Jensen/JOURNAL OF EMERGENCY NURSING

gun,

he l e a r n e d t h a t ch i ld ' s

p lay can be lethal .

He l e a r n e d tha t some ch i ld ren l ive w i th less t h a n o thers who d i e - - t ha t a p r e e m i e w i th more wil l t h a n p o u n d a g e can surv ive a f i f teen-year-o ld w i th h a r d e n e d m u s c l e s a n d h a n d s o m e ch in who h u n g h imse l f b e t w e e n a t e n n i s racket a n d three t h in spo r t ing jackets .

S o m e t i m e s he w e n t to

the mop closet to ge t suppl ies ; o ther t i me s b e c a u s e he w a n t e d to cry.

He l e a r n e d to talk g e n t l y a r o u n d w a i t i n g paren ts , t ry ing to help t h e m relax w h e n their ch i ld ren f inge rp r in t ed the g lass on the ch i ld ren ' s fish tank.

S ome t i me s he looked into the i r faces a n d w o n d e r e d why; b u t he could always, a lways tell the t imes they l e a r n e d ch i l d r en die.

"Please keep his hands warm" Sect ion Editor: Sue Moore, RN, MSN, CCRN, CEN Author: Trina Williams Deal, RN, BSN

F I inally, the clock s t ruck 7 AM, the mag ica l hour w h e n m e m b e r s of the n i g h t shift smirk to t h e m -

se lves a n d think, "Whi le eve ryone else t r udges to work, I 'm go ing to bed . " The d i spa t che r ' s shr iek over the radio i n t e r rup t s t hese h a p p y t h o u g h t s w i th the d r e a d e d a n n o u n c e m e n t tha t a ped ia t r i c p a t i e n t wi th t r a u m a who is in code s t a tus is en route w i th CPR in progress . The i n v i t i n g i m a g e s of w a r m b l a n - ke ts a n d soft p i l lows i n s t a n t l y vanish , r ep laced by a d r e n a l i n e - c h a r g e d act ivi t ies . Dur ing the s ee m-

Ms. Deal is a staff nurse, Emergency Department, Onslow Memorial Hespital, Jacksonville, North Carolina.

i ng ly e t e rna l m i n u t e s a w a i t i n g the a m b u l a n c e , I p repare the t r a u m a room for the arrival of the pa t ien t . There was no w a y to p repare myse l f for w h a t w a s to follow, b u t I w a s soon to d iscover a per- sonal s t r e n g t h I was u n a w a r e I had.

The p a r a m e d i c s b r i n g the p a t i e n t to the t r a u m a room, r a t t l i ng off the history. A 7-year-old wh i t e boy invo lved in a motor veh ic le acc ident . His Dad was

For reprint& write Trina Williams Deal, RN, BSN, 110 Deerfield Rd., Jacksonville, NC 28540. J EMERG NURS 1995;21:91-2. Copyright �9 1995 by the Emergency Nurses Association. 0099-1767/95 $3.00 + 0 18/9 /59290

February 1995 91

JOURNAL OF EMERGENCY NURSING/Deal

driving him to school, like any other day, when the sun 's glare bl inded him. Before he was able to regain his vision, the car collided with a garbage truck. The primary assessment reveals a little boy, breathless and pulseless, with massive head inju- ries and compound fractures of the femur and humerus.

There is a s tampede toward the patient. A nurse resumes chest compressions, and the anes- thesia team inserts an endotracheal tube and main- tains the respirations. The t rauma team crowds the patient. With orders flying and adrenaline pumping, both into the patient and through the code team, central lines are placed, chest tubes are inserted, and peritoneal lavage is performed. It is organized chaos. Each member of the code team desperately works to save this little life.

Suddenly in the midst of all the activity, the boy 's mother comes to the bedside. She looks at her little boy, holds his cold, mottled hand, kisses his bloody cheek, and whispers, "Mommy loves you." In one hand she gent ly holds her son's limp, cold hand. In the other, she clutches his school picture, a picture of a smiling little boy so full of life. A pic- ture so different from the lifeless, bleeding, muti- lated body lying on the t rauma table. After her lov- ing words of encouragement and desperate prayers for miracles, Mom trust ingly places her precious lit- tle boy 's hand into my hands and pleads, "Please keep his hands warm." The emotions wash over me like an ocean tide. I look at her, my burning eyes trying to fight the tears, hoping she would not see the anger and sorrow bubbl ing just under the sur- face. With that, Morn is escorted from the room. With her simple request, Morn unknowingly makes a powerful impact on my life.

At that moment, the falseness of everything I depended on for happiness becomes blindingly ap- parent. My bank balance no longer matters. Those exciting plans for next summer ' s vacation suddenly

seem trivial. I am angry at myself for wast ing so much time on life's frivolity.

After hours of heroic efforts proved futile, the code is called. The patient and family are gone.

Standing in the empty t rauma room, my ears still r inging with orders, heart still racing with ex- citement, and eyes still s t inging with tears, my mind becomes a melody of soul-searching questions followed by a chorus of "wha t if's." What if he had slept a little later; what if he had decided to ride the bus today; wha t if they knew their little boy would die today? Would yesterday have been different? Maybe that good night hug last night as she tucked him in would have lasted a little longer. Or maybe

At the c lose of e a c h day, as I w a t c h m y little girl p e a c e f u l l y s leep , I t h a n k God for the gift of ano ther day.

Dad wouldn ' t have scolded him for get t ing a "C" on his math test. Maybe they would have played with him last night instead of wash ing those dishes. Or, maybe not. Maybe yesterday was just fine the way it was.

This little boy was part of my life for only a short time, but this powerful experience is etched in my memory forever. I now have a greater appreciation for the blessings in my life and a reaffirmed under- s tanding of what is truly important. Thanks to that little boy, I make sure that every day is lived to its fullest potential. At the close of each day, as I watch my little girl peacefully sleep, I thank God for the gift of another day.

The JOURNAL OF EMERGENCY NURSING is currently s eek ing articles on caring for patients from different cultural, rel igious, and sexual backgrounds /or ientat ions . The tentat ive deadl ine is March 15, 1995.

Please cal l or w r i t e t h e t h e m e i s sue g u e s t editor Sue Moore, RN,

MS, CCRN, CEN, 5400 Iroquois Circle, Reno , NV 89502 ; (702)

8 5 7 - 8 8 9 5 , or contact Karen Halm at the ENA National Office, 216

Higgins Road , P a r k Ridge , IL 60068 ; (800) 243 -8362 .

92 Volume 21, Number 1