RN, BSN, CEN
A young mother was brought to the trauma bay having been hit by a truck. The trauma team worked to stabilize her. Her injuries were many. Shortly after the mother's arrival, Tanisha Sosa (called "T") learned that a pediatric trauma patient was 5 minutes from the hospital, no time to call a second Trauma Alert. T went to work preparing the second trauma bay for her incoming 3-year-old patient. He had also been hit by a truck and was being coded on arrival to the ED. The team learned that these new patients were mother and son. The toddler darted out into the street while walking with his mother to pick up his older sister from school. Like most mothers, this one tried to protect her son from injury by following him into the street. She, too, was hit by the truck.
As both trauma teams went into overdrive, the mother's condition improved. Her son's condition did not. T told me that it was clear to the team after about 5 minutes that his injuries were too severe to allow for his survival. But, hoping against all odds, the team continued the resuscitation under the direction of the doctor. Giving up was not an option until all hope was gone. Forty to 45 minutes after his arrival, the team's efforts stopped and the boy was pronounced. Defeat. Sadness. Devastation. T began to respectfully and lovingly prepare his body so that his family could say goodbye. Twenty to 25 family members waited outside the ED. Thankfully, the mother's condition was now stable. The doctors shared the devastating news with the family and proceeded to carry out their responsibilities. Moving on is essential. Another trauma patient could be wheeled through the doors at any moment. T and other team members were left with the challenge of picking up the pieces of a family in the throes of grief.
A staff member translated for the Spanish-speaking mother. She asked about her son. She told the staff that she thought that she had saved him from the truck and that she had taken the brunt of the crash. As is often the case, she expressed disbelief upon learning of her son's death. It can't be true. This cannot be happening. He wasn't really gone. But he was gone. T and another nurse knew instinctively that mother and son should be together one last time. They brought them together in the trauma bay. T put the boy next to his mother. Crying, she said that she could feel his heart beating. T reiterated that he was gone as she provided comfort and put her own feelings and suffering aside to console her patient. T allowed the mother, son, and their family to remain together for about 2 hours. The woman's other children, a 9-year-old boy, and a 13-year-old girl were present. She told them that she wanted to die with her son. T told us how this 9-year-old boy, whom T described as an "old soul", told his mother that she needed to live to take care of him and his sister. They needed her!
The next day, T went to STU to visit the mother. She needed surgery. She touched T's cheek and thanked her for caring for her son. Always a nurse regardless of the setting, T proceeded to wash her and change the linens. The mother told T to get someone else to do the work. "You don't work here," she said. T told her that it didn't matter that she didn't work on that unit. She would take care of her needs. And she did.
T and the other caregivers learned that, although he was just 3 years old, this boy was a very beloved member of a large family. They shared stories of how he brightened their lives and how he would be severely missed. The family is grateful for all that the trauma team did for their family even if it meant that one family member didn't get to remain with his earthly family.