Friday, July 27, 2012

Of Tragedy, Heroism and Recovery


In the wake of the recent mass shooting in Aurora, Colorado, our hearts indeed go out to the victims, their families and loved ones, and the many people impacted by this horrific and inexplicably nefarious event. When senseless terror such as this is visited on innocent citizens, it is a shocking reminder of the ways in which violence can tear open the heart of a community—and a nation—in a matter of moments. 
 When events like this occur in our midst, we frequently do not consider the impact that it has on the first responders who initially respond to such traumatic events, as well as the hospital staff, surgeons and nurses who deal with the (often prolonged and painful) aftermath.
In September of 2001, the entire world learned of the heroism of the New York City firefighters and other first responders who charged up the smoky stairwells of the burning World Trade Center, and many of those courageous individuals gave their lives in the line of duty on that unforgettable day.
Since I’m a nurse who coaches and advises nurses on self care, burnout prevention and overall health and wellness, I’d like to take a moment to consider how nurses and their healthcare colleagues themselves react to such traumatic events, especially when standing on the front lines.
When trauma victims such as those in Aurora are transported by ambulance to a nearby emergency department, the ED staff are often notified of what they might expect and hopefully have time to begin preparing before the critically injure patients begin to arrive.
In the case of the Aurora massacre, one can only imagine what might be going through the minds of the nurses and other staff members of the hospitals on the receiving end of the racing ambulances. Were their friends and neighbors among the dead or injured? Would a colleague be one of the critical patients rushed from the scene in need of life-saving assistance? How would it feel to see a favorite teacher or local barista bloodied and fighting for her life as the sirens announced their arrival through the emergency department doors?
The military understands the effects of such secondary trauma, and their crisis debriefing models developed over the decades can be skillfully used to debrief first responders, nurses, medical staff and others from the horrific scenes to which they are often witness. Some seasoned nurses and medical professionals may be somewhat inured to such sights and experiences, but it can take a toll over time, and learning how to walk the mind and heart through these types of exposures is an important skill to master.
Yes, we grieve and we feel deeply for the individuals who have been injured, maimed, killed, and traumatized. We mourn and pray with their families, loved ones, friends and colleagues as everyone connected with such tragedy attempts to come to grips with such an event and make sense of it in whatever way seems possible.
We also want to remember those who ran into that theater and faced the initial shock of the bloody scene before them, as well as those who administered first aid, recovered the dead, and transported the injured to the facilities where they could best be cared for--and hopefully saved.
Once delivered safely to the local hospitals that were ready to receive the victims, it was the medical staff—nurses, doctors, surgeons and others—who then bore the brunt of the secondary trauma as they struggled in haste to salvage lives shattered by unanticipated and inexplicable violence. And the presence of children among the injured and dead is simply another layer of trauma and shock that is even greater to digest and accept.
The ripple of trauma is wide in a scenario such as Aurora, and we hope that the paramedics, nurses, surgeons and others who treated—and are still treating—the injured are taking care of themselves even as they care for those in need of their professional skills and expertise.
Those frontline medical personnel need to remember to hydrate well, eat nutritious food, take time for self care, practice good sleep hygiene, and spend time away from work where the stresses of this traumatic event can be briefly set aside.
For those who are prone to give until it hurts—and then give some more—it’s a high priority to get away, debrief with friends, family and colleagues, and allow the nervous system to recalibrate.
Laughter and play (yes, even under these circumstances), exercise, hydration, good nutrition, rest, and other positive actions and experiences can help to mitigate the effects of stress and trauma.
When under the effects of such experiences, cortisol and other stress hormones flood the circulation, and hydration and cardiovascular exercise are two of the best ways to flush these chemicals from the body while enhancing the production and secretion of dopamine and other chemicals that counterbalance the deleterious effects of stress on the human system.
Short-term crisis counseling or a professional crisis debriefing can also be very helpful at times such as these. Likewise, grief specialists can add a particular caliber of understanding and normalization when individuals impacted by trauma are reacting to such unusual and potentially life-altering circumstances. These professional counselors will tell all survivors and witnesses that any reaction is normal in grossly abnormal situations such as this, and patience and tenderness are called for in the days and weeks to come.
This advice can be equally applied to the families and friends of the Aurora victims, and time is one of the best healers when trauma has paid an unexpected visit.
We hold the victims and their loved ones in our hearts, and we equally send our support and wishes for self care and well-deserved rest to those who helped to save and mend the innocent individuals caught in the inexplicable crossfire in Aurora.
Everyone affected by this event needs healing, whether they are direct victims of the shooting, friends and family of the victims, or the professionals and others who somehow cared for those individuals.
Self care is paramount at such times, and as difficult as it can be, every person traumatized by these events must be sure to treat themselves and their loved ones with the utmost kindness, gentleness and compassion. And for the nurses and healthcare professionals giving their all when it’s needed the most, this advice could not be more timely nor important.
Everyone will need to move on from this tragedy. Having said that, moving on in a healthy and thoughtful way is essential for long-term recovery and the resumption of a life that has been unfortunately and inexplicably touched by pointless, senseless and tragic violence.
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