When I was saying my farewells to my friends at Grossmont Hospital ER, the most common comment I received was, “You’re nursing skills will be so useful in Thailand.” I would smile and nod, but deep down, I suspected that most of my nursing knowledge consisted in starting IVs and pushing meds. Sure, there’s CPR, but outside of the clinical setting, what value are all my skills if I don’t have the proper tools? All the same, I made sure to bring my stethoscope and trauma shears with me… just in case.
Have you ever driven by an accident in on the highway, saw how bad it was and just kept driving? That’s what I would do. The medics were always there anyway, so what use could I be? So when we driving from Tak up to Mae Sot, a dangerous journey, or so I had only been told, I just kept driving when we passed a rolled over car with people all around and cars pulled over. Shannon asked, “Should we turn around?” It took me a minute to understand what we could do to help. Then I remembered (I can’t believe I’d forgotten!): I’m a trained emergency nurse! So I turned us around, parked the car and got out.
Shannon told me to remember my stethoscope. I thought it was a good idea. So put it around my neck and went traipsing through the jungle toward the wreck. I paused a few times, hesitating to offer help with so many people already there. But I kept on and soon discovered that there were four passengers who had been thrown from a van. Thanks to the stethoscope, I was immediately welcomed and given “street cred” as someone who may know what he’s doing.
The first person I saw was the most gruesome, with an open right wrist fracture, but he was alert and talking to someone attending to him. I left him and looked for someone sicker. The second girl was unconscious, lying on her side. I began calling for someone who spoke English and a young girl was retrieved. She helped me assess the girl who began to arouse. She was soon alert, oriented to name and denied neck pain or neurological deficits. I instructed her to lay still until medics arrived.
The next girl was probably the sickest. She was obtunded at best, barely opening her eyes, not answering questions, but mainly unconscious. She had a scalp avulsion and bruising to the right side of her face. Once medics arrived and we immobilized her on a backboard, it appeared she may have had some abdominal distention as well. The last girl was anxious and had oral trauma. She appeared to have either altered mentation or was mentally disabled, difficult to assess through the cultural barrier.
I made sure that everyone was kept from moving and I told everyone to stop trying to wake the victims up with smelling salts. The medics arrived probably 15 minutes after I did. I was able to irrigate, dress and splint the wrist fracture while we waited for them. I was really impressed with response of the medics and they listened to my instructions to prioritize the two girls that were altered. Their backboarding skills were very good and I was able to be a part of their team and helped to carry one of the girls up to the road.
Throughout my time there I had moments of emotional breakdown. I’d never experienced anything like this. I felt honored to be able to help. I felt traumatized for having to see this. I felt horrified that this had happened to these individuals. And I was sobered for the safety of my family. I would have to stop every couple minutes and just sort of weep for a few seconds and then carry on with the work. In the hospital setting, trauma patients come in fairly regularly, but we have the luxury of working in a controlled environment and the patient has already been triaged by the medics on the scene. Also, the victim is now a “patient” and it is much easier to remove our emotions from the equation of patient care.
Walking away from this experience I felt very overwhelmed. Thankfully, this isn’t an everyday occurrence. But I know I can expect it to be more frequent than in the States. I’m still trying to make sense of my part in all this. I’ve left the field of nursing for a time so that I can pursue agriculture and humanitary relief. I didn’t really think that my nursing skills would come into the mix here in Mae Sot. But this experience has me hoping for more… maybe not a roadside trauma, but I think I’d like to put the gloves on again.