catastrophic injuries


I re-watched “Landing at Point Rain” last night and like HONESTLY, MAN.

anonymous asked:

Oh, fuck off you whiny bitch. You realize Goku and Chi Chi never kissed in the Manga, right? Therefore they never kissed in canon, you stupid idiot.

Is this Chris Jericho?  Wow, this is kind of an honor. 

There’s two schools of thought on this matter, Chris, and I’d like to give a brief overview of them if I may. 

The first is “argumentum ad ignorantiam“, which is just Latin for “argument from ignorance.”  It’s a logical fallacy that tries to assert that something is true because it can’t be proven false. 

And this is the core problem with the entire Kisscourse.  The core continuity of Dragon Ball lies in the original manga.  If Goku and Chi-Chi had been seen kissing in that publication, then this entire discussion would be moot.  But this never appears in the manga, so everyone’s left to argue from different source material. 

In the Dragon Ball Z anime, Goku and Chi-Chi kiss in Episode #147, although we can’t see their faces when they do.  But this moment isn’t in the corresponding scene in the manga.  It’s filler, and the canonicity of filler is questionable at best. 

However, in Dragon Ball Super Episode #60, Goku expresses seeming ignorance of kissing in general.  The strictest interpretation is that he not only doesn’t kiss his wife, but he has no idea what kissing even is.  The loosest interpretation of this scene is that Dragon Ball Super fucking sucks.  Like the filler of Dragon Ball Z, the entirety of Dragon Ball Super is of questionable canonicity, mainly because it keeps contradicting established continuity.  Shenron’s wishing powers, the events of Movie 14, and even Trunks’ hair color are altered without explanation or justification. 

And so everyone clings to one of those scenes as circumstantial evidence to support what comes down to an argument over the content of the original manga.  While Goku kissing Chi-Chi is never depicted in the manga, it can be implied through inductive reasoning.

1. Goku and Chi-Chi are married for several years.

2. Goku and Chi-Chi have two children during the course of this marriage.

3. Humans, (such as Chi-Chi) reproduce via sexual intercourse.

4. Among humans, kissing is often used to express sentiments of affection, sexual activity, and sexual arousal.

It is reasonable, then, to conclude that Goku and Chi-Chi have engaged in sexual intercourse at least twice.   During these occasions, it is also reasonable to assume that the couple have kissed. 

Note that I say “reasonable” and not “provable”.  We don’t actually see them have sex or kiss.  The only evidence is the existence of their children. 

Nevertheless, this is a far stronger case than can be made for the notion that they never kissed, ever.  The manga is silent on this matter as well.  If a couple never kissed, how could we know for certain unless is was explicitly stated in the manga?  And this brings me to Vegeta’s penis.

See, we know Goku has a penis because he constantly takes his pants off throughout the manga.  These scenes all happened when he was a little boy, but we never see him suffer any kind of catastrophic groin injury in the manga, so I think it’s reasonable to assume he still has a penis as an adult. 

But we never see Vegeta’s penis in the manga.  Ever.  Oh, he gets a buttshot now and again, but we have no idea what’s doing up front.  He’s often depicted with a telltale bulge in his tights, but that could be a fatty tumor of some sort.  Maybe that’s where he keeps his gum.   Hell, Vegeta’s an alien, so there’s no telling what sort of anatomy he has.  It’s unknowable.  Just because Goku has one doesn’t mean it’s universal among Saiyans.

“But he and Bulma had two children together!” you might argue.  And this is true.  But Bulma’s a genius, and perhaps she resorted to in vitro fertilization to accomplish this.  Maybe Vegeta has alternative genitals in his knees, like that alien in Star Trek VI: The Undiscovered Country.  We just don’t know. 

And the other media are completely silent on this matter.  The DBZ anime, Dragon Ball GT, Dragon Ball Super, the movies, the Toriyama interviews, none of these sources explicitly confirms the existence of Vegeta’s penis. None

By your logic, anon, the only reasonable conclusion is that Vegeta has no penis.  If he had one, then surely we would have seen it in the manga.  But we don’t, so that means it must not exist.  Why else would such an important detail have been omitted from a shonen manga?  

Furthermore, we can conclude that none of the Dragon Ball cast have kidneys, since we never see those in the manga either.  Obviously, if Toriyama had intended for his characters to have kidneys, he would have drawn them at the beginning of the manga to establish that fact up front.  But he didn’t, so his position is clear. 

Do you see where I’m going with this?  Put simply, absence of evidence is not evidence of absence.  Your entire argument hinges on the lack of a kiss scene in a manga that deliberately avoids romantic interaction as a dramatic choice.  The only kiss depicted in the manga is when 18 gives Krillin a peck on the cheek, and that’s it.  Does that mean 18 invented kissing?  Of course not, that’s fucking stupid, and everyone knows it. 

For my part, I’m not interested in proving that Goku and Chi-Chi kiss.  To me, it’s fait accompli, because they have a long monogamous relationship with two children.  It makes more sense for them to have kissed than it does for them to have not.  I don’t care how stupid Goku is, and I don’t care how big a man-baby Toriyama wants me to think he is.  He can tell me the sky is green all day long, but I can still look out a window and decide for myself. 

Now that’s the first school of thought.  The second school of thought is much shorter and more direct, Chris.  It’s actually just two words: suck it. 

anonymous asked:

What are some unique torture techniques to elicit a *false* confession. I'm writing a story in a fantasy setting, and am trying to think of something different than the ones you normally hear about (whipping, the rack, etc.). The character is in custody for about a week before the confession is made. It doesn't have to be "clean" but the character has to be able to survive without the use of modern medicine. Ideas?

Hmmmm. Well as you probably know I try to match techniques to real world cultures even for things like fantasy and sci fi. I get the impression you’re less interested in this necessarily ‘fitting’ the world though and if that’s what you want for your story that’s fine.

A quick note on unique tortures before we start.

They happen but they’re rare. Torturers overwhelmingly tend to stick with what they know. They do also experiment with aspects of other National Styles or things they’ve heard/experienced before. But this rarely means creating something totally unique.

Torture generally isn’t inventive or ‘interesting’. It’s usually people doing the same awful things over and over again.

If you want your character to go through something unusual then I’d suggest having a reason in story for the torturers to pay special attention to this character. Perhaps they’re under a huge amount of pressure to ‘solve’ the case they force the character to confess to. Perhaps they genuinely believe this character is guilty and think it’s a particularly horrific crime.

From my point of view it’s a lot easier to suggest a practice that happened commonly elsewhere in the world (or is less commonly depicted in fiction) rather than one that’s entirely unique. So… I’m afraid that’s what I’m going to do.

The tortures you came up with as ‘typical’ suggest a heavy western European influence to me. With that in mind a torture that was common in England historically but doesn’t seem to be in the popular consciousness as much is tearing flesh with red hot tongs. Definitely scarring, it could be disabling if areas near the joints are attacked (this reduces mobility) and while it’s potentially fatal it does not have to be.

Falaka is a practice that your readers will probably have heard of, but it doesn’t often crop up in fantasy stories so you might want to consider it. This is beating the soles of the feet. With harder objects, such as heavy sticks, it can break the bones of the feet and ankles. A way this was carried out that made injuries to the feet more likely was tying sticks to the legs behind the knees (keeping them straight) and raising them above the body, with the victim lying on their back. This wouldn’t usually be lethal but could result in catastrophic injuries to the feet, hampering the character’s mobility in future.

I’d also suggest ‘pumping’ as an old European torture that’s survivable and rarely seen in fiction. It involves forcing the victim to swallow a large amount of liquid. Usually water is used, often dirty water. Sometimes salt, irritants or human waste is mixed with the water. In historical times it was usually done by forcing a funnel into the victim’s mouth and pouring. The internal organs swell dramatically and painfully but the process leaves no lasting external marks or injuries. By the end the victim often has liquid pouring out of their mouth, nose and anus. The torturers usually increase pain by forcing the victim to curl up and applying pressure to their legs, crushing the swollen internal organs. They may also kick or slap the victim’s swollen belly.

One of my sources suggests a less usual ‘wheel’ torture where the victim was tied to the outer edge of a large wheel, mounted above the floor. A fire was lit under the victim and torturers turned the wheel to apply heat to varying parts of the victim’s body. I’ve seen multiple illustrations of this practice from historical Europe but I can’t say how common it generally was. Applying fire to the feet and genitals seems to have been the most common choice.

This would cause serious burns but the torturers would have some control over how badly burnt the victim was (unlike with a brand or hot tongs). The result is that damage could be mitigated. The character would likely have scars and they might have difficulty walking but they wouldn’t necessarily have large, life threatening burns.

The final European practice I’m going to highlight is a type of restraint torture that as far as I can tell was only used in a small part of England (the east near Cambridge).

The victim was made to lie down on a series of iron bars, evenly spaced out. A heavy metal collar was put around their neck, with large spikes going out from the collar. This prevented them from moving their neck and resting their head comfortably on the ground. It forced the victim to lie with their head strained so that the chin was near the chest. A heavy metal bar (or cuffs) were then applied to the legs.

This wouldn’t be entirely clean. The metal of the bars and restraints would dig in, leaving at best red marks and at worst deep cuts. Pressure sores are also possible. These could leave scars but so long as none of the wounds became infected the character would probably survive.

More generally I’d say it’s important to remember that prison conditions in historical European countries (that your fantasy may be based on) were often torture in and of themselves. Starvation, dehydration, unsanitary conditions, dark, cold and damp cells were all common. So was infestation by insects and rodents, lice and fleas. Solitary was relatively rare so far as I can tell, but overcrowding was common. I’m aware of at least one case in England where prisoners drowned in their cells because they were on a flood plain. Deaths from cold and disease appear to have been common.

Finally if you want the character to confess think about why they might do so.

False confession under torture isn’t common (the statistical sources we have show a rate of around 10%, which rises to around 30% when bribery is used as well). It does happen but you might also want to consider other reasons people falsely confess.

One of the most common reasons is a simple risk analysis. The accused person realises that they can’t adequately defend themselves in court (this may be because of prejudice, their financial situation or a number of other social reasons) and so they think that confessing is their best option. Most justice systems deal more leniently with people who confess and show remorse than they do with people who insist they are innocent. Think about whether this applies to your story and character.

Finally take a look at my Masterpost on the common effects of torture if you haven’t already. It should help you write this character after torture.

I hope that helps. :)

Edit: @acemindbreaker made an addition to this in a reblog about torture techniques similar to the Russian Conveyer and some of the modern Chinese methods, and some ‘interrogation methods’ that tend to produce false confessions. I think I’ve lost the connection to it because I do not know how to steer tumblr.


caramelmachete  asked:

My main character was slammed into a brick wall and hit his head. He lost consciousness briefly, was alert for a few minutes, and now has lost consciousness again. His partner rushes over to my MC. Assuming that his partner has a very good understanding of first aid, what should the partner do? Will my MC's pulse and breathing rate be slower or faster than normal? An ambulance has already been called. What other steps should the partner take?

Your character is dying.

The strike / loss of consciousness / brief period of lucidity / re-loss of consciousness is pathognomonic (read: One True Diagnosable Sign) for a traumatic subdural SUBARACHNOID hemorrhage, which is an arterial bleed inside the skull. That blood expands and puts pressure on the brain, which has nowhere to go… but it will go there anyway.

Your character’s breathing will likely ramp up and then decelerate, with periods of just… stopping. It’s called Cheyne-Stokes respirations, and it’s the body trying to manage cerebral bloodflow. His pupils will be uneven, with one bigger and the other constricted. His pulse will be normal and dip down to slow and then back up to normal; as he worsens, it will simply be slow.

Understand that what you’ve given your character is a catastrophic injury. A great many SAH patients don’t live, and he’s going to, he needs brain surgery basically yesterday.

As for first aid, keeping the character on his side isn’t a bad plan (but first they should feel the spine to make sure the neck hasn’t been broken). This will help when the injured character starts vomiting profusely.

If you want to make this a less lethal event, I would consider either a) simply extending the period in which the MC is unconscious the first time (and not putting them out a second), or b) have them lose consciousness and wake up a few minutes later but be very confused and lethargic.  Trust me, a few minutes is still enough to indicate plenty of brain damage, and plenty of drama and fear, because the seconds stretch into minutes in those situations.

For further reading I suggest you take a look at the head injury tag and the TBI tag!

Thanks for your ask and I hope I could help!

xoxo, Aunt Scripty


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Soukoku Week 2017 Master Post

Taking a page out of a lot of peoples’ books and making a SKK Week master post of my fics! All of these fics are under a series on my Ao3 titled “Soukoku Week 2017.” But here’s a little bit about them in more detail:

  • Day 1 [Sartorialism] The Brown Coat - A character study based on how Dazai and Chuuya appear before Dazai left and four years later when they meet. 
  • Day 2 [”that’s what being a partner means, right?”] A Simple Word - The night Dazai left the Mafia. 
  • Day 3 [historical au] in another time - Dazai is a field doctor and Chuuya suffers a catastrophic injury. Warnings for gore and major character death. 
  • Day 4 [memento mori] for the best - After Dazai leaves the Mafia, Chuuya is punished. Warnings for torture and graphic medical procedures. 
  • Day 5 [horror au] i didn’t awaken with a sense of purpose anymore - The longer Chuuya doesn’t use Corruption, the more it eats away at who he is. Warnings for gore. 
  • Day 6 [Dazai’s quote] heart that believes in others - Chuuya had his own version of looking after Dazai over the years. Warning for major character death and suicide attempt. 
  • Day 7 [free day] but this condition persists - AU. Dazai and Chuuya are roommates at a psychiatric facility, which might be helpful rather than harmful for both of them. Warnings for implied suicide and self injury, and implied alcohol abuse. 

I loved writing these, and I had a lot of fun with the prompts! I hope you enjoyed/enjoy them! 

joycewritesjournals  asked:

Hi Auntie. My 25-30 year old character is shot in the arm, then immediently glanced by/partly run over at speed by a very large truck. His leg is crushed under the knee and he has to have it amputated. Does that seem like a realistic injury to need amputation? How quickly would he die without medical care? What would happen on his arrival to the hospital, as far as what treatment he would receive immediently to keep from dying? Sorry if these are stupid questions, Thanks loads for what you do.

Hey @joycewritesjournals ! Thanks for your ask. Absolutely none of this is a stupid question. 

I would believe this story if the kid was running away from the shooter and into the truck, particularly if he actually ran into the side of the truck and got his leg caught underneath. 

A BKA (below-the-knee-amputation) for a crush injury like this is absolutely a realistic outcome, especially if pulses in the foot are lost. Damage to the leg tends to be catastrophic from crush injuries, and outcomes may be better with amputation than with surgery to try and fix the demolished tissue. 

First things first: You asked how quickly this character will die. The answer is, if there’s an arterial bleed, about 5-15 minutes; however, truckers do not want people they have run over to die, and will likely stop and apply a touriquet made out of some material or other. Shirt sleeves work well, belts work poorly, but something. It’s also likely that there isn’t an arterial bleed, so your character has basically infinite time if that’s the case. 

Your character is going to get scooped up by EMS, have anything that’s bleeding intensely treated, and, if there’s time, have that leg splinted. Next stop is a trauma center, where the character will be stripped naked and inspected for injuries. Doctors will touch his head, his neck, his chest, his abdomen. Depending on the trauma team, he may have a finger inserted into his rectum (with a glove and lube) to check for rectal tone, though this is falling out of fashion. 

He’ll get IVs and pain medication, and the team will work from there. Treatment will be dictated by a single maxim: what will kill him first? 

Assuming there’s no arterial bleed from the crushed leg – and often times there won’t be, but often times there will – the team actually has some time to call down orthopedics and get a consult about that leg. Even if there was an arterial bleed, it’s already been stopped, either by the trucker or by EMS, so the ER will just have to manage the blood values, likely with what’s called a massive transfusion protocol, where the character is given 1:1:1 units of packed red blood cells (PRBCs), fresh frozen plasma (FFP), and platelets. He may also receive an injection of a medication called tranexamic acid, or TXA, which promotes clotting. 

The surgery isn’t going to have to be immediate, as in get this the fuck out of my ER; the leg can wait to make sure that they have a good sense of what else is going on. Ultimately, the leg is going to go, and it will go in the first few hours, but the team has time to organize, make a plan, get consent, allow the character to make some phone calls, etc. 

One other thought: expect some significant damage to the knee in all of this. A lot of force has been applied to the lower leg, probably not in an “ideal” position, and the knee will have some twisting. ACL issues, tendon repairs, dislocated kneecap… any of these would be realistic and would actually add to the realism. 

Since you asked about immediate care, that about covers it! Hope this was what you needed :) 

xoxo, Aunt Scripty


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can you believe pascal suffered a catastrophic back injury that put him out of two races and then he got p11 on his debut and THEN scored points today (BEFORE A WILLIAMS!!!!!!!!) despite the world’s dumbest penalty adn thenn seb fcking won it anyway despite already receving champagne and a trophy for his troubles 

anonymous asked:

Ohhhhhh my God, the person we bought my gelding from did the "slam on the brakes to stop pawing" nonsense. She'd hear him pawing, slam the brakes and sometimes swerve the truck and trailer.

what a great way to turn an annoyance into a potentially catastrophic injury or motor vehicle accident

Raspberry Rain

@kurt-and-blaine-anderhummel prompted: I haven’t slept in like 3 days everything is funny and your hair smells really good (where Kurt is the one that hasn’t slept and Blaine sits next to him in class and he keeps leaning his head on Blaine’s shoulder and keeps telling Blaine that his hair smells good from his scented hair gel). Klaine Alternative Meeting AU. 4K [AO3]

“Okay, class. Settle down. Put your books, notes, and flashcards away - if you don’t know it by now, it’s too late for you to learn it. I’m going to start passing out the quiz in about one minute, as soon as it is officially 9:00,” Professor Francesca announces, her tone as cold and imperious as always. “You’ll have ten minutes to complete it and then we’ll start our new material in chapter four once they’ve all been turned in.”

Blaine shoves the color-coded note cards for his History of Theater course into his backpack, stealing a glance towards the door as he does. The seat next to his is still vacant which bodes very, very poorly for Kurt, the cute sophomore that sits beside Blaine typically. After all, their professor is a notorious stickler for punctuality. Anyone not in his seat at 9:00 am on the dot is marked absent and doesn’t get to take the quiz. And barring a catastrophic illness or injury, there are no makeups either. 

Keep reading


Garry Newlove, a married father of 3, lived in Fernhead, a close-knit community in Warrington, UK.  The area had increasing problems with drunken teens roaming the streets, an issue that came to a head for Garry Newlove on the evening of August 10th, 2007.  After confronting a gang of youths for vandalising his wife’s car, Garry was viciously attacked in front of his home. His 3 daughters witnessed the brutal assault, and tried in vain to ward off their father’s attackers.

After suffering numerous catastrophic head injuries within the space of 2 minutes,  Garry fell into a coma, and his wife Helen made the decision to turn off his life support machine a couple of days later.  Thanks to a number of eyewitness accounts, Adam Swellings, Steven Sorton, and Jordan Cunliffe (aged just 19, 17 and 16 respectively), were soon identified by police. The day of the attack, Swellings had been released on bail for assaulting another man just weeks previously.  Sorton had been identified by police as he was missing one trainer; the other had come off while kicking Garry Newlove in the head. A further 2 assailants were also put before the court, but are unable to be named for legal reasons.

During the trial, the defendants reportedly laughed and joked throughout the Newlove family’s witness testimonies, even dropping off to sleep at points in the proceedings.  However, they soon stopped laughing when all 3 named suspects were found guilty of murder and sentenced to life in prison.

unb0und. annnnd im turning the tags from that last reblog into an actual text post

Nina’s one and only scar is her empty eye socket, from when Zero blew out her left eye when she was seven years old. If it weren’t for Zero, Nina would in all likelihood be covered in scars, considering how many fights she gets into and how many times she’s endured catastrophic injuries. But Zero is so possessive that they see themselves as the only one with the right to leave permanent marks on Nina’s body – so they’ll always either regenerate Nina’s body free of scars or forcibly burn any scars away. The way Zero sees it, they laid their claim on Nina’s body when they gave her that empty socket. They will never, ever let anyone else supersede that claim.

At the point where nothing terrible happening means it’s been a good day.

i.e. i didn’t drown my phone nor did i find a horse with a catastrophic injury today so it’s been good.

All my muscles are in spasm and I hurt and I feel like shit but today’s been fine.

One of the best things about bnha is the accurate representation of the human bodies physical limitations. You don’t see the superheroes shaking off broken arms at the end of every fight or magically bouncing back from a catastrophic injury with no consequences whatsoever.
Instead, we see Midoriya having a very real consequence of the loss of movement in his arms because of the constant strain he has been putting on his ligaments, Iida having lost some mobility in his left arm/hand after it being practically shredded, and All Might’s decrease of time where he can be in his superhero form because of the injury to his side, ultimately becoming unable to be in that form anymore are some examples.
These physical limitations make it feel like the characters of bnha are actually human instead of having us question how the hell their bodies can handle attacks of that severity and still be fine afterwards, and I admire the author for adding this detail that is looked over in a lot of superhero stories.

I remember

I remember the day I was accepted into nursing school, the thrill, the excitement, and I recall the fear.

I remember the first patient I took care of; elderly female, The simplicity; the meticulous care of a bed bath, brushing her hair into a high ponytail. I recall her smile.

I remember the first time I saw a vented patient, the stillness of the human form amid surrounding chaos: a tangle of IV lines, cardiac monitor beeping, peg feeding, multiple decubiti, contact isolation - so, so many gown changes. Family weeping, vent alarms, chest tubes and suctioning - oh my, the sensory overload. I recall the palpable fear - how in heck would I be able to do this every day?

I remember the late nights studying, researching, the repetition of skill practice, the solitude, the 3am feelings of wanting to quit nursing school, give up on a dream. I recall the group study sessions where I didn’t feel so alone, the wonder of new things learned in clinical, the relief of passing exams & evaluations, and I recall the support of Professors who believed in me when I didn’t.

I remember Pinning, and Graduation, the melancholy of no family in the audience, and I recall the realization that friends are the family we choose over, and over again.

I remember the agony of reviewing years of clinical and lecture information in prep for the NCLEX, I recall the 75 questions of terror, the certainty I’d failed, the loss of control over waiting for results, and the unparalleled relief it was all over with a simple word;

I remember the joy of securing my first nursing job, the beginning of a new journey, the freshly ironed scrubs, squeaky clean nursing shoes and shiny stethoscope. I recall with wonder, signing “RN” after my name for the first time.

I recall the feeling of finally being on my own, no professor, no hospital educator, no preceptor - pure terror mixed with a sort of odd “thank goodness and about damn time”

I remember the overwhelming sensation of having too many patients, no breaks, difficult assignments, baby nurse hazing, and wanting to hide in the med room/patient’s bathrooms and cry.

I remember my first code - the chaos, the deathly gray pallor as we failed at reviving a patient, the sound of cracking ribs, pools of blood, crash cart supplies strewn all about the bed and floor. I recall the silence when everyone left the room and it was just me, the patient and a shroud.

I remember the feeling of failure and tears that would not come.

I remember wanting to quit more days than I wanted to work.

I remember my first DNR, the realization that when patient wishes are respected and managed well, there was dignity in death, and an honor to be the last person holding my patient’s hand as he moved onto the next world.

I remember the first time as charge nurse, the storm of chaos, the understanding you cannot please everybody (or at times, anybody), and I recall the immense relief of the silence at the end of the day.

I remember the traumas, the catastrophic injuries, the emotional and physiological distress, the cries of pain echoing down the halls. I remember the joys of a life saved, the simple pleasures of holding a patient or family in comfort, the mistakes, irritations, struggles, humor & humility of daily practice, and I recall the soul searching reflections of learning from my patients and coworkers every day.

There are definitive moments in a nurse’s career;
Great trial and great joy.
These are the moments we remember,
To carry on.


My college buddy Zack Weinstein is in COLOSSAL at Dallas Theater Center. The play centers on a University of Texas football player, struggling to move forward in the wake of a catastrophic spinal injury. These production photos are beautiful, and mostly I’m proud because Zack is a quadriplegic actor, playing a quadriplegic role. And that’s fucking cool.

Hello friends:

I am unable work and my permanent disability cheque is getting cut in half next month and I am terrified. Apparently the word ‘permanent’ means nothing to insurance companies. (The same company that classified my injuries as catastrophic and permanent? Sigh.) If you could toss a couple bucks my way I would really add up and help me exponentially next month when I can barely afford rent. I have a lot of expenses that are not covered by insurance and the fact that they are cutting my disability payments in half is going to devastate my ability to heal and cope and survive. I’m going to fight it but it could take up to a year to for it to be reinstated. I could use all the help I can get. Between physio and kinesiology and school and medication and lawyers and general living expenses, I’m exceptionally screwed. Even a few dollars could help me survive.

(You can read the story of my disability here)

Nursing Reset

People often question why/how nurses get to the point of burnout so early on in our careers, and why it seems we are having a tough time with this profession, and sometimes, they are just irritated with our inability to deal with it all.
We spend our entire shift (and careers) caring for others, prioritizing their needs, listening & comforting people during their trials and their joys, all the while pushing aside how we feel, we push aside how the traumas and anguish affects us - and most of the time we don’t think about it, we just get on with it, over and over again….but sometimes the not thinking about it builds up.

I often think about the nurses who have been at this work for 20, 30 years - sometimes I hear people snipe about them sticking to one unit for so long, but I look at it differently, I have incredible respect for their daily endurance, and capacity to go back day after day during the toughest and most challenging times, unsafe staffing, absurd situations, bullying, favoritism, or extraordinary stress of each shift.

I haven’t been a nurse that long, only 8 years, and it occurred to me that the day I received my license, it was perhaps one of the most accomplished days I’d experienced thus far. Perhaps a bit materialistic - although sometimes the payoff for hard work is a glorious moment, if fleeting. Yet, now, 8 years later, it passes without my realization; how did this happen? A date I had looked forward to so much as a nursing student, now as an experienced nurse passed without so much as a pause to reflect and be grateful.

No, I wasn’t thankful. I was doing a per diem shift in the ICU, a unit I had returned to some months back, since I am between jobs and no clue what’s next as an educator. ICU was almost like coming home. A familiarity of controlled chaos, cardiac monitors, ventilators, IV pumps, and meticulous monitoring of patients at their most vulnerable and critical time. And the support of nurses & doctors who unfailingly take care of one another, no bullying zone.
No, I wasn’t as thankful as I had once been on this date. I spied a ventilator being rolled into my room, no warning that a cardiac arrest was on its way. But that’s ICU, anticipation and expectation of met codes, arrests, upgrades that are moved in quickly for stabilization, and ICU nurses springing to action. No, I felt removed from the nurse I once was - a sort of detachment as I hooked up my patient, listened to the code team’s report, and apology of the mess they were leaving me with. No, I wasn’t even annoyed. I knew they were doing the best they could, codes are messy - there is rarely getting around that. I wasn’t annoyed at all. I was void of emotion, which some may argue is necessary to logical thought process in critical situations. I spent the shift chasing my own tail, managing drips, labs, rhythms, carefully labeling lines, establishing a system in the room that was preparatory, anticipating life threatening events, collaborating with doctors, praying as we turned the patient to remove the blood soaked linen and clean the mounds of stool - for any critical care nurse knows the cardinal rule of post cardiac arrest patients: never turn them unless you want another code on your hands. Sometimes it works out, and sometimes you kick yourself for having made such a stupid decision when they go bradycardic and arrest, then expire.

End of shift. A marathon, really, that leaves you feeling as though you neglected your second patient, and didn’t save the first. What’s the point? Where’s the quality of care? Would I have entered this profession knowing I would feel empty 8 years later on the very same day?

I stood, at the end of shift in the now empty room that hours earlier saw crowds of caregivers, family sobbing, patient connected to supportive life devices, tangles of lines infusing medications, alarms blaring, and shouting of orders. I stood, thinking about how we reset each room after each loss…and how we reset internally. I thought about the countless catastrophic injuries and heartache this room has seen, the many, many crash carts stationed by this door, the lost souls of patients that may still reside in this room, in transition…and I thought about the squeaky clean, bleached floors, immaculate bed, neatly folded monitor leads, reset and waiting to admit the next patient - knowing not of the devastation that housed this room mere hours ago. I thought about the energy of the room, and wondered if the incoming patients felt it too.

Instead of being simply grateful for the simple things in nursing that once held my heart, I am burned out - it isn’t something I thought would happen, it isn’t only from working copious hours, or backbreaking work. Sometimes it comes from a place of self disappointment, sadness at not being the nurse you once were or hoped you would be, stress of not belonging/inability to find a job that fits. It’s both frustrating to realize people just don’t understand why we feel this way, why we aren’t handling it the way they want us to, expecting us to magically snap out of it, perhaps feel the necessity to mock it, or worse yet - pity us (that’s a misinterpretation of what we ask); and it’s frightening to realize this may be the end of a career I’d once worked so hard for.

I stick with it, because I remember the simplicity of appreciation I once felt. I stick with it, because I remember the feeling of being entrusted with the lives of others, and I stick with it because one day the burnout will be a distant memory.

Burnout isn’t something we should roll our eyes at. It’s devastating to a nurse.

If you’re a nurse who is experiencing this, has experienced this, or nearing this, I support you. If you are a friend of a nurse, I ask of you to simply support us.