You can’t put your family on ecmo

I have spent every day since March 7th, 2020 in warrior mode. On March 6th, 2020 I did not even know I had a warrior mode.

I know you are probably thinking that I am referring to Covid-19. And yes, as a nurse manager of an ICU during a pandemic, I have been very vocal about the toll the patients have taken on us. But what I am actually referring to is the day my husband broke his ankle.

I knew Covid was coming, so I was taking a 4 day weekend with my husband to go on dates, ride our dirt bikes around Southern Missouri, hike. You know, stuff that is supposed to recharge your batteries. Day 2 of date weekend was a Saturday. My husband is always very diligent about safety when it comes to bikes. Gear is important, the right boots are important-not wearing the right boots will get your leg broke. I suspect you know where this is going. He took a spin around the yard to test out his new chain and I’ll be god damned if he didn’t break and dislocate his ankle. Prior to that day we were very active-we hiked almost every weekend and did projects together all the time. As an aside: the ankle is the worst joint to break because all of your weight is supported by that joint.

The following week was a whirlwind of orthopedic surgeon appointments, pain meds, and planning for a potential pandemic. My husband had his surgery on a Friday and two days later we got our first suspected covid patient in the ICU. I happened to be at the hospital of course. My husband was home alone set up in a recliner with every possible thing he would need throughout the day within reach. This would be our life for the next few months-me setting everything up by the recliner, helping him down the stairs, then leaving for 12 hour days at work trying to plan and keep everyone calm. Meanwhile the thought of my husband in the back of my head all day, needing to go home to help him but staying at work to help the world instead.

This scenario played out in most ICUs and med surg areas across the country. Healthcare workers showing up, working hard, going home exhausted and scared, repeat, repeat, repeat. I will not bore you with all of the things we did, saw, and felt during the time after March 13, 2020, I know you are all tired of hearing about it.

The point of this blog is that most healthcare workers put their home obligations aside during this time. Our kids were doing online school at home alone while we worked. Two of my children failed quite a few of their classes-I didn’t even care. Maslow’s hierarchy and shit. While I was working, my kids were essentially raising themselves, running the streets (don’t worry, I live in a nice middle class suburban neighborhood)-they were on their own.

When we began to get the hang of taking care of covid patients, we found that if we had a young enough, healthy enough patient who was doing crappy, we could put them on ECMO. ECMO is one of those things we do in medicine to take the place of your lungs and your heart, it is, in very simple terms, and artificial heart/lung. It does not cure but it does buy time. The risks involved with this are great, but at least we had this one last thing to try to save them, at least we had ecmo.

When things started to settle at work and the dust began to clear and we weren’t so panicked-we started looking around and trying to reorient ourselves to the world. I still feel like I am trying to fit into a world that I do not know. For the first few months, we just sortof treaded water waiting for another surge.

As we turned our heads to our homes, we all began to realize the huge toll this took on our families. We are a profession of mostly women, so most of our kids were without a mom for a year and a half. We were there, but we were not *there*. Relationships were neglected and damaged. I had one nurse tell me that the only place she felt normal was at work. That is fucked up.

My own family life has suffered. My kids are struggling with mental health. Most of us are in therapy and those who are not probably should be. And meds…thank god for meds.

So here we are, twirling in the wind, not knowing what to do or how to make things better. We are so used to being in control at work but we have no control in our home lives. Some say healthcare workers are not suffering from ptsd because we do not have the same symptoms as soldiers who went to war. It’s true, our symptoms are a bit different. The biggest difference is that *most* soldiers are not women. Women internalize and process things different than men. Soldiers are also offered support from the military in the form of PTSD resources like 1:1 counseling, group therapy, family therapy, PTSD specialists, etc…all free of charge to the soldier. They get disability benefits, and there is an entire department dedicated to PTSD called The National Center for PTSD. We are on our own, the burden falls on us. Sure, most hospitals have an “Employee Assistance Program” which provides a few free counseling sessions, but this is much bigger issue than that. It is going to take years to recover and repair our relationships. Our kids are now a generation of Covid kids with little direction and discipline. Our partners don’t understand us, how could they? We are different than we were the day before our first Covid patient.

So what is there to do? I don’t know, I’m too busy trying to get through the day. If you are a healthcare worker, my advice is that you turn your head toward your important relationships. The ones who would take a bullet for you. Now is the time to take care of you, to take care of your family. Because you can’t put your family on ECMO.

Special thanks to C.V. for walking me through this & coining the phrase.

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