The Hardest Part

I wrote recently about death and it's a bit of a load of bunk if I'm honest 24 hrs later. But I'm going to leave it up and just write an addendum.

The hardest part of working in emergency medicine and hospice care is maintaining your composure. It's the same for healthcare in general for me. The variety of roles I've found myself in. The difficulty comes from different sources that change constantly but if we broke down to the root of it all, that's what we would be facing.

The simplest form of it is not breaking at a smell. It's a simple thing but something we deal with all the time. Whether it's as an aid cleaning up a patient or resident after a bowel movement or bladder void gone wrong, or helping clean up a patient who missed their basin or emesis bag while vomiting. Those are the simple ones.

Harder is not letting the shock show on your face at a wound that's more severe than anticipated, or vitals or a lab that tells a hard story. Maintaining that decorum can be difficult.

Yet harder for me was those moments when I didn't know what to do. Especially as a medic. Knowing when to say "I don't know" in a way to not raise alarm was a balancing act. Countered by when you were it, and you had to take a moment, not panic and figure out what you did know, what you needed to do for the one guy that needed your help as a bunch of faces looked at you for guidance. I didn't handle every situation right but my confidence grew. I got better at it. Or at least I think I have.

The hardest for me is part of my current job. Not breaking in front of family after someone is gone. Some of these patients in hospice have been part of a near daily routine for months before they pass. It's impossible to not develop report, a relationship. We're human, I'm human. Bonds just form. When some are gone it burns, it stings. It can be demanding to bury that, take a deep breath and push on with the job at hand whatever that may be. It could be one second helping coordinate or call a funeral home etc, and then prepping the body the next until there's a call light and you're down the hall helping someone with hygiene.

That's the tricky thing about death in this setting, or even trauma. It's just part of your day. You can't carry it with you from patient to patient or you lose that composure. But it still sticks with you. It's still weight, it's still an emotion. It's still there.

I chose this path because I care. That isn't a direct hindrance. But it can complicate things. It can be harder to move on. To maintain that composure. And I need to be real about that.

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