EMS stretchers lining the hallways, 30 people in triage for hours and the local medical command phone rining to let us know that there has been a multiple explosion situation with many casualties heading our way.... and not one administrator in sight. This was it for me. I have found this sight and am heavily scouring the nurse entrepreneurship section.
4 years ago' a 15 years old girl was shot by a terrorist when she got out from school. he waits there and she was the first to go out! the school was very closed to the hospital but she lost too much blood and arrive too late/ I canot forget her face and I cannot forget her mother.
re:worst situation encountered. Working in the resuscitation room on a night shift, a 36y/o female brought in with PV bleed, post birth three days previously. On arrival, the pt. was bleeding out. Fluids, FFPs gelo being pumped through but BP dropping, tachcardic. Transfused, but continued bleeding out. Finally brought to theatre, still bleeding+++. Husband in attendence the whole time.
I work now in a very small out of the way hospital. I have in the past worked many places PICU,ICU,ER, Flown rotor and fixed, military corpsman. I have been doing this since 1988 and I have seen many things, however just this year in this small ER that I have found myself calming down, we had a psych. pt. steal an ambulance. We had a nice little discusion prior to him acquiring the ambulance that left him with a swollen face and me jumping from the moving rig. I have found in my seasoned time this to be the better choice. I was highly concerned with him in the hands of a large motorized rig. To make it short...Police enter the scene and chase him down the highway,after the police take out the tires he is pulled from the ambulance, by the way he has loud country music playing. He is calm with the police that take him into custody, they call later to ask if it would hurt someone if they ate their own feces...yes thats right, he ate it.
If other people were to read these posts they would think we were all lying or crazy!! Here goes my contribution...ER bursting at the seams. Hallway pts everywhere. I have a septic pt with a pressure in the 80's that I am slamming fluids in & starting pressors. Then, someone tells me that the 8 month pregnant lady in one of my other rooms just "fell out" and lost a pulse. We did an emergent C-section while the mother was in cardiac arrest. I have never been so scared in my life!!! No family with the woman. No prenatal care. The NICU nurses come flying in with baby warmers like the keystone cops. Meanwhile, we are on the phone with an ex-sister in law trying to find family. It was horrible! THe baby lived. Mom has an anoxic brain injury. Did I mention that her mother brought in her other 2 children to the ER. Both were under the age of 5!!! SAD!!!
Hi I'm new here, I'm still a student but do a lot of time in our ED and my worst situation has been, during our floods early this year a woman who was trying to cross a bridge which was flooded, she had her 3 year old daughter in the car with her and she was 20 weeks pregnant, the car got swept into the river, she managed to get her and her daughter out and got her daughter to a bank on the side, as she was putting her down the mother got swept away down the river and was eventually found a couple of hours later stuck up against a tree, she came in with multiple lacerations, pelvic fractures, hypothermia, and due to the pelvic injuries she misscarried later that night, her daughter they think jumped in after her because they couldnt find her on the scene, and searched for hours and eventually found her hours later and as we were moving the mother to ICU, the little girl was brought in,but there was nothing we could do, rigor mortis had already set in. it was terrible and we couldnt tell the mother until the next day, imagine losing your child and unborn child at the same time.
The worst thing working in a Trauma center is knowing that one day you will see someone you will know. I was working the night shift when a call came in that we had a level one trauma self inflicted GSW to the head. I was assigned to take the patient upon arrival. Generally we have two nurses on a level 1 trauma and the primary nurse, myself, generally take report from the first responders. I was obtaining a report took all the vitals down, what happened, etc. When the time came for me to take a name and DOB. The name sounded really familliar to me. I turned and looked and it was a very good friend of mine that was just recently terminated from his job, lost his child in an automobile accident, recieved a divorce, etc. It had never hit me so hard before. I generally took care of the patient without really thinking about their life outside and the circumstances that lead to their injury. Ever since this time, I have learned to obtain as much information about my patients and have learned to become more attentive to their needs. I hope that I never have to see my family come in on my shift but these are chances we have to take working in a truama center.
I have been an ER nurse for quite sometime now. I get use to the daily death and destruction sort of . I work in a level 1 trauma center in tucson az. The other day however I encountered something I never have. The TFD and TPD brought in two children. The 2 year old boy although being DD is going to be fine the little girl 4 mo. old was 3.3 kg she had been tied down ankles and wrist, right ankle was crushed, multible bruises and had been starved, no startle reflex, and she just kept staring up at me so sweet and all I could do was let her eat and tell her she was safe and going to be alright now. They have not caught the parents yet as far as I know. When they do they better protect them from us...........David RN
It's hard to pick a "worst"......but the most recent was a 50 y/o fem that came by ambulance being paced after being alert and oriented at the scene and faded en route to us. I work a late evening shift usually with 2 inexperienced nurses on nights (a major recruitment issue). The simple version.....with 3 ER nurses, 1 ICU nurse, 2 floor nurses and the nursing supervisor I felt alone! No one else knew how to use the pacer pads; a floor nurse starting doing chest compressions on the patient who was looking up at us and moaning (obviously not needing compressions); no one knew what meds to get the doc for RSI........and the list goes on and on. I love the people I work with and I being relatively new (3 yrs) empathize with their lack of knowledge and hesitancy......just scary. We eventually stabilized the patient with her native rhythm and flew her to our sister hospital with a heart center. Tense situation!!
I was working nights in a very small hospital. OR is never operational 24/7. We have no trauma level. So it is 9-10pm and I responded to a code in OR. Now keep in mind it is like 10pm. What could they possibly be operating on? As I run to the code I pass multiple crying family. I enter the OR and see 2 incubators and crying newborns in them. On the OR table lay a lifeless mother. She had went into labor prematurely and they did a stat c-section. Dad was there all was well. She delivered the twins and after the second one cried, she crashed. It was an amniotic embolus. Nothing we did or could have done would bring her back. I was 22 with no children. I still have no children and when I think about having kids, her story sticks in my mind and I just don't know.......
I work in L&D, but one of the nurses at our small hospital had been trying to get pregnant. Had endured 6 invitros, paid for by her parents, and had decided to give it up and adopt when her parents talked her into one more try. She got pregnant with twins on try #7, but developed cardiomegaly during the pregnancy, and delivered the twins @ 34wks by C-section. Two, red headed boys, both did well, and left the NICU after a few weeks. But by the end of her pregnancy, her cardiac ejection fraction was only 25%. After the babies 3mo well child visit with their pediatrician, she and her husband went home, put the babies down, and took a nap together. Two hrs later, the husband could not awaken her, and called 911. They brought her to our ER, where they arrived coding her, and continued for several hours. Her cardiologist tried everything, couldn't get her back. When they finally called it, we had to practically shut down the whole hospital, we were all so disraught. I will never forget seeing her husband sitting on the floor holding both the babies, crying, while the code team tried to save her.
Hi i'm still in training and wil hopefully go into Trauma when I'm finished, but a colleague of mine told me a terrible story the other day, many years ago while working night shift in a trauma unit, a man walked into the unit at about 2am in the morning wearing a large coat, and he appeared to have a large bulge over his abdomen, he was taken to a cubicle by one of the RN's my colleague heard the RN swearing at the patient and went to investigate - the man - who was married to one of the RN's working in one of the other wards - was looking after thier 2 year old daughter and had attempted to have intercourse with her but her pubic bones locked on to him! and in the attempt to get her off him he broke her neck, they had to take him to theatre! so disgusting that anyone could do that to thier baby, and the mother who was a RN couldnt handle it at all and ended up being hospitalized in a psychiatric facility. I was shocked and disgusted when I heard that story.
ugh, I didn't even get halfway through the first page and I got weepy. I don't even have PMS! You E.R. nurses have to give yourself big credit, that's some very painful stuff that just scars itself into your soul. All nurses see awful things, DAILY, things that become the norm and desensitize us...this stuff is a whole new level. It really must change you in so many ways. Your really amazing
We were dispatched three counties over to a multiple victim 10-46(Wreck with Injury). Keep in mind, at the time all we heard is "Trauma patient" as regulations which are in place to keep pilots from getting hasty in their pre-flight checkoff's only permit dispatch to reveal to us "Trauma Patient" or "Medical Patient". Therefore, we must be in the air preparing for any problem that may arise until we hit the scene and LZ command gives us the scoop.
Upon landing at the scene, we witnessed a green neon, and a white cadillac looking vehicle(You couldnt necessarily tell because the car was crushed so bad). Anyways, as we are landing; we are blown away, to say the least; as we realize that what we thought was a piece of the car on the guard rail from above, turned out to be a 17 year old, impaled by it; with obvious signs of morbidity. The kinematics of how that boy went from the vehicle, about 20 feet away; to the guard rail, is beyond me. One trooper on the scene described it as a wrecklessly high amount of speed, coupled with intoxication and a slow motor response(of which I assume he was speaking of the effects on the brain, not on the car). This patient was deceased, no helping him--so once we touched the ground, and my partner hit tail watch(to keep bystanders from walking into the invisible rotor in back), we approached to find 3 other teenagers, the most severe of which having been ejected from the vehicle and showing postural abnormalities, pupils fixed, with signs of transtentorial herniation and or damage to the corpora quadrigemina(brain injury was my specialization area in Paramedic and Nursing School).
What scared me the most was the fact that the paramedic first on the scene stated that this individual was conscious and lucid, and now finding her in this state was a CLASSIC textbook case of epidural hematoma (as 22-50% of individuals with this presentation are suffering from just this etiology).
As my suspicions turn toward the middle meningeal artery, I cannot help but notice her CPP is changing, and cushing's triad is becoming more and more imminent as the brain stem struggles to regain control, not to mention the paralyzing thought of post-injury oxidative free radicals, the clock at this point was definately not our friend.
Given the urgency of the situation, we load the patient, having initiated two large bore lines, put some mannitol on board, administer a few other pharmacological regimens, and transport this patient to the receiving trauma center.
From being her nurse in the TICU, I can tell you; this girl was a fighter.(I work as a flight nurse and a TICU nurse, she was my patient in both capacities). She held on for almost 2 months, in a chronic vegetative state, and then as if to say "my work here is done", one night, a friend was visiting and had apologized for something, soon after she slipped out of this world.
I had always found it romantic, the notion that the world would stop when I depart it. However, the reality is far less sweet.
If we could light a candle on this Earth for every loved one that we lost, we would set this world on fire.
