Gun trauma hurts caregivers, too
Destruction of bodies, lives hitting staffs hard
In response to a recent medical journal article that calls firearm violence “a public health crisis,” the National Rifle Association tweeted, “Someone should tell selfimportant anti-gun doctors to stay in their lane.” What ???? As a nurse who spent years working with trauma patients and the physicians who treated them, I witnessed the effects of gun violence up close: colostomies, brain injuries, shattered bones and paralysis, to name a few. Years after a bullet had damaged their spinal cords, some paraplegic and quadriplegic patients still regularly cycled through the hospital with bedsores and infections.
In response to the NRA’s tweet, Dr. Joseph Sakran, a trauma surgeon at Johns Hopkins Medicine in Baltimore, tweeted back, “Gun Violence IS Our Lane.” He then went on to create a Twitter account @ThisIsOurLane, which as of Sunday had 27,900 followers.
San Francisco pathologist Dr. Judy Melinek expanded upon the point: “Do you have any idea how many bullets I pull out of corpses weekly? This isn’t just my lane. It’s my f— highway.”
That was just the beginning; The docs have gotten graphic. Using the hashtags #ThisIsOurLane and #docs4gunsense, emergency medicine physicians have posted photos of blood-soaked scrubs and of operating room floors slimy with victims’ blood.
They are posting accounts of what it’s like to sit with parents after you’ve informed them of their child’s death; what it’s like to hear the anguished screams of a mother echoing in your brain days and weeks later; what it’s like when you have children the same age at home.
Now we’re getting into my lane: burnout, vicarious trauma, secondary stress and compassion fatigue. All of these terms reflect normal human responses of people whose work regularly exposes them to trauma: physicians, nurses, social workers, medical therapists of all kinds, first responders, public defenders, judges, psychologists, prosecutors, journalists and others.
It takes real courage to tell your patient that a bullet severed his spinal cord and that the injury is irreparable.
It takes real courage to inform your patient’s family that in spite of your best efforts, their loved one died of multiple bullet wounds.
This kind of work takes its toll. Symptoms include sleep disturbances, fatigue, intrusive images, nightmares, excessive anger, irritability, anxiety, fear, tearfulness, social withdrawal, despair, hopelessness and cynicism.
As a psychiatric nurse, I suggest that expressing more and suppressing less is healthier than silently suffering. “Selfcare” might help, if emergency room physicians had the time and energy to pursue practices such as yoga, mindfulness meditation and regular exercise. But given the major stressors of unrelenting exposure to human pain and suffering, excessive workloads, documentation requirements, the threat of malpractice suits and a loss of professional autonomy — to name a few — structural change is urgently needed.
By educating employees about the symptoms of caregiver stress, health care institutions can break through the denial that prevents a concerned professional from reaching out to an afflicted colleague.
Work schedules must be made more compatible with private life. The health care environment itself must be made safer — physical assaults on staff are highest in the ER and psychiatric areas.
Gun violence is a public health crisis in the United States. Mass shootings may dominate the news, but two thirds of firearm deaths — 22,000 annually — are suicides.
Nonfatal gun injuries deeply affect millions of caregivers, family members, friends, coworkers, teachers, schoolmates and others. While the NRA continues to turn a deaf ear and a blind eye, the rest of us need to open our eyes, ears, and hearts and grapple with our reality.