Friday, August 17, 2007

an abusive relationship

i had a patient the other day come in after being assaulted by her boyfriend. she was very beautiful and young enough to get any guy but old enough to know better. when i asked about the frequency of like occurences she only laughed and said "oh yeah, this has happened before. i was married once, i guess i really know how to pick 'em." i was floored for two reasons. one, it's never ok for someone to abuse you, mentally or physically. and being married is not an excuse. the second was because after being hit the first time she should have known to walk away. apparently to some people love conquers all. we ended up calling P.D. (we're legally bound to report abuse cases) and she ended up refusing to make a statement. i wasn't surprised.
the funny thing is, i was at work the other day when someone (a nurse) said that working in the ER is like being in an abusive relationship. i laughed at the time but now i realize she couldn't be more right. let me break it down for you. 12 1/2 hours on your feet isn't easy. somedays we get to sit down, some days we spend 12 hours on our feet and the only time we sit down is to use the restroom. some days we get a lunch, some days we don't. patients are irritable, doctors are sassy and nurses back talk and talk about people behind their back. but there are days when everything goes right. or a patient says thank you and means it. or you save someone's life and you know you kicked butt. or a doctor isn't sassy and nurses get along. when it's good, it's really good. and you forget about the bad times because you love your job. you go back because it's the drive to save someone's life that fuels you. you know the rush you get when you hear a code blue called overhead. you want to be in the room, pushing drugs, starting an IV, doing chest compressions, hanging drips and titrating to get results....all to hear the words "we've got a pulse". you forget about your feet hurting and your hungry stomach. you don't think about how tired you are physically and mentally after a 12 hour shift of pure chaos because you think maybe tomorrow will be different. and you go back again and again. the ER apologies with thank you's from patients, homemade food from co-workers, and if you're lucky a slow night. and you forgive it and you go back.
this is the relationship i'm in. but i love it and to me, that's enough.
i watched a patient die today. he was young, 50-something with an extensive history. he didn't look bad, like the normal overweight, short-of-breath man we usually get. he was having chest pain and his family found him slumped over. he'd been down for an hour before they found him. we worked him for about 45 minutes and then pronounced him dead at 3:30am. his daughter and wife cried loudly at the bedside after we'd called it, screaming and yelling at the patient who'd just passed. it wasn't in english so didn't understand but all i could imagine was her saying "why didn't you tell me you felt sick" or "why did you leave me?" it made me so sad.
my abusive relationship with the ER today was bad. i am beaten and broken and i am in bad need of rest. but i will go back for more on sunday because this is who i am and what i do.

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