Condition: Critical

It has occurred to me that crisis response in the ER parallels our personal lives. When a nurse gets an acutely ill patient, their initial arrival is met with many helping hands. The doctor is right there and extra techs and nurses flock to the room to help stabilize the patient. The need is obvious and generally a team assembles without you even asking.

But as the initial stabilizing and testing settles down, staff start to return to their own patients and to the other demands of the department. The primary nurse will eventually find themselves left alone to manage this very ill patient, and sometimes resume care of their others. After the initial influx of help has abated, one can find themselves overwhelmed. A request for more help at this stage can occasionally even be met with ire – can’t you handle this yet? Do you still need help? This is the hardest part of critical care in the ER. The part after all the help leaves.

Isn’t life like that? Big events like childbirth, acute illness, and loss generally bring a big wave of support. Friends and family pour in to help, make meals, take over chores, encourage you and check on you. But as time goes on the friends and family slowly taper away as people return to the demands and distractions of their own lives. Months in when most support has moved on, a new mom or the bereaved can find themselves overwhelmed… silently drowning, unseen behind the curtain of regular life, while everyone assumes the greatest crisis has past.

There’s an anxiety I know all too well in the ER. It’s when help starts to disappear and you’re thinking “Wait! I’m not ready to be alone yet!” And yet who wants to appear weak, and so we soldier on – ready or not- and hope we don’t go down.

Critical care, like life, is so much better when done as a team. Maybe we can do it on our own, but it’s so much better when people have your back. Like the nurse that stays with you and your critical patient a little longer until you feel confident. Who checks in on you periodically to make sure you’re not drowning. The charge nurse who delegates another nurse to care for your other patients. And you always being ready to do the same.

I am so thankful for the times someone has seen I needed help and jumped in. But we do have to learn to ask for it. The newer nurse may not ask because they fear seeming weak. The veteran nurse might not ask because of pride. Because they’ve always been able to manage their shit and they’re used to being the rescuer not the rescued. But there comes a day when we will all need help – because in the ER one person can never always be enough.

Isn’t this true of life? Thank God for the perceptive friends who check in on us when time has distanced the initial “event”. Who pick up the extra things we can’t manage until we can. But we also have to learn to ask. Despite the possibility of the perception of weakness, and despite our pride from being used to strength.

It is important to remember that, yes – a crisis needs an influx of people, but that need doesn’t have a clear end point. A grieving parent isn’t past the worst of it after the funeral. A new mom can be exhausted and overwhelmed at any point. Life is distracting and busy, but let’s remember to check in. On our teammates, on our friends.

A person’s most vulnerable point is often after the crisis, not just during.