HJNO Mar/Apr 2025

ROUNDTABLE 16 MAR / APR 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS is a victim of violent trauma. They are available for patients who are not victims of violent trauma, because PTSD can happen for patients who are in a car accident. They stepped up, really ramped up their services and were working tirelessly for days after seeing trauma patients who were admitted. They do a phenomenal job. Maslanka Not only did trauma recovery do a phenomenal job for patients, but they did so much for staff as well. They participated in all the hospital debriefs and departmental debriefs that happened. Just the other day, we ran into someone from the health department who was on their way to their office for a post-MCI debrief. They were really there for patients, staff, the entire community. Lacy Yeah, like you said, the community. They stepped up their services for our EMS teams as well, who were the initial responders, were first on scene. Our BWA center and our trauma recovery center came together and did a mental health debriefing for those teams so that they could ... They're still expected to go out there and work the Super Bowl and Mardi Gras and everything else. Offering those services to the first responders has been a whole part of this as well. Editor We actually have Dr. Rajo writing an article that's going to be adjacent to this roundtable on compound trauma and their team’s suggestions. Greiffenstein The impact on nurses can't be overstated. We develop a really personal relationship with the families and these patients, particularly in the ICU where they're usually put one-on-one or one- on-two nurses, so they spend a lot of time at the bedside, having those difficult conversations. They're the person who comforts. I can attest that a lot of the nurses in the ICU, particularly, were personally affected by this and showed up the next day, stayed their shift, and did what they needed to do and provided that comfort and kept coming back. Editor How do you control your panic in a situation like this? Maslanka We're used to it. Baudouin I think that, unfortunately, is a true answer. You are a bit conditioned to it. And, more importantly, if you have those strong relationships with both your colleagues and your stakeholders, then you are able to put on at least temporary blinders, if necessary, to get the job done. We want to make sure that we are putting our patients first, and that is how we're able to execute it, maybe with a slight tunnel vision, initially, and then be able to focus on those things that Dr. Greiffenstein mentioned, like that whole care and that trauma recovery. Really, you’re just pushing through every day, and it's a different experience for everyone — how they do it, whether you're a bedside nurse or if you're an ED nurse or a physician. I think everyone was really touched in a different way, but I think that relying on the strength of your colleagues and your team and those you know is how you get the job done when it's an unpleasant day. Elder I think you become very task-oriented, initially. You know the plan, you start working the plan … The patients come in, we evaluate, we reevaluate, and we keep working that process. You do that to a point of then something else is going to happen. For example, we're the trauma center, so we get all these trauma patients. Well, there were other traumas occurring at the same time in the community that we were getting with the MCI. We received 26 patients during the acute phase of the MCI. Well, what we didn't know at the time was that, really, 20 of those were from the MCI, and six were from other incidents that occurred. There were some motor vehicle collisions. To us, the patients looked the same — the same injuries. It wasn't until later that we sorted through it and figured it out. Were these people involved; were they not? But at the time, those were extra patients that were coming through, so you have to deal with it in real time and get through that. Then, you have to remember that of the patients that were here and that were admitted, our last patient was discharged from acute care on day 24. Editor That was my next question. Elder We had people that were here for over three weeks — patients that were dealing with their injuries, and that's just the acute portion. For a lot of our patients, they ended up going to inpatient rehab or needed home health at the back end; because while they were acutely fixed and healed, they still have a long way to go. The whole time they're here, you're dealing not only with their acute trauma or medical injury, but you're dealing with that whole picture. That trauma recovery team or a trauma psychologist is working with them throughout the entire time they're here. These are things that they're going to have to deal with even once they're out of the hospital. And if they're local, that's great; we can bring them back. But we had people that were not local, so they're flying back home to other parts of the country, and they're going to have to seek some of those resources there, too. It doesn't end at discharge. Lacy From a leadership standpoint, I think it is checking in with your team. At least for me, every time I go around and ask the nurses, "Hey, how are you doing today?" I knowwe're in February now, but for a while there, it was something every day. It was just ramped up every day. I think for leaders, just identifying what burnout looks like and making sure that you stay ahead of it, and asking your team, "Hey, are you good? Are you okay? What resources do you need?" Even if it doesn't look good, they may need a lesser shift, or assignment, or whatever