For an emergency nurse, dealing with gun violence doesn’t get easier

Even after treating patients in the emergency department for more than 10 years, Angie West says she doesn’t have a secret to coping with the difficulty of treating patients with gunshot wounds.

West works as an emergency nurse at UPMC Shadyside in Pittsburgh and is an educator at the Shadyside School of Nursing.

In an interview with Chief Healthcare Executive®, West said it doesn’t get easier when talking to families of victims of gun violence.

“You would think after all these years of experience, I would have secret data, you know, a certain phrase for when I talk to them, or a certain coping mechanism,” West said. “I have not developed a way to do that yet. So, I guess it's something still in progress, unfortunately.”

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West has seen victims of gun violence almost every day in the emergency department. As a nursing instructor, she’s also seen patients with injuries from firearms in the intensive care unit. West recalled seeing a woman in her 40s who sustained multiple gunshot wounds and had to explain to her loved ones that she faced a difficult road.

“It's hard to see the family not understand or accept that,” West said.

She said she’s treated patients with traumatic brain injuries, and family members grasp for hope when there’s a slight movement of the patient’s hand.

“Sometimes it's a little hard to watch,” West said. “They see a flicker in a patient's hand and are like, ‘Oh, she's moving her hand, she's getting better.’ And you try to explain to them because of the type of traumatic brain injury that they have, that that's not a purposeful movement. It's reactive.”

• Read more: Emergency nurses treating gun violence can’t ignore the pain

Some patients stand out in her experience. West recalled a woman in her 20s who was fatally shot, and the victim had a child less than a year old.

“It's those situations that are just so heavy,” West said.

When asked about the toughest part of dealing with patients who are victims of gun violence, she said, “It’s family, every time.”

West grew emotional when talking about the fatal shooting of a 14-year-old boy, and having to take the boy’s mother back to see her son.

“I can still see her face,” she said. “This was like five years ago. I see her face all the time.”

West said she’s wondering about how much she internalizes from what she’s seen in the emergency department.

“I don’t know if I am manifesting this internalization in other ways, whether it's my relationships or with my friendships, or with my personal health,” West said. “And I'm sure it has. If I have a couple of bad days in a row, I don't want to talk to anybody for like a day or two. I drive home in silence. So there's definitely things I've noticed. But I have to wonder, what subconsciously am I doing to deal with all these items that I've just internalized.”

West said she isn’t sure about the circumstances surrounding most of the victims of gun violence she has seen. At times, she said it’ll be clear the victim is a gang member, because extra security will be posted around the hospital in case there is a chance of retaliation. But West said she’s not sure why many of her patients with gunshot wounds arrived in the emergency department.

“I don't know. It's not a direct part of my care. Some people want to know where were they, who did it … I couldn't tell you. What I need to do is focus on the situation at hand, right now,” West said.

Even though it isn’t easy being an emergency nurse, West said she has no intention of working in other parts of the hospital.

She said she does feel a responsibility to stay, noting that some don’t stay in emergency medicine for a long time. But she also relishes being an emergency nurse.

“I love this type of nursing, I really do,” West said. “And it's not something that will ever change. There's no other type of nursing that I want to do.”