By Ashley Newson

As a senior trauma nurse, I felt I had built up quite the wall. I had dealt with hundreds of traumas and many awful situations, and I could hold my tongue and my tears through all of them. Pediatric traumas are always more difficult - many of my coworkers do their best to avoid them. Pediatric traumas come with many more layers and typically much more emotion.

On an early December day, my pager went off -- it was a fifteen-year-old hanging, and we had a few moments to prepare before the team arrived. The patient was in custody at the juvenile detention center and was found after an unknown amount of time. Typically, these outcomes are grim and we felt we should let the family know so they could see the young girl before she passed. When the mother was contacted, her statement to us was, "If she makes it until her birthday (January 21st), I'll come to visit." I could not believe how cold she was -- being a new mom to a little girl, I could not imagine treating her like that.

A small crack started to form in my wall.

From One Tragedy To The Next

Before I could dwell too much on the sadness I was feeling for the lost little girl, my pager went off again. This time it was a young man with a knife wound he sustained while protecting his mom from her boyfriend. He was bleeding from the abdomen and presented with stable vital signs.



The young boy was calm and recounted the entire situation to the police at the bedside. The investigators wanted his statement in case he did not survive his injuries, which were a splenetic laceration with bowel involvement. His FAST was positive and he needed to go to surgery. We packed him up and sent him to the operating room, my eyes welling up as he was rolled out.

The crack got bigger.

The Breaking Point

When the next page came in, I had just finished lunch and a FaceTime session with my daughter and our nanny. It was a head-on collision involving two small children and one fatality.



The two little girls rolled in -- one was three years old and the other was only five days old. I was primary for the three-year-old, which meant I was responsible for carrying out the orders. My hands shook and my heart raced. The left side of her face was badly bruised and her eye was completely swollen shut. I started an IV, drew blood, and prepared her for a CT Scan. While we were in the scanner, I held her hand the entire time. Her biggest concern was her little sister and her mom.



When we returned to the trauma bay after scanning, the paramedics were there. The paramedics began to describe the scene, both babies in the back seat and mom in the front, decapitated.

Not knowing if the little girl had witnessed this, my wall crumbled.

While waiting for results, I bathed the little girl; she smelled of gasoline and had shards of glass in her beautiful brown hair. I lay next to her, held her hand, and prayed for her. The worst part was that we had no idea how to get in touch with any of the remaining family members. The police had been attempting to find the father of the two girls when their grandmother finally arrived.

Related: Must-Know Tips To Stay Emotionally Healthy As A Nurse

Dealing With The Aftermath

Both girls had small head bleeds and would be watched in the PICU overnight. I escorted them up, and the rest of the day was a blur.



I was broken up over these girls. What would their lives be like in the near and distant future? I decided to make something positive for them. I went to the store after my shift and bought Christmas gifts for them. Then I spoke to all the other nurses who had been in the trauma unit that day, and they bought gifts as well. I became obsessed with these girls. I Facebook stalked their mother. I was not sleeping, I cried constantly, and I felt helpless. I had severe PTSD.

People typically only associate PTSD with the victims of accidents, but we forget the impact these events have on first responders and hospital staff. I was able to recognize my symptoms and had the resources to talk to a skilled professional.



With events like Sandy Hook and the Joplin tornado, more and more first responders are dealing with massive depression. These types of reactions need to be brought into everyday conversation and recognized as a real issue in high acuity situations and professions. It's in the interest of everyone's well-being and mental health.



That day made me step back from emergency nursing. I am currently working in the PACU and feel it was the best decision in the interest of my mental stability.

Being aware of your own mental health and emotional limitations is key to surviving within the nursing profession. Talk to each other, be supportive, and always understand that if you don't take care of yourself, you are significantly less effective and less present for your patients who truly need you to be at your best.

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