Anyone who works in emergency services knows that there are a lot of days where you spend almost as much time being a counselor, a psychiatrist, and a social worker than you do as a professional in your field- ER, EMS, Fire, Law Enforcement. Comes with the territory. By the time people roll through the doors of my ER, all of their problems – medical and otherwise – have been piling up for so long that they all come out at once.
Emergency services occupies a role that’s both humbling and stressful at the same time. Things that people haven’t been able to tell anyone else, problems that’ve been bothering them, things that’ve gone wrong in their lives… finally, there’s someone who’ll listen to them. Who cares.
We don’t work the long hours, or go a whole shift without eating or peeing because those things are fun. We do it because we care. And because of that, we take our patients’ problems, and we put them onto our already overburdened shoulders.
Nobody has to tells us to. We just do it. Pick people up and help them shoulder their loads, ignoring our own stress, our own needs. And we do it no. matter. what.
The unofficial motto of nurses is “Nurses don’t quit- they just burn out.” Dark, but true. We work hard. We take on everyone else’s problems. Let our own pile-up until we’re burnt to a crisp. Suicide, stress, and PTSD rates among emergency services providers are at critical levels because of it.
I know personally. I hold every single pediatric code I’ve ever worked on my heart. No exceptions. I remember every single one, vividly. In your hands, you can still feel their ribs cracking under the pressure of your chest compressions. The crunch that the IO catheter makes when it goes through, into their bone marrow. The bright pink foam coming from their lips, spraying into the air, droplets landing on ashen grey skin. Mom shrieking and crying in terror in the background.
Sometimes, in the middle of the night, I’ll sit awake and try and think through what I did wrong; or what I could have done differently that would’ve changed things. And there’s the thing, too. I was only one of an entire team of people in those codes, but we all take it on as a personal burden.
When I worked in Pediatric Acute and Intensive Care at the UVA Children’s Hospital, we had a leukemia kiddo who I absolutely loved. He was amazing. Sharp as a whip. He’d give me crap for being a UVA fan- he was a Hokie, and so every time the Hokies beat UVA, he’d rib on me mercilessly. Heh, I never heard the end of it. Anytime UVA won, he’d shrug and go, “It was a fluke!”
God, I loved that kid.
He’d demand I be assigned to him, and then tell me that, to feel better, I had to play video games with him in his room. And he’d kick my butt in them, too- I told him that I was just letting him win, but he knew. He was never obnoxious, never mean-spirited, no matter how sick he got. He was awesome.
One weekend, I’d worked a 7am-7pm shift, and had spent a decent part of that day hanging out with him. Instead of taking a break between doing vital signs and such, I’d go see him. He was fine; wasn’t feeling a hundred percent towards the end of the day, but anyone who works with our cancer kiddos knows that’s normal. But I got busy, held late, and then had to rush to leave… without giving him a hug goodnight.
I got to work early the next morning, and they rushed him by me as I was just coming out of our break room from punching in. Headed to the PICU. I followed the crowd of nurses, doctors, his family, over to the ICU room that had been cleared for him.
He died an hour later.
Kids… you gotta understand. Adults, they’ll go down a slope when they’re getting worse. Their bodies are more robust, have more reserve capacity. Gives us at least some time to intervene- or, at least, to prepare… both medically and psychologically. Kids, though? They drop. Fast. Off a cliff.
There were so many people in that room, I just hung back and was stunned. I mean, I had just been playing video games with him… he’d been fine! I hadn’t even said goodbye to him the day before… I hadn’t even given him a hug goodnight.
When it became rapidly clear he wasn’t going to come back, I stepped out of the room. His parents were hovering just down the hallway. They knew it was bad, but most folks who haven’t worked codes, particularly pediatric codes, don’t get it. It’s nothing like the movies or TV. And, I mean, damn – they were his parents. They had to have hope anyway, right? So I went and stood with them, saying the usual platitudes you say at times like this – they’re doing everything they can, he’s in good hands, the docs and residents and PICU folks know what they’re doing, etc.
But… then dad. Dad, big, burly dad. Tough guy, at least four inches on me, biceps the size of my thighs. He looks me dead in the eye, and asks me, point blank: “Is he going to make it?”
What do you say to that? How the hell do you even answer that?
But I didn’t even get a chance to work out what to say, because he saw the answer in my eyes. He knew. And he grabbed me, wrapped me up in a hug, and sobbed into my shoulder. Sobbed the tears of a parent who sees the life of their child flash in front of their eyes – toddling steps, looking up at you, smiling. The feel of them against your shoulder, fast asleep. Singing “You are my sunshine” to soothe them as they cry in their car seat, knowing it’s just a few more minutes to home. Them waving goodbye to you as they walk into school for the first time. All that, by in an instant… and he knows it’s all gone, all that time, all those moments, are at an end. Forever.
I held it together; I really don’t know how. But I did. And somehow, I got through my shift. And I got home. Walked into the front door, slumped down on the floor. And cried. Cried like I’ve only ever done once or twice in my life, before or since.
I still see that code, too. Maybe if I’d have been doing chest compressions, instead? If it had been me, I could’ve saved him. All total bull, of course; that PICU nurse was doing her job just fine, but even knowing that logically, again… in the middle of the night, I think- I should have jumped in there and just done it. He’d still be here. At home. Playing with his friends. His parents.
That’s just one of a dozen or two things just like that I carry around with me, everywhere I go.
Ask any of us; ask any of my friends in Fire, and EMS, and law enforcement. My experience isn’t special… we’ve all got our share of these sorts of stories- lots of which are way worse than this one. And every time a new story comes along, we just shoulder the load and keep moving forward.
And the next one.
And the next one.
So I decided I was tired of watching career politicians ignore how many folks are hurting in our district, while doing nothing that might risk their jobs. Who gerrymandered themselves into districts where they don’t even have to bother trying to listen to the voters any longer- only their donors.
I kept thinking of the folks who’d be dropped unceremoniously for the safety net to catch… because my friends and I are what holds that net together. Whatever fallout there is is going to come down directly on us.
And like I said, those of us in emergency services? We’re not going to quit. No matter how hard it gets. No matter what we have to endure, we’re just going to keep working harder, and harder, and harder… but hard work and perseverance can only get you so far alone.
I saw that anvil, hanging overhead. Hanging over the heads of my brothers and sisters in emergency services. Over the people of our community. And I said there was no way I’m just going to sit here and let that weight drop onto us. Whatever happens, I’m going to make sure someone was speaking up for us- was FIGHTING for us.
That’s why I’m fighting for every voter out there who feels like their voice has been lost in the process. Who feel like politicians don’t give a damn what we think. Who have no regard to our lives, our families, and our well being.
And that’s why I’m doing what I’m doing. That’s why I’m in it for the long haul. That’s why I’m running for the Virginia House of Delegates here in the 58th District- and why I’m going to fight for YOU, no matter what. Because I carry the torch lit by the generations of nurses that came before me. When people need help- we get to work.
We don’t quit.
Kellen Squire is an Emergency Department nurse from Barboursville, VA, running for the Virginia House of Delegates in the 58th District this fall.