Front Row

We all know that the economy has gone to sh**, sadly those of us in healthcare have gotten a front row seat in the impact this has had on our communities.

In the last couple months our SI\SA (suicide ideation,suicide attempts) have drastically increased. Before we would get people "attempting" suicide more for attention getting behavior than from depression. Now on average I deal with 2-3 true attempts a shift. These are patients that by shear luck someone has found them and called 911.

The despair these patients and their families find themselves in I cant even imagine. The sad story is that time and time again there are children involved, so not only have they been helplessly watching their parents struggling to make ends meet but now have to deal with fact that their parent choose the easier answer of death than the harder fight of staying with them and protecting them albeit with a less flashy lifestyle.

While I fight to keep these families together, I cross the hall and walk into another patient's room and advocate for the destruction of another.. The DV (domestic violence) rates are shooting up. Patients ,in particular women are showing up in droves with injuries that only a closed fist or boot could make. They come in with their bogus stories and babies that look at me with timid faces telling me about their Mommy's "ouchie". My heart breaks for these children stuck in almost a lose lose situation.. Stay in the current situation and watch the abuse and become a victim of it as well, or have mommy leave and end up on the street or living in the car because so many shelters are full right now.

I wish I had a solution... I pray the President does as I see only things getting worse as my community looks down the barrel at the upcoming layoff planned for the end of this month at our local major employer.

Very Classy

Just when I thought I had seen it all... Woman comes to the ER after her husband is brought in by medics for suicide. He is being kept alive (he arrived brain dead due to trauma) for possible organ donation and until she can be located. She comes running into the ER hysterical.... with boyfriend in tow!!

Final Answer...

"The crime of suicide lies rather in its disregard for the feelings of those whom we leave behind."
E. M. Forster quotes (English Novelist and Essayist, 1879-1970)

My ER beds have been filled the last several weeks with lost and desperate souls. We have never seen so many genuine attempts at suicide, that if not been found by someone would have been successful.

Working in the ER we get alot of pseudo suicide attempts. In actuality they are attention getting stunts, Lonely Laura takes a bottle of pills and then immediately calls 911, resulting in getting her stomach pumped and a consult with our emergency social worker(ESW), or Dumped Dan who cuts his wrist then calls his EX to tell her what "she " has caused him to do, resulting in police bringing him in, after tazing him, for sutures and a consult with a ESW. Each case causing family and friends to rush to the ER and giving the patient what they wanted=Attention.

These patients are very frustrating to deal with. They typically are very emotional, dramatic and manipulative. They treat their loved ones horribly and hold them fully responsible for their own self harm. They put their families thru these emotional rollercoasters time and time again.

They bring out the worst in us nurses.. resulting in us wanting to tell them how to do it right next time. But sometimes they figure it out on their own.....

This last week we had a 30yo paraplegic hang himself with the machine used to lift him out of bed leaving his wife and children behind; an elderly man who placed a hose from his car exhaust to his passenger window after losing his wife, a loaded gun was found at his side; a 50yo man who took a massive OD of pills and alcohol because he faced foreclosure on his house due to an injury keeping him from working; a mid 40's male who ran into traffic on the freeway after fighting with his wife; a 30s male hung himself when faced with an extended prison sentence; a 50 yo woman distraught over a relationship ending slit her wrist in front of her daughter, a 14 yo girl in teenage turmoil took everything in her parents medication cabinet, and finally a 12yo boy with a long history of mental/emotional problems in his short years, mixed alcohol and his psych meds. (These were just my night shifts, there were several more on the other shifts.)

These cases take a toll on ER staff for different reasons.. When they come in it is a fight to save a life they no longer wish to live. When the patient is "successful" the families are hit with the shock of it, then grief, anger, confusion, and guilt... I watch them go thru it before my eyes and I struggle to find the right words to console them.. Families flood us with Whys? and How could they?... The answers elude us.. Forever locked in their loved one.

I will never understand the dark place these patients find themselves, where there is no other solution or person to turn to.. But I hope I am able to prick a hole in that darkness by showing them I cared enough to fight the fight to make them "Failures".