ED social worker, Ursula Pascarella (1951–1994)
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In memoriam ED social worker, UrsulaPascarella(1951-1994) Section Editor: Marilyn Rice, RN, BSN, MPA, CEN, CNA Authors: Emmy Hunt, RN, MSN, CEN, Suzanne Legere, RN, CRNI, and Barry Worthing, RN, BSN, CEN, Portland, Maine U rsula Pascarella, LCSW, was a psychiatric social worker in the emergency department at Maine Medical Center for 7 years. She worked with pa- tients and families in crisis caused by sudden loss, mental illness, violence, and the impact of drugs or alcohol, offering them support and endlessly looking for the best resources for each one. We all knew that, because we read her meticulous notes that resem- bled calligraphy and frequently watched her drag out of the emergency department at all hours of the night still saying, "Could I have done more?" On September 11, 1994, Ursula was driving her two boys, Matt and David (ages 10 and 6), home from a fair celebrating Native American culture when her car was struck broadside. All four persons were critically injured, and Ursula was trapped in her car for nearly an hour. One ED physician remarked that it was such irony that Ursula should lose her life because of an alcohol-impaired driver-- the kind of person she spent her time caring for and helping. When Ursula arrived in the emergency depart- ment, she was pale, cool, restless.., but still con- scious. A 30-minute blur followed. The act was so familiar to us, in a way: intubation, large-bore IV lines, O-negative blood on the warmers, grossly positive belly tap and then off to the operating room at full speed. It was not familiar that our patient was ONE OF US. We tried to imagine the pain and fear her husband must be feeling. It must be like that in times of war. And then we heard. She did not make it; she died in surgery.., words we use all the time for OTHER people, not ourselves. The aftermath was devastating. Anger, frustration, inability to concen- trate, and deep sadness. The question kept popping up, "Why couldn't we have saved her?" The same skills, used by the same people, have defied death before--why not for Ursula? Working in the critical care area of the emer- gency department, each of us dons a fragile armor to sustain us in all the encounters we experience day by day. It enables us to function but does not take Ms. Hunt is Head Nurse and Ms. Legere and Mr. Worthing are staff nurses, Emergency Department, Maine Medical Center, Portland, Maine. Ursula Pascarella with her two sons. away all our emotions. But every now and then, the trauma is great enough to perforate our protection and cause us deep pain and sadness. Ursula's death was just such an event. We miss everything about her: her gullibility over magic tricks and zeal for joking, the home- baked goodies she brought to work, and the many small overtures of friendship... "I'll walk out with you," or "When are you going to dinner?" One of her driving passions was to keep working at bringing the emergency disciplines closer together. Many have commented lately that our group's experience with tragic loss has indeed brought us closer together, opened up some channels for shar- ing and warm relationships. Just the way Ursula would have liked. You're gone! It's been 2 weeks now I still can't believe. Every shift I expect to see you Hurrying around the corner. Late, just a few minutes David's game, Matt's scouts. Always others before yourself But not this time. For reprints, write Emmy Hunt, RN, MSN, CEN, 54 Montrose Ave., Portland, ME 04103. J EMERGNUR8 1995;21:185-6 Copyright 9 1995 by the Emergency Nurses Association. 0099-1767/95 $3.00 -~ 0 18/65/63123 April 1995 185
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Transcript of ED social worker, Ursula Pascarella (1951–1994)
In memoriam ED social worker, Ursula Pascarella (1951-1994) Sect ion Editor: Marilyn Rice, RN, BSN, MPA, CEN, CNA Authors: Emmy Hunt, RN, MSN, CEN, Suzanne Legere, RN, CRNI, and Barry Worthing, RN, BSN, CEN, Portland, Maine
U r su l a Pasca re l l a , LCSW, w a s a p s y c h i a t r i c soc ia l w o r k e r in t he e m e r g e n c y d e p a r t m e n t a t M a i n e
M e d i c a l Cen t e r for 7 years . She w o r k e d w i t h pa - t i e n t s a n d f ami l i e s in c r i s i s c a u s e d b y s u d d e n loss, m e n t a l i l lness , v io lence , a n d t h e i m p a c t of d r u g s or a lcohol , of fer ing t h e m s u p p o r t a n d e n d l e s s l y l ook ing for t h e b e s t r e s o u r c e s for e a c h one. We al l k n e w that , b e c a u s e w e r e a d her m e t i c u l o u s no te s t h a t r e sem- b l e d c a l l i g r a p h y a n d f r e q u e n t l y w a t c h e d her d r a g ou t of t he e m e r g e n c y d e p a r t m e n t a t all hou r s of t h e n i g h t s t i l l s ay ing , " C o u l d I h a v e d o n e m o r e ? " On S e p t e m b e r 11, 1994, Ursu la w a s d r i v i n g her two boys , M a t t a n d D a v i d ( a g e s 10 a n d 6), h o m e from a fair c e l e b r a t i n g N a t i v e A m e r i c a n cu l tu re w h e n her car w a s s t ruck b r o a d s i d e . Al l four p e r s o n s w e r e c r i t i ca l ly in jured , a n d Ursu la w a s t r a p p e d in he r car for n e a r l y an hour . One ED p h y s i c i a n r e m a r k e d t h a t i t w a s such i rony t h a t Ursu la s h o u l d lose he r l ife b e c a u s e of an a l c o h o l - i m p a i r e d d r i v e r - - t h e k i n d of p e r s o n she s p e n t he r t i m e ca r ing for a n d h e l p i n g .
W h e n U r s u l a a r r i v e d in t h e e m e r g e n c y d e p a r t - men t , she w a s pa le , cool, r e s t l e s s . . , b u t s t i l l con- sc ious . A 3 0 - m i n u t e b lu r fo l lowed. The ac t w a s so f ami l i a r to us, in a way: i n t u b a t i o n , l a r g e - b o r e IV l ines , O - n e g a t i v e b l o o d on t h e w a r m e r s , g ro s s ly p o s i t i v e b e l l y t a p a n d t h e n off to t he o p e r a t i n g room a t full s p e e d . It w a s not f ami l i a r t h a t our p a t i e n t w a s ONE OF US. We t r i ed to i m a g i n e the pa in a n d fear he r h u s b a n d m u s t b e fee l ing . It m u s t b e l ike t h a t in t i m e s of war.
A n d t h e n w e hea rd . She d id no t m a k e it; she d i e d in s u r g e r y . . , w o r d s w e u s e all t he t i m e for OTHER peop le , no t ou r se lves . T h e a f t e r m a t h w a s d e v a s t a t i n g . Anger , f rus t ra t ion , i n a b i l i t y to concen - t ra te , a n d d e e p s a d n e s s . The q u e s t i o n k e p t p o p p i n g up, " W h y c o u l d n ' t w e h a v e s a v e d he r?" The s a m e ski l ls , u s e d b y the s a m e peop le , h a v e de f i ed d e a t h b e f o r e - - w h y no t for Ursu la?
W o r k i n g in t h e c r i t i ca l ca re a r e a of t he emer - g e n c y d e p a r t m e n t , e a c h of us dons a f rag i le a rmor to s u s t a i n us in all t he e n c o u n t e r s w e e x p e r i e n c e d a y b y day . I t e n a b l e s us to func t ion b u t does no t t a k e
Ms. Hunt is Head Nurse and Ms. Legere and Mr. Worthing are staff nurses, Emergency Department, Maine Medical Center, Portland, Maine.
Ursula Pascarella with her two sons.
a w a y all our emot ions . But e v e r y n o w a n d then, t he t r a u m a is g r e a t e n o u g h to pe r fo r a t e our p ro t ec t i on a n d c a u s e us d e e p p a i n a n d s a d n e s s . U r s u l a ' s d e a t h w a s jus t s u c h an event .
We m i s s everything a b o u t her: he r gu l l i b i l i t y over m a g i c t r i cks a n d zeal for joking, t h e h o m e - b a k e d g o o d i e s s h e b r o u g h t to work , a n d the m a n y s m a l l o v e r t u r e s of f r i e n d s h i p . . . "I ' l l w a l k out w i t h you , " or " W h e n are you g o i n g to d i n n e r ? " One of her d r i v i n g p a s s i o n s w a s to k e e p w o r k i n g a t b r i n g i n g t h e e m e r g e n c y d i s c i p l i n e s c loser toge the r .
M a n y h a v e c o m m e n t e d l a t e l y t h a t our g r o u p ' s e x p e r i e n c e w i t h t r ag ic loss h a s i n d e e d b r o u g h t us c loser t oge the r , o p e n e d up s o m e c h a n n e l s for sha r - i ng a n d w a r m r e l a t i onsh ip s . J u s t t he w a y Ursu la w o u l d h a v e l iked .
You ' re gone! I t ' s b e e n 2 w e e k s n o w I s t i l l c a n ' t be l i eve .
E v e r y shi f t I e x p e c t to s ee you H u r r y i n g a r o u n d the corner . Late , jus t a f ew m i n u t e s D a v i d ' s g a m e , M a t t ' s scouts . A l w a y s o t h e r s before your se l f But not t h i s t ime .
For reprints, write Emmy Hunt, RN, MSN, CEN, 54 Montrose Ave., Portland, ME 04103. J EMERG NUR8 1995;21:185-6 Copyright �9 1995 by the Emergency Nurses Association. 0099-1767/95 $3.00 -~ 0 18/65/63123
April 1995 185
JOURNAL OF EMERGENCY NURSING/Hunt, Legere, and Worthing
W h y ?
W e c a n n e v e r k n o w
Y o u h a d y o u r r e a s o n s .
W e t a l k a b o u t y o u n o w
I t ' s OK t h o u g h , i t ' s a l l g o o d t a lk .
W e t a l k a b o u t y o u r w o r k
H o w m u c h y o u c a r e d .
H o m e l e s s , p s y c h o t i c
G r i e v i n g or t r a v e l e r s .
T h e y k n e w y o u for o n l y m i n u t e s
I ' m s u r e t h e y c o u l d f ee l i t
T h e m a g i c t h a t is you .
W e r e c o u n t t h e d a y y o u c a m e to u s for h e l p
T h e d a y y o u a n d y o u r b o y s n e e d e d us .
Y o u a s k e d n o m o r e of u s t h a t d a y
T h a n w e e v e r a s k e d of you .
W e m o u r n t h a t d a y a n d w i s h i t a w a y
A n d y e t w e ' r e g l a d w e w e r e c h o s e n to h e l p .
T h e o u t c o m e w a s n o t w h a t w e w a n t e d
But , y o u h a d o t h e r p l a n s .
W e k n o w t h e m n o w .
You g a v e y o u r s t r e n g t h to T o m , D a v i d , a n d M a t t
I t s h o w s e v e r y day .
A g a i n y o u ' v e g o n e t h e e x t r a m i l e for o t h e r s
Y o u ' v e t r u l y g i v e n a l l of y o u r s e l f to o t h e r s .
W e k n o w y o u r s e c r e t w i s h
S o m e o n e t o l d u s r e c e n t l y .
You j u s t w a n t e d to b e l i k e d .
A s u s u a l y o u ' v e e x c e e d e d y o u r g o a l
W e l o v e you , U r s u l a . - - B a r r y W o r t h i n g ~
*Mr. W o r t h i n g w a s c h a r g e n u r s e t h e e v e n i n g Ursu la died.
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