Preparation

I learned this summer that a hospital operates in a constant state of preparedness.  Yet, even as you are prepared you will simultaneously never be prepared.  Pages would go out overhead and to your personal pager for the following situations: Level 1 (trauma), T-10 (most severe trauma), code blue (cardiac arrest), STEMI (heart attack), Stroke Alert, and Rapid Response (a dramatic change in patient status).  Each of these things demanded a different sort of preparedness.  An overhead page is accompanied by a chime that I will never forget the sound of in my entire life.  It is a Pavlovian response when that bell is heard, instantly you grab your pager and turn your ear toward the overhead speaker.

The strangest moments I experienced this summer were while waiting at the main Emergency Department desk or upstairs at the T-10 room as we waited for the trauma patient to arrive.  The charge nurse would generally have a vague description of the situation (gender, age, and a brief description of the incident).  However, "motorcycle collision" or "motor vehicle collision" can have varying levels of intensity.  As I waited at that desk, in front of the trauma rooms, there is nothing in my life that could have prepared me for what I would see.  I would wonder, will this person be dead or alive?  Will I see their internal organs today?  No sight really bothered me until the burn patient came in on one of my overnight shifts. That was a sight, smell, and experience that I will never forget.  I had never smelled severely burned flesh, but instantly I knew what it was.  Horrifying.  Yet I still had a job to do.

You can get all the training in the world, carry all the right supplies, yet, you can never really be prepared to do something until you are in the middle of it.  Then, you find a way.  Because you have to do it.  Because everyone in that trauma room has a job, including the chaplain.  I never once froze if I had a job to do, even in the most terrible trauma situations.  It only comes afterwards that you realize how unprepared you actually were.