How confident do you think you would be if a healthcare professional was caring for you and had a recent traumatic brain injury? It’s doubtful you would know unless this were a new injury or obvious problem. Isn’t that what brain injuries are: Invisible Injuries? So who’s policing healthcare professionals when they do not understand traumatic brain injuries? Denial, denial, denial.  Errors are not widely publicized and rarely are documented. They are supposed to be documented. When errors are documented they are usually not in your medical records unless it’s a subtle mention so they do not raise red flags. There is a separate incident report created that is not attached to your medical file.

Healthcare is also guilty of pushing their employees back to work. Why don’t  healthcare professionals understand TBI or mental/brain dysfunction? They are the least likely people to be compassionate and understanding when an employee is ill (mentally or physically) or injured.  Unfortunately, their misgivings may become part of your life threatening injury or illness and affect your health and life forever.  I will share only one situation at this time so not to overwhelm anyone with what’s happening inside our healthcare facilities.

Imagine your baby was just born and transported to the neonatal intensive care unit for special care because of a number of complications your newborn has.  So as a new mother or new father you expect those caring for your newborn infant who is in the intensive care to be alert and able to respond to anything.  How would you feel if you noticed a huge scar like a question mark across the entire side of your nurse’s head with half their head shaven?   Her hair was thick, long, beautiful, curly, and divided in a manner that one should not see…and then you discovered that horrific scar!  This was my nurse friend.

What happens when you are a nurse with a TBI and years later your nurse friend has a TBI?  Oh, so many questions and than I think about patient safety again.  Many other thoughts go through my mind. This happened to me, my dear friend, and others as well…all healthcare professionals!  The circumstances surrounding the injury itself were different in each case.  The outcomes are different most likely owing to the urgency and immediate medical interventions.

This happened to my friend of 21 years.  She is a registered nurse. Who ever thinks it will happen to them? I know she never thought it would be her.  She was usually safety conscious about everything.  That speck of confidence and doubt understanding TBI may have left her more vulnerable to this injury.  After all, just a couple months after my TBI she commented “If you were motivated you would be back at work.” She knew nothing ever stopped me from anything.  Well, I did confront her with this comment and she denied it even though others witnessed this…but she’s entitled to deny whatever she would like.  After all,  the blame is always “she has a brain injury,” and “I never said that!”

What people don’t know is those with TBI learn how to compensate and journal.  If you are a nurse you document everything, and I did just that.  Even though one has a slow or delayed processors documentation clarifies everything. With notes people with TBI can figure out what is happening much clearer than quick and spontaneously communication.  Sometimes it takes days, weeks, months, or even years but eventually one gets it loud and clear and is able to figure it all out!

Anyway, it was August 9, 1999 and a beautiful sunny summer day in Hinckley, Ohio when my nurse friend suffered a mild traumatic brain injury.  She was repelling while rock-climbing and flipped slamming the back of her head into the rocks.  A helmet was not required, but the depth of brain injury wasn’t well understood until it happened to her.  She saw me frequently and obviously she did not understand until this eventful day.   She was dazed but walked to her car.  Her husband witnessed a grand-mal seizure and help was called upon immediately. Emergency transportation to Youngstown, Ohio by life-flight helicopter occurred.The closest trauma center was full.  I would have felt confident if she were transported to the nearest and best Level One Trauma Center in Cleveland, Ohio.  Maybe I was partial because I worked there…and I know the trauma center is exceptional, in spite of what we’ve been through after my TBI. Unfortunately, it was a busy emergency day and the nearest trauma center was quite far away.

I had very little energy but I used every ounce every day and never stopped helping anyone.  My husband drove me to Youngstown, Ohio at least a 90 minute drive from our home.  I was there as a friend and an advocate.   I sat by my dear friend, praying for recovery, reassuring her how much she was improving even when things looked bleak.  I knew she could hear me.  She’d open her beautiful hazel eyes periodically and looked so lost! This was one of the hardest things I’ve witnessed.  I knew I needed to be strong.

On the other hand, I knew firsthand how difficult recovery could be.  I found myself next to her in the intensive care unit holding her hand and comforting her, her husband, and her family.  My luggage was packed to stay the duration of her hospital visit.  I would have never left anyone in the hands of healthcare professionals and either would she.   We had an agreement among each other that we would watch over one another if anything happened.  It did happen! I did what I promised and what I would do for any friend!

The course of her hospitalization was incomprehensible. I was by her side as a friend and advocate until she was discharged merely 3 days later.  She regained consciousness within the first 24 hours, even though they had her in a medically induced coma. So where there is a will there is a way!  While still in the ICU (intensive care unit) I cringed at her care or lack thereof. This was a nightmare of two nurses.  One with an old “closed head injury” and never referred to as a TBI until the past two years and now and a newly undiagnosed TBI. Doesn’t TBI include brain surgery?  She never heard anything about a mild traumatic brain injury for over a year following her surgery.  I guess it’s something we should just assume, even if we don’t know!  How could that be?  I am referring to an area with world renowned healthcare facilities and if this is happening in this prestigious area of healthcare what is happening around the rest of the nation and world?

God only knows what happened when I left her side for rest and naps.  All I could do was my best.  My best was to be there for her as much as I could.  The hospital provided rooms for immediate family members only.  So, I needed to become her sister through her hospitalization.  Another flaw in the system.  It shouldn’t matter if you are blood related or related as significant people because that’s a personal preference. That is an entirely different issue.

While in the ICU these were my observations: They didn’t even have a name band on her 24 hours later.  They brought her an entire tray of food for her to eat lunch. It was not even soft foods.  It was a regular diet.  Horrific!  They should have known that someone with a brain injury frequently chokes because they have difficulty swallowing.  Choking and swallowing difficulties can lead to aspiration.  When a patient aspirates food will go into the lungs and cause an aspiration pneumonia creating a new problem.

When beginning to eat after injury patients need to be monitored while eating to make sure they don’t aspirate. They need to make sure they can chew or remember how to chew their food. Reminders are important for every aspect of functioning immediately after brain injury.  This is a common problem. She obviously needed reminders to chew her food.  She began to just shovel the food into her mouth with fingers not using the utensils everyone would assume to use.  I was there so she was okay.  I wanted to see how she would respond before giving her cues to do next.  This helped me to see what she remembered and what she did not. Where were the intensive care nurses? I can only imagine they were short-staffed and over worked.  Possibly they were clueless. Maybe they just lacked the education and understanding of traumatic brain injury?

When they transferred her to a regular medical unit the nurse’s assistant handed her a couple towels and told her to follow her to the shower.  I was devastated.  First, she just had brain surgery, second she was dizzy, and she could have easily fallen.  She walked as though she was intoxicated down the hall and behind the assistant by at least 10 feet. They were laughing as though it was all a joke!  In my heart and my mind I was crying and fearful for what was happening and yet to come.

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