Tuesday, May 22, 2012

Reflections from the Joplin Tornado

As I start this off, I want to make one thing perfectly clear please.  I’m not a “Hero”.  I never have been.  Please don’t call me that.  I’m a man that did what anyone else in my role and my skillset would have done.  @MurseWisdom is a Veteran that served in a war zone.  @MurseWisdom is a hero.  Both of my parents proudly served in the military.  They are heroes.  

Dr. Kevin Kikta is a hero.  He wrote a story called 45 seconds about his night in the ER that night.  It’s a chilling read.  http://statemagazine.org/?p=531

Dr. James Smith is a hero.  He was doing surgery when the tornado hit and ran over 7 miles home to check on his family.  http://www.outpatientsurgery.net/news/2011/05/24-Operating-Through-the-Tornado

The countless, unnamed nurses, RTs, Rad techs, and all the medical personnel that covered both hospitals that night and continued to staff them until everyone was taken care of are the heroes as well.
Please save that prestigious title for them … they deserve it.

With that being said, here we go.  I’ve debated the last few days what exactly I wanted to say. I figured I would say, what I felt, what I did.

It was 5:41 p.m. and it was 32 seconds that would forever change the lives of people that lived anywhere near Joplin, MO.  I was watching the coverage on The Weather Channel.  There was discussion that Joplin and possibly a hospital had taken a direct hit; however, I knew this to be true well before it was confirmed on the air.  Facebook literally blew up.  I knew that St. John’s had taken a direct hit because of Facebook.  But when the weather channel cut live to a Mike Bettes standing in front of what used to be the hospital; my heart sank.  “I have friends and classmates that work there” I thought and then Mike came on the air and pleaded for doctors, nurses, medical personnel to please come to Joplin.  http://www.youtube.com/watch?v=r8kg2dEJo_Y&feature=related

It was all I could take, myself and several other nurses loaded up to make the drive to Joplin not knowing what the hell we would find but knowing that we had to do something.  We arrived about 4 hours post touchdown and went to Memorial Hall where the medical triage was.  Upon arrival there, we found them fully staffed and they suggested we go to another secondary site.  We got there and waited about an hour before I finally was able to get through to the Red Cross.  They basically said that if we were already in Joplin that we should go to Freeman hospital.  

Driving to Freeman hospital was problematic to say the least as we had to drive past what was St. John’s hospital.  We were stopped 3 different times at three different roadblocks, one being right next to St. John’s hospital.  I do have to say that this was one of the most amazing experiences as a nurse.  The police officers stopped us, I said “We’re nurses” and they screamed “nurses” and opened the roadblocks for us.  Once we got to St. Johns we had to drive around the back of the hospital. Pictures will NEVER do this justice.  I’ve heard it described as what pictures of the atomic bomb in Hiroshima looked like and I’d have to agree.  It was complete and utter devastation.  People were wandering around aimlessly obviously in shock of what had happened and the place smelled of strong, strong natural gas.  We arrived at Freeman hospital finally and walked into the ER lobby.  It was one of most surreal scenes I’ve ever seen.  The lobby was literally overflowing with people and I would estimate approximately 1,000 people waiting to be seen.  I found a friend of mine that worked there and he said they were out of most every supply except gauze and gloves mostly so if we could do some basic first aid and try to find the most ill patients to be seen first.  We walked around and spoke with people, treated and cleaned bumps and bruises, and found severely injured people to pull back the moment ER beds opened up.  On the ambulance side of the ER they had a convoy of over 100 ambulances and they were literally loading people up and dispatching them to hospitals in a 200 mile radius.  There were buses loading up less severely injured people and transporting them as well. 
The looks on the faces of the people in the lobby is something I will never forgot.  It was disheartening seeing the look of pure shock at what had happened and trying to make sense of it all.  How could 32 seconds completely change their lives like that.  While we treated the bumps, bruises, and lacerations; we were not able to treat the mental issues that were filling that hospital and that town.  We stayed until about 4 am and then went home knowing that as much as we felt we did we probably didn’t do enough.  Little did I know at the time, but my ex’s brother was frantically searching for his daughter who was working at a local restaurant at the time.  Unfortunately, while they found her; her injuries were too severe to survive.  However, she died a hero as well.  She was working to keep customers and other employees calm before the tornado hit the establishment… she wasn’t even 18 yet.  

I’ve talked to employees from both hospitals and some still have trouble sleeping or still have mental issues relating to that 32 seconds.  

So there are a few things that I learned from this event: 1.  Social Networking is a must.  As I said, I knew that Joplin and St. John’s was hit long before it was announced.  Facebook was also a lifeline for people looking for loved ones at that time because if you couldn’t make a phone call you could send texts a little easier and a text to a loved one or facebook was a welcome sight for families.  2.  If you don’t know how to text – learn.  And teach your parents, grandparents, anyone with a cell phone to text.  To put it into perspective, I tried over 100 times to call the Red Cross that night.. I got through once.  Text messages were going after only a few times of trying to send.  3.  NO HOSPITAL IS PREPARED FOR A DISASTER OF THIS MAGNITUDE.  Freeman was out of supplies initially within a few hours.  Our hospitals are trained to keep supplies on hand for anticipated need.  Not for 1,000 people showing up in your lobby to be treated in a few hours.  I have disaster training and used to work in that field.  This last one scares me the most because I used to think our hospital is ready, but I think we would run through supplies in a matter of hours as well and then would have to get inventive like Freeman staff did.

However, Joplin doesn’t want to be known for that.  They want to be known for their drive to rebuild and they have done an amazing job.  It should be an inspiration for everyone of how to overcome adversity.


Sunday, May 20, 2012


So I mentioned in my post that I was a hypomaniac, which sounds funny but true. 
An ER doc one night said you are a hypomaniac and I laughed.. until I pulled up the DSM-IV criteria and met most if not all of them.  Anytime I walked in dragging ass he'd laugh and say you got too much sleep didn't you.  I truly function better on 4 hours of sleep than 8 hours of sleep.
So here are the DSM-IV criteria for hypomania:
DSM-IV-TR defines a hypomanic episode as including, over the course of at least four days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms:
Hypomania isn't a bad thing though usually.  Dr. John Gartner wrote a book about how hypomania actually is what drives America.   His book is called "The Hypomanic Edge" http://www.hypomanicedge.com/

There are advantages of hypomania as well:
For me personally, I've learned how to read people.  I've also learned the rules for work.  I was approached a few years ago and asked to take a semi-management position.... except I was told that I will befriend the current person, learn as much as I can, and then watch them take the fall.  It was that moment, that I realized administration is three steps in front of everyone and I vowed to be at least two from that point on.  I'll do what I have to do to succeed.  Callous... probably.  I don't fail.  I refuse to fail. 
I've also considered a career in politics.. because I have no doubt that I can do it.

"Some commentators believe that hypomania actually has an evolutionary advantage.[5] People with hypomania are generally perceived as being energetic, euphoric, visionary, overflowing with new ideas, and sometimes over-confident and very charismatic, yet—unlike those with full-blown mania—are sufficiently capable of coherent thought and action to participate in everyday activities. Like mania, there seems to be a significant correlation between hypomania and creativity. A person in the state of hypomania might be immune to fear and doubt and have negligible social and sexual inhibition. People experiencing hypomania usually have very strong sex-drive. Hypomaniac people are often the "life of the party." They may talk to strangers easily, offer solutions to problems, and find pleasure in small activities. Such advantages may render them unwilling to submit to treatment, especially when disadvantages are minimal."

Disadvantages though means that I drag ass for a few days if I sleep too much and of course foolishness can be a double edge sword.  It can ruin relationships as well as ruin you financially (if you make a bad business move)... but that's a chance you take cause the payoff can be huge.

Tuesday, May 15, 2012

Defense Mechanisms

Sorry it's been a while.  You know how it is with finals and all.  

So I’ve posted some “#BeingAnERNurse means” and it got me thinking about ER nursing.  One of the things that came with working in a smaller community is that there is a better than average chance that I’ll know my patients, their families, or will see them out and about.  This can be a double edged sword. 
Every time that ambulance rolled through the doors, there’s a piece of me that wondered if it was someone I love.  I heard a story of a nurse working in an ER like mine and the ambulance rolled in with a severe trauma… It was her husband.  She literally went catatonic and woke up several weeks later in the hospital. 
With this fear comes the point of my blog post tonight, defense mechanisms.  One of the defense mechanisms that I have (and I only know this cause I can willing admit it) is that I don’t look at faces, unless the injury is specific to the face.  I know this sounds weird until I explain it. Hell, then it might still be weird.  If I don’t look at the face then I don’t know whether I know that person (yes, I know you literal people will say look at the name and to you I say shut up, LOL… Actually, traumas come in John Doe so it doesn’t help anyone).  I have literally taken care of people for 2 hours and when they get admitted to the hospital I realize that I know and recognize them.
This does make for two strange situations though: 
  1. I’ve had people come up to me in Wal-Mart and say “Thanks for taking care of my husband so well”  and I look at the them and how no idea who they are.  But if they tell me what room they were in and a little about the case, I can tell them exactly what we ordered, the diagnosis, and the disposition… Strange I know
  2.  I have a hard time recognizing faces outside of work.  I see people and think.. shit I know them from some place but I can’t pinpoint where.  It usually takes me seeing the person 5-6 times consistently before I can remember their face.

Again I have this defense mechanism in place to protect myself from the inevitability that I will probably work on someone that I know and love. 
So do you have any defense mechanisms in place? 

As always comment here or tweet me. 
And of course follow the me and the rest of the #MurseMafia on twitter.