L E T T E R S

What was the hospital policy regarding wait times and

patient reassessment? How many patients were waiting to

be seen? How many patients were in the treatment area?

What was the level of acuity of the patients in the emer-

gency department at that particular time? What was the

patient/nurse/doctor ratio? What prevented other staff

from intervening? Where were they? Another patient went

to provide comfort. . .where is the humanness of the hos-

pital staff? A janitor so focused on cleaning that he went

around the person. What is that about?

Why is there a closed circuit TV in this particular

emergency department? Who monitors it? Who called the

police? Is this what we do when we think the patient is a

‘drug’ seeker?

What was the system? How can it be described?

What policies and procedures were in place at the time?

What were the staffing levels? What was the educational

level of those involved? What resources were available to

the staff involved? Was it clear how to move up the chain

of command?

I believe that the personnel involved were terminated.

My assumption is that it was the nurse or nurses who were

terminated. I would venture that it was the ‘system’ that

was guilty and more culpable than the individual nurse

or nurses. Firing the individual or individuals may make

us feel like we have done something to prevent this from

happening again but it won’t. If the system is not fixed,

it will happen again.

It is an understatement that ‘‘cruel deaths are not a

legacy we should be part of.’’ I would certainly hope not.

We need to examine closely and then change the system that

allowed this to happen to a fellow human being.—Karen

Crouse, EdD, APRN, FNP (BC), CEN, Chair, Department

of Nursing, Western CT State University, 181 White Street,

Danbury, CT 06810; E-mail: crousek@wcsu.edu.doi: 10.1016/j.jen.2007.08.004

Compassion Around the World

Dear Editor:

I have always considered myself a caring nurse. How-

ever, as a trauma nurse, there were times when I was very

‘‘task oriented,’’ shall we say. I did not feel I had time to be

as caring as I would have liked to be.

December 2007 33:6

As a trauma nurse at the Air Force’s only level I trauma

center, I often took telephone calls in the trauma room from

the patient’s family members. Frequently I would think,

‘‘Man, I don’t have time for this. Doesn’t this person know I

am busy trying to save the life of this person?’’ I would tell

the person on the other end of the call whether the patient

was stable or critical and pass a message to the patient from

them. Normally it was a simple ‘‘I love you.’’ I felt this was

the right thing to do and would make the family feel better.

After all, it always made me feel better. So, what made me

look at the way I talk to family members of trauma patients?

I guess it was becoming that family member on the other

end of the phone line.

I had been stationed in South Korea for about

3 months when I received a phone call from my cousin,

John. He said he needed to tell me something. Suddenly,

I knew; the sound of his voice wasn’t one of pleasantries.

I asked what was wrong. He then painted a picture I never

wanted to see. For most people in the military, this is the

biggest fear: hearing that something has happened to your

family and you are 3500 miles from home.

John told me that my parents had been in an automobile

accident. My mother was fine but my father had been airlifted

from the scene. They swerved to avoid a wooden pallet. The

truck they were in f lipped, slid for about 100 yards, and then

rolled down a steep embankment.

My mom had her seat belt on. She had been trapped

in the vehicle and required extrication by EMS. How-

ever, John thought she was going to be all right.

My dad, who was notorious for not wearing a seat belt,

was not so lucky. He had been ejected about 100 feet from

the truck. John knew his injuries had to be bad because the

state trooper had radioed for the airlift.

John informed me where each had been taken. He had

already requested that the physicians at the respective

hospitals contact the American Red Cross (ARC) so that

I could be released from duty to come home.

Once I was off the phone with John, I called his wife,

Salley, who was with my mother at the hospital. Salley told

me my mom was going to be OK; she had some deep

abrasions and road rash to her arm. I spoke with my mom,

and she was completely out of it. She kept repeating that

she was so sorry, she had killed my father. I tried to reassure

her that my father would be fine, hoping to ease her grief.

JOURNAL OF EMERGENCY NURSING 527

L E T T E R S

Both my mom and I are trauma nurses and know about the

severity of patients air lifted from an accident scene. Salley

came back on the line and told me she would stay with my

mom until I could get home.

I then called the hospital to which my dad had been

taken. Once the trauma nurse was on the phone, I told

her my story. This nurse introduced herself as Barbara. She

said she understood the whole military situation, and said,

‘‘Your father is very ill. He was ejected from the vehicle and

he has a concussion. He also has a broken pelvis and a

pneumothorax. He has been sedated and intubated and

they are placing a chest tube now.’’ I thanked her and asked

if she would tell him that I loved him and would be home

as soon as possible. She then showed me what a special

nurse she was and what a good trauma nurse should do in

this situation. She said, ‘‘He can’t talk to you because of his

tube, but he can still hear. I will put the phone next to his

ear and you can tell him yourself.’’ I told my father I loved

him, I was sorry I wasn’t there, and to hang on, that I

would be home soon. When Barbara came back on the

line, I told her I would never have thought to hold the

phone to a trauma patient’s ear and how much I ap-

preciated it. She said no worries, and she would take good

care of him until he went to the ICU. I was wholeheartedly

assured she would do just as she said.

It took me 3 days to get out of Korea and 4 days before

I made it to my dad’s bedside. On the way to the hospital

from the airport, my mom told me that when my dad was

extubated, he asked for me. She told him I was in Korea

and that I would be home soon. He told her that I had

spoken to him while he was in the emergency room, but

she just waved it off as a ‘‘side effect’’ of the concussion.

When I walked into his hospital room, I gave him a

hug and a kiss and told him I loved him. He asked me what

took so long to get there. I told him that I had gotten home

as soon as I could. He said, ‘‘But, I remember you talking

to me in the emergency room.’’ I told him that was on the

phone, I wasn’t actually there. He said, ‘‘It sounded like

you were right next to me.’’

My heart soared. I was euphoric that my dad

remembered my talking to him in his time of need. I knew

then exactly what to do if I were in the trauma room when a

family member called. I believe I discovered the epitome of

what is right for the patient and their family in Barbara on

528 J

that cold day in January when she provided me and my dad

with care and compassion when we needed it most.

I have since worked as a primary care nurse, a f light

nurse, and, of course, a trauma nurse. No matter how tired

or frustrated, I do my very best to treat every patient and

their family just as you would want your family to be

treated. I hate to say that it took living the situation to

learn from it, but it did. I only hope I can touch my

patients and their families lives the way Barbara touched

my life.—Major Tammy ‘‘Flo’’ Hayes, RN, MSN, CEN,

Acute Care Clinical Nurse Specialist, U.S. Air Force, Roberts-

dale, Ala; E-mail: ernurs2@hotmail.com.doi: 10.1016/j.jen.2007.01.021

The Goodness and Compassion of Emergency

Nurses Everywhere

Dear Editor:

I have been a loyal ED nurse and ENA member for

years, and I believe the following story is worthy of men-

tion, and one you might find touching. This story dem-

onstrates the goodness and compassion of ED nurses

everywhere—heroes saving lives each and every day.

I recently read, with much enthusiasm, the article

published in the June 2007 issue of ENA Connection

about ENA members caring for Virginia Tech shooting

victims, and I could not help but share my story with you.

On November 20, 2006, our day started out much

like one in most inner-city emergency departments—busy

but not overwhelming. We had patients held over from the

night shift, a few waiting in the lobby, and a few waiting on

inpatient beds. Things were f lowing as usual until around

10 AM, when we received the initial call informing us that a

school bus had crashed. More than 30 students were

brought to the Huntsville Hospital Emergency Department.

Among the injured were 4 young women who sustained

major head injuries and later died. This tragedy made

national news.

In Boston, Massachusetts, at Beth Israel Deaconess

Hospital Emergency Department, nurses heard about the

tragic event and performed a most honorable gesture—they

bought lunch for the staff of Huntsville Hospital

Emergency Department and had it delivered the next

day. On November 21, 2006, at 11:30 AM, several pizzas

OURNAL OF EMERGENCY NURSING 33:6 December 2007