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Traumatic choices
AMA Victoria’s Marketing & Communications Coordinator Nicole Saccaro reports on a new hospital education program that graphically shows young people the impact of their choices.
An 18-year-old lies on white sheets, unmoving. He took a risk. He chose to ride his motorcycle without wearing a helmet and now he is in an induced coma in intensive care. His mother stands by his bedside, tired. She explains how proud she is of him: “He is a good boy…he was just being a boy”. She is desperate for something good to come out of his trauma, and hers, so allows a group of school students to stand by him, to see first-hand the consequences of a choice he made, and pleads that each of them think before making a decision that can have a lifelong effect.
A trauma-causing accident occurs in a split second. That shock moment reverberates across families, and communities, and the health professionals, police and emergency workers responding to its impact. Seriously injured people receive critical treatment as soon as possible, and improvements in major trauma treatment mean survival rates are increasing, but in many cases survivors suffer permanent disabilities for the rest of their lives. What if the occurrence of trauma could be reduced in the first place?
An innovative new program draws on the experiences of trauma professionals to educate young people, by showing them what can happen when you make a wrong decision. This is the not-for-profit P.A.R.T.Y. (Prevent Alcohol and Risk-Related Trauma in Youth) Program, run out of The Alfred and The Royal Melbourne Hospitals. The program has a focus on preventing accidents before they happen by giving secondary school students and young offenders real life experience at the emergency and trauma units at a major Melbourne hospital. This program features doctors, nurses, emergency workers and allied health professionals who volunteer their time as presenters, to tell their stories in the hope that they can help reduce the incidence of trauma.
As Dr Stephen Parnis, AMA Victoria Vice President and a consultant emergency physician, explains: “In emergency we see young people involved in trauma every day. We are extremely keen to promote all aspects of trauma prevention, including less risk-taking behaviour by young people”.
Rather than dictating to students, the program takes them on a journey through a traumatic event, from the moment a decision is made by a victim to its result in a horrific consequence. Confronting images and tragic stories form the basis of these presentations – they are engaging and interactive but high on shock factor, leaving some students visibly shaken.
Janet, the P.A.R.T.Y. Program Coordinator at the National Trauma Research Institute at The Alfred, describes their approach: “Every case study presented, every morbid picture and x-ray is denoted by the word ‘choice’. ‘This young woman made a choice to get in the car’, ‘that man made a choice to drive his car under the influence’”.
The students are then led through the hospital, stepping into the shoes of doctors and nurses. They see where helicopters and ambulances rush in, and where injured patients are wheeled through to the emergency department. A real-life story is told by two trauma nurses, as students wear lead vests and scrubs and cut their way through their dummy patient’s clothes. They begin gently, with humour, but it is a serious tale. The nurses describe the calls they must make to parents and loved ones:
Just imagine if your parent got a call from The Alfred at 2 am, they were told you are in a bad way and they have to drive down not knowing how bad the situation is.
Just imagine if your mate had died, you didn’t know yet, you had just been cut out of a vehicle and it looks like you are going to lose your legs.
Just imagine if you had to have this tube put through your nose, this device inserted into your throat so you couldn’t speak.
A picture of a gravesite appears on the screen; a moment of silence follows. The students are quiet, walking down the long corridor to the intensive care unit. The jostling and joking is gone. They are shown an ICU bed set-up as a nurse explains how each piece of equipment works to keep a patient alive. Then the group is taken to the bed of a patient, like the young man in a coma, whose mother tries to draw some good from her painful situation. She describes what happened to him only ten days ago, explaining that once he comes out, ”we will have to start over again”.
An initiative like the P.A.R.T.Y. Program focuses on adolescents, who are particularly vulnerable to the pressure of their peers, and can be prone to risk-taking behavior, often involving alcohol. The tour deconstructs all of the circumstances around a horrific event, leaving students to consider their actions and where their choices may possibly lead them.
Accidents happen, but some can be prevented, with some awareness. Like many of us, Dr Parnis has been personally affected by the death of a relative in a road accident. “Despite the best paramedical care, she died en route to The Alfred Trauma Centre. I think of the sort of person she might have been had she been alive today. She was sixteen. What a waste. That’s the overwhelming feeling for emergency health professionals – the sense of utter waste”.
Professor Russell Gruen, Professor of Surgery and Public Health at The Alfred and Director of the National Trauma Research Institute explains why this kind of initiative is so critically important: “As a trauma surgeon in Australia’s busiest Trauma Service, you’d think I’d be used to caring for young trauma victims. But I’m also a father of two boys for whom I have hopes for the future. Perhaps that’s why every injured young person brings a painful reminder of the fragility of the human body, even when it’s young, strong and seemingly immortal. The facts speak for themselves. Approximately 1500 people die and at least 4000 are seriously injured on Australian roads every year, and injured drivers are most commonly male and under 24 years of age. Because young people are so often involved, serious injury accounts for more productive years of life lost in Australia than heart disease and cancer combined. In a split second, a young person with a promising future can become a road toll statistic or an invalid whose dreams are shattered and who now needs lifelong care – a situation that many people regard to be worse than death.”
There is a structured system in place to manage the care of those affected by major trauma. But the bigger picture is the social context, and the understanding that one moment’s decision can affect and alter the lives of many, forever. Health practitioners play a critical role in education, as well as care. This is health prevention at its most visceral, and real.
This article was published in the June edition of vicdoc
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