Wiped out.

One day not so long ago, after a mostly full day at the 'office,' I'd picked up a six hour shift to help pad the pocketbook, to maintain skills, and to help out my professional alma mater as she struggles under the weight of staff exodus and over-capacity.

And it was freakin' awesome. One of those shifts that makes me say "That is why I do this job!" It started out pretty tame, only a couple of people in the waiting room, which is unusual in and of itself - I got sent to triage, which I was expecting, and okay with. Two friends of mine were the other nurses in triage, one an 8-month pregnant Barbie look-alike who's moderately feisty even when she's not great with child, and the other a sassy little Hispanic chick who doesn't take crap from anybody. We joked that it wouldn't be the right night to cop an attitude in the waiting room... but it never really got too busy. A routine trip to the back to take a patient to a room, though, and I overheard that it was about to get less boring.

Seems a sizeable tornado had touched down and raised hell not so far away, charge didn't know details yet but we were gearing to external disaster alert, and they were officially using the "mass casualty incident" terminology. The statewide disaster resource network computer showed six air services dispatched to the area to retrieve patients, as well a handful of spare ambulances, and our own transport bird shipped out with eight units of o-neg for somebody who wasn't doing too well. I swung into action discharging patients and otherwise emptying beds, ignoring triage for the moment. Called Scott, who sometimes has a heads-up with stuff like that due to being able to hear all the AMR radio traffic when he's on duty - he didn't know any more than we did. Returned to triage while we waited to hear more. Details trickled in. Stuck in a tree. 50-60 structures. Open fractures. Massive facial trauma. A kid. Pulseless leg. Door-to-door searches. It sounded ugly. We soon knew that we'd be getting at least three full traumas. And staffing, while not short, was short on folks who're trained and certified to do trauma. The air was starting to feel that charge, that energy that precedes full-on chaos. And I love that.

I pulled a patient back to triage, and our tech poked her head in and said "You're being paged to Resusc 2, stat." So stat I went. Incoming, a 40-ish male, found in a tree with part of a house on top of him, pressure of 70 after 4 liters of fluid, yada yada. Everything went smoothly when he got into the room, the seamless and amazing way fifteen people can be clustered around one gurney, hands everywhere, everybody poking and taping and unbuckling and untangling and reaching around with cords and lifting and examining and somehow, miraculously, nobody getting in anybody's way. I was running the rapid infuser, which wasn't all that rapid for some reason, and that's always a bloody job. Especially so when one of the trauma surgeons doesn't clamp the tubing when he undoes it from the cordis for a second. Shoes, ruined - oh well. We had him for a grand total of about 6 minutes, his spleen had been "obliterated." Tough.

And all the while this was going on in three trauma bays, we had a guy having a whopping heart attack a few doors down, cath lab team there to do a quick scoop and save. One of the girls showing off her new engagement ring in between patients. And around the corner the most impressive anaphylactic facial edema I've ever seen; they were about to do a last-ditch crich when somebody managed to intubate. My pregnant Barbie friend blushing about the monstrous diamond ring, earrings, and necklace her boyfriend brought to her mid-shift as a for-no-reason surprise. The whup-whup-whup of helicopter rotors overhead. Add to that the usual smattering of cops roaming around, general medical lingo tossed up and down hallways, folks like me with gallows humor sharing a moment of Jeff Foxworthy levity while we waited for the next tornado victim...

Chaos, thinly controlled, the machine working like it should. People remembering what it feels like to be part of a team. Newbies stepping up to the plate and finding they can hack it. EMT and nursing students observing in awestruck wonder. And the rest of us, a much-needed dose of validation, followed by a sincere 'thank you' from one of the best charge nurses I've ever had the pleasure of working for. (Judy, you rock, and strong work holding the ship together.)

I. Love. This. Job.