Trauma care: a family's perspective
It is a parent’s worst nightmare.
In March 2014, Carolyn and Eric Groot-Nibbelink returned home well after midnight from a week-long vacation. However, that became a distant memory later that day when Carolyn received a phone call.
“An OPP officer told me that Jenica’s car had been hit by a very large truck and she would be flown to London Health Sciences Centre.”
Jenica, 27, is the oldest of Carolyn and Eric’s three daughters. With a master’s degree in English from Western University, and serving as an assistant chaplain at Western, Jenica was planning to attend Calvin Theological Seminary the coming September with a Presidential Scholarship.
The day of the accident, Jenica had just finished leading a church service and was on her way to visit friends.
“I have no memory of the accident. In fact, my memory in general did not begin coming back until July 2014. Even today, my memory of events a few months prior to the accident is fragmented,” says Jenica.
Eric, pastor at Bethel Christian Reformed Church, recalls Jenica’s arrival at LHSC’s Emergency Department.
“They allowed us to see Jenica before she was taken to the Critical Care Trauma Unit. She was just lying there, she was intubated, and she had not received very many facial cuts. I remember Carolyn just standing there, stroking her face.”
Jenica was in a coma due to severe head and brain trauma, which were her primary injuries, and her prognosis grew increasingly grim the longer she remained in the coma.
A huge component is keeping the line of communication open with the families of patients, says Dr. Neil Parry, general surgeon, critical care and trauma surgeon. “The unknown is the most frightening and we are very honest with both the bad and the good news so families have a grasp of the nature of the injuries and what they can expect in the immediate and near future.”
As Jenica was on a ventilator for over two weeks, she received a tracheostomy (moving the breathing tube from her mouth to her neck). This allowed her to be slowly weaned from the ventilator until she could breathe on her own. While feeling great joy, the journey was long from over for the family, as Jenica remained unresponsive for many more weeks.
Trauma victims require a significant level of care and during this time Jenica would have a multidisciplinary team of highly specialized nurses, physicians, physiotherapists, social workers, dieticians, personal support workers and other health-care professionals required, to provide care for her around the clock, says Dr. Parry.
From morning till night, Jenica’s family sat at her bedside.
Eric says, “I previously thought I understood trauma, doing what I do offering spiritual care to people. I have been with people in so many difficult kinds of gut-wrenching crisis situations, empathized with people, identified with people, cried with people in waiting rooms. I’ve laid awake at night thinking about other people’s crises. But I don’t think any of that really prepared me for experiencing it myself.”
Five weeks later, it was time to remove Jenica’s tracheostomy tube. For the first time since the accident, Jenica was responsive, whispering “hi” when a nurse said “hello” and giving a thumbs-up when asked if she could raise a finger. It was a dramatic moment of hope.
Shortly after, Jenica was transferred to St. Joseph’s Health Care London’s Parkwood Institute to begin her rehabilitation journey.
Today Jenica still faces many challenges.
“My typical week includes daily rehabilitation therapy at home, followed by a physiotherapy, voice or cognitive therapy appointment. I also have regular appointments with my hand therapist, psychologist, audiologist, physiatrist and endocrinologist,” says Jenica. “It is a lot of work, more than a full-time job!”
Carolyn and Eric reflect on the long-term cumulative effect of that Sunday back in March 2014. In their experience, a trauma like this affects not only the individual but also the entire family.
“We are extremely grateful for the timely and exceptional medical care Jenica received at LHSC - both of which are so critical in traumatic head injuries,” says Carolyn.
“The compassionate care given, and sensitivity to us as a family shown by staff, especially by nurses, is firmly etched in our minds. Seeing and experiencing the demands placed on them on a daily basis gives one a deep appreciation for the challenging work they do.”
As Carolyn explains, one can not underestimate the huge difference that taking the time to listen, clarify and answer the questions of loved ones, as well as the seemingly “little acts of kindness”, can make in a patient’s and family’s journey.