Simple Safety Tips From An ER Nurse: Family, Kids, Work

Simple Safety Tips From An ER Nurse: Family, Kids, Work

In our world today, the focus of families and caregivers is on safety in and out of the house. Join our discussion as we learn how to teach not only ourselves but your children and grandchildren how to handle the hazards in today’s complex world. Topics will include first aid, preventing injuries, childproofing your home, car seats, contact sports and more.

In This Episode

  • 00:38 – Opening: Simple Safety
  • 03:10 – Educating Parents
  • 09:04 – Being a Male Nurse
  • 10:18 – Taking Classes
  • 16:43 – Calling 911
  • 19:14 – Best Tips for Parents
  • 23:42 – Caller of the Day: Susan
  • 25:12 – Injuries from Sports
  • 26:34 – First Aid Kits
  • 28:50 – Compare to TV
  • 31:20 – Unusual Stories
  • 35:07 – Closing Comments

Safety Resources

  • Safe Kids Worldwide – a non-profit organization working to help families and communities keep kids safe from injuries.
  • AAPCC – American association of poison control centers.
  • Green & Healthy Homes Initiative – Breaking the link between unhealthy housing and unhealthy families.

Recommended Books on Safety

  • Safe Kids: A Complete Child-Safety Handbook and Resource Guide for Parents
    by Vivian Kramer Fancher
  • Keep Safe! 101 Ways to Enhance Your Safety and Protect Your Family
    by Donna K. Wells, M.Ed., M.P.A. and Bruce C. Morris, J.D.
  • Keeping Kids Safe: A Guide for Parents of Toddlers and Teens – and all the Years In Between
    by Dr. Kenneth Shore
  • The Safe Baby: A Do-It-Yourself Guide to Home Safety
    by Debra Smiley Holtzman

Key Takeaways for Parents

  • Remember that every child comes with an important safety feature – his or her parents.
  • Learn to recognize warning signs and symptoms of illnesses and be familiar with lifesaving techniques like Heimlich and CPR.
  • ER physicians care for 20 million sick and injured children each year.
  • There are an estimated 200,000 emergency room visits from playground equipment accidents.
  • There are 15-20 deaths a year as a result of playground injuries.

First-Aid Kits

A well-stocked first-aid kit, kept within easy reach, is a necessity in every home. Having supplies gathered ahead of time will help you handle an emergency at a moment’s notice. You should keep one first-aid kit in your home and one in each car. Also be sure to bring a first-aid kit on family vacations.

Choose containers for your kits that are roomy, durable, easy to carry, and simple to open. Plastic tackle boxes or containers for storing art supplies are ideal, since they’re lightweight, have handles, and offer a lot of space.

What to include in each of your first-aid kits:

  • Hydrocortisone cream (1%)
  • Antibiotic cream (triple-antibiotic ointment)
  • Disposable instant cold packs
  • Alcohol wipes or ethyl alcohol
  • Soap
  • Sharp scissors
  • Safety pins
  • Thermometer
  • Tweezers
  • Adhesive tape
  • Your list of emergency phone numbers
  • Extra prescription medications (if the family is going on vacation)
  • Adhesive bandages in several sizes
  • Blanket (stored nearby)
  • Antiseptic solution (like hydrogen peroxide)
  • Calamine lotion
  • Elastic bandage
  • Antiseptic wipes
  • Flashlight and extra batteries
  • Sterile gauze
  • Mouthpiece for administering CPR (can be obtained from your local red cross)
  • Plastic gloves (at least 2 pairs)
  • First-aid manual
  • Acetaminophen and ibuprofen

Episode Transcript

Rick Jamie: Hi, This is Rick Jamie. I’m an ER nurse in Cincinnati Children’s Hospital. I’m the father of two little girls. And you’re listening to Vicky and Jen on what really matters.

Vicky: This is Vicky and Jen, making life simple so you can enjoy what really matters. Welcome to another episode of our simple safety series. Thank you for listening today. I have an interesting statistic for you. ER physicians care for 20 million sick and injured children each year. So that is why today we have an ER nurse with us today. Thanks for coming in Rick.

Rick Jamie: Thanks for having me.

Vicky: Tell us a little bit about yourself.

Rick Jamie: I have been a paramedic for about six years. Before that. I was in something totally unrelated to medicine. I’ve been working as an ER nurse at Cincinnati Children’s Hospital for about the last four months. So I’m a little bit. I’m a new nurse but not entirely new to medicine.

Jen: Now do you have children.

Rick Jamie: I do. I have two daughters Lauren and Kate.

Vicky: And so your correct title is E.R. nurse.Ok.

Jen: Are there different levels of an emergency room nurse or…

Rick Jamie: Everybody pretty much has the same skill set when you’re at a level one trauma center which is what Children’s Hospital is and just sort of clarify what a level one trauma center is a level one trauma center is capable of handling anything that hits the door that is from neurosurgery to orthopedics to communicable diseases. Anything, where you get into some of the smaller community hospitals and they don’t have neurosurgeons on staff 24/7 they don’t have orthopedic surgeons on staff 24/7. So you really have a complicated disease process or injury pattern then you want to go to a hospital that’s better set to deal with that immediately instead of having to call people and.

Vicky: Well and you are probably getting the whole gamut being in your location and I believe Cincinnati Children’s is one of the top 10 in the country is it not.

Rick Jamie: It is. Yeah. A lot of research that goes on there is a lot of articles written about helmet use in kids on TVs and motorbikes and how you know they should never mix.

Jen: Yeah and it’s all coming from that hospital a lot of it does.

Rick Jamie: And I think that’s what gives children such a world-renowned reputation. Aside from the fact that they invented the polio vaccination there, they do a lot of research when it comes to disease processes diabetes Injury Prevention and things like that. So what’s kind of interesting about that also is as a nurse your job is not only to treat the patient but to try and educate the parents along the way so you can kind of help prevent another visit which is sometimes harder than teaching children that’s all those things. It is especially when you’re dealing with adults that have sort of varying levels of education. And it is sort of and sometimes a willingness to really kind of accept information and guidance from somebody.

Jen: So what when you say you are educating the parents by just consultations through nurses and doctors or handing out literature all of the above.

Rick Jamie: I mean kids will hit the door that is having difficulty breathing or chronic asthma sufferers and you know you go into the room to do your exam and the parents will smell like ashtrays and you just sort of take for granted that kids with breathing problems you don’t smoke around them. And not everybody knows that. And to go in there with sort of that preconceived notion that these parents you know are bad parents because they’re smoking around this kid with asthma. You’ve got to kind of leave that baggage at the door and you go in there and really tell them and sometimes they just don’t know. And sometimes they just don’t care or they think that because I’m smoking you know outside or I’m smoking in the living room and the kids in the bedroom that it doesn’t really matter they don’t get that you know the residual smoke that’s in the couch and that’s in the drapes and that’s in their clothes that when they pick this kid up they’re still being exposed to that stuff.

Vicky: One of the hardest things about the job trying to set aside maybe what could be personal feelings.

Rick Jamie: Absolutely and that’s what they teach all through nursing school is to you know you put away your baggage because it isn’t about us is about the patient and what can you do to sort of improve their outcomes.

Jen: I bet that’s really hard. That would be it is very difficult.

Rick Jamie: There are times you just you know you’ve got to walk out of the room and if it’s really bad then you know why they have social workers there.

Jen: So what are some other bad parts about your job.

Rick Jamie: The Hours and hours that night isn’t that bad. Marginally emergencies happen all the time.

Vicky: So you know through the night is the night busier than the day it just kind of depends.

Rick Jamie: Yesterday was Friday the 13th so you know we get some busy stuff. Get some gunshot wounds and things that come in you know that are totally unexpected but you know it kind of depends I mean you never know. You walk in there some days it’s absolutely dead and other days it’s you know you don’t stop.

You would think that the night wouldn’t be as busy because children should I’ll be shooting I guess but.

Well, I’m glad to hear that you have days that are dead. That’s because I was going to ask is there ever a boring day in the yard.

I don’t say that I wouldn’t say that it’s actually boring but it’s not. Some days just aren’t as busy as others. We had some for the last couple of weeks it’s really kind of picked up.

You’ll get sort of it gets busier and certain date parts when you’ve got kids at home when they’re waking up so you get the early morning rush and then you’ve got you know sort of that late evening rush and then on the weekends it’s usually pretty steady.

Is there a busy season in the getting into it.

Yeah. Oh really.

The winter I would think would be the summer for different reasons summer for more traumatic injuries and when kids were out playing falling off bikes and that kind of stuff during the winter you get more of the respiratory problems and in flu symptoms and illness.

Since I don’t know when I think of E.R. I think of more you know like on TV the traumatic stuff the lead you know more of the bleeding and stuff as it passes.

Yeah like accidents as opposed to illnesses I guess people have gotten to the point with the way healthcare is now that they wait longer and they get sicker before they actually seek you know that’s what she’s saying.

Yeah, you’re going to the emergency room for a cold or whatever.

And some of the right some of that stuff that you wouldn’t even think of going to a hospital for. You know people use emergency rooms as their primary care physician if you don’t have a primary care physician. You know if you don’t have insurance sometimes that’s your only options.

So see to me going to the E.R. would be the very last resort. I would go see my primary care physician.

But you’re saying that people just don’t know any better and so like oh I’ve you know they’ve had a runny nose for you know two days I’m going to bring them into the E.R. three in the morning. I mean there’s no difficulty breathing there’s really no true medical emergency. But you know people just don’t know and I think that’s one of the hardest things from you know from a nursing standpoint is even from a physical standpoint is you have to constantly keep in mind that not everybody knows what you know. And just because you’ve seen all this stuff that you’ve got to kind of keep in the back of your mind that you know people just don’t know. So you want to try and educate them when they come in and it might come easy for you.

You see this stuff all the time it seems like common sense to you. But it’s Tylenol.

Yeah, that is saying about common sense sometimes it ain’t so common. It doesn’t happen often. Well, how do you take more traumatic patients obviously in front of the runny noses like it’s not the first time you certainly shouldn’t do it.

Right. If a kid hits a door with a runny nose and then another kid hits a door with you know deformed rest then they’re in a lot of pain obviously you’re going to deal with the issue of pain first because you don’t want these kids to be hanging out in pain obviously and then if it’s a gunshot wound obviously they’re going to jump the front end.

Now people have probably picked up already that you’re a male nurse. Yes. Do your buddies tease you about that second.

It’s mostly from my family in the Gaylord Focker jokes from the adults. I like it.

I started off doing this from a certified I did an EMT basic course and that’s when you just really kind of learn to put bandaids on oxygen and put people on backboards.

It’s really kind of noninvasive basic life support and just sort of got smitten with sort of that hands-on patient contact and went to do a paramedic course after that which was about 14 months and you know it just kind of had that desire to want to do more and had an opportunity after 9/11 to sort of re-evaluate you know what I was doing and just sort of on that cosmic level it was I really doing something that was going to be worthwhile and sort of came to the conclusion that now I wasn’t and had an opportunity to sort of leave behind what I was doing and pursue nursing and that’s what I did. So no regrets.

What do you think about taking like those intro courses and stuff like that? Do you think that that’s something that parents should all do like you know the first day? I know that I have you know first aid and CPR and I know how to do the Heimlich and stuff that’s mostly because I was scuba instructor so I kind of had that I feel like that’s important and I find that sometimes it’s hard for me to grasp that parents and caregivers you know don’t know some basic first aid issues so is that something that you all try to teach parents that maybe they should be taking some of those basic courses.

Are you always I always encourage people to be educated.

And if you can get them to do basic CPR course that’s you know you can’t ask for anything better or the babysitter of course if you’ve got kids.

That’s a good thing, isn’t it? I know the Red Cross teaches that and of course Red Cross teaches all of these classes for you know anybody just like the American Health Association and stuff but if you’re going to be watching little kids I think the key is if you’re going to be a babysitter or a parent or grandparent or an aunt or uncle you need to know you know basic airway management and maybe kids choking.

What do I do if they fall down? What do I do if they get hurt if they get hit by a car? What do I do? Instead of standing are thrown your arms up there I’m panicking screaming and running for a phone. You know knowing some really basic interventions can be lifesaving.

Well, there have been some recent happenings just I’m thinking it was in just two weeks ago a 9-year-old girl died choking on a hot dog in school that you know that basic is the universal sign for choking is grasping at her throat. Evidently she didn’t know that and evidently, the supervisors in the cafeteria didn’t recognize what was going on. You know I mean 9 years old she’s probably joking around eating lunch whatever and chokes on a hot dog. And you know that is just a simple Heimlich maneuver. Pop popcorn and hot dog and candy.

And you know all those things that can get lodged in an airway. Things that kids like to eat. I mean it doesn’t take much to. And they’ve got really small airways compared to ours so they can’t you know it’s a little bit easier for them to get something stuck in there. So being able to clear that out isn’t difficult. It doesn’t take you to know maybe two or three seconds to show somebody how to do it right. You know it can be lifesaving.

And I’ve always been in the early Chowne care field and I have taken numerous classes communicable diseases and you know I’ve learned how to do the Heimlich and CPR have renewed it. Time after time but I’ve never had to use it. So the thought of that absolutely terrifies me. You’re fortunate that you have your question. Absolutely but you know I am. Is it one of those situations you don’t use it and you lose it you know. And then my fear would be doing something wrong.

You can’t excuse me just at the risk of sounding morbid. I mean you can’t kill the dead if somebody is really if somebody is really that in need of help. And I think that’s where the CPR courses have kind of gotten away from being sort of very militant in their approach and you know demanding that people do it absolutely correctly got more into this sort of holistic approach. You know let’s just make it comfortable and easy for people to learn how to do because they understand that laypeople are going to be operating on the level of health care providers or the expectation that the skill is going to be performed on that level isn’t there. However, if something needs to be done you know here’s how you do it. And something is always better than nothing right.

You got to try and surprise. Well, unfortunately, I have been in an emergency situation with my daughter, not no blood. It was it was a seizure but I had no idea. I had never seen one. And I found that my husband you know Jeff has all the classes too and it was kind of weird how it just kind of kicks in I guess and especially when you’re talking about your own kid you know this is your kid and something just kicks in. And your goal is Let’s help.

You know she started having a seizure. I heard Jeff too you know. Are you OK?

You know that standard that you hear at the beginning of you know when you’re taking a CPR class and I didn’t even know what was going on I was in the other room but I just I went to the phone and I hit 911 and I said Jeff I’m calling 911. Why. And he says you know gives me the stats. You know I believe Jasmine is having a seizure. And this is what’s going on. You know and so they answered the phone I kicked it in.

We were you know it was really weird because I had wondered here that you did so well use to it sounds like you surprised yourself. I totally surprised myself. But don’t get me wrong after the whole incident was over. We were home for a long time to think about it. Yeah, I think about it. And I lost it. It was very scary for me. Evidently febrile seizures are pretty common. I heard that after this incident I had never heard of one before and there had two.

Now and the second one was much calmer I knew what was going on I actually drove her to the E.R. It’s just it’s amazing how it just kind of kicks in and you will take over.

So yeah it’s one of those things that if you’re not using it or lose it. In my opinion, I think it’s just a few. If you’re one of these people that’s aware and keep yourself sort of educated to this that if something happens it does kind of kick in and you do end up just kind of doing it and then it’s encouraging.

I mean it’s your kind of look at it as a set of problems. I mean you don’t sit and go oh my god this child’s choking what am I going to do. Oh, wait a minute. I mean you just kind of look at it go oh and you just kind of move in and start doing what you have to do.

Well and luckily I believe most areas now in our country have the 911 service.

So yeah in a metropolitan area I mean you’re going right you’ve got a 901 service but that brings another plane up the second time that Jasmyn had this seizure. I actually drove her to the emergency entrance because it was obviously going to be a lot faster than me calling and waiting and then it was real. Well, that does bring up another point I made. I knew it was because after this first seizure I went to the hospital found the emergency entrance and I knew exactly where I was if it happened again. I knew where I was going to park exactly what was going to happen which is also another everybody is that well-prepared right.

She knew you.

No no, I don’t and that’s my question. When do you know to call 911 whenever you think it’s necessary or when do you load the family in the car and take it upon yourself.

You know there’s my what I always tell people is if you think you need it you need it.

There’s no wrong answer for it. I would rather have somebody rather be safe. I’d rather have somebody call and not need it and use it than somebody that needed it didn’t call and should have done it right and should’ve done it because you can just endanger yourself and whoever’s in the car with you and anybody else on the roads because if your child is having a seizure in the front seat or in the back seat you know your concentration is not right your mine isn’t there.

I felt comfortable enough on the second time I kind I called my friend. She came over she watched Jane. I put Jasmine in the car because at this point the seizure was actually over but I needed her to be checked out.

You know she was safe there breathing that’s a good thing. Screaming kids are good kids. Yeah, I remember somebody told me that for is if they’re screaming or breathing and breathing is good.

And I even this is kind of you are my all chuckle but unfortunately I know exactly where the hospital is by my folk’s condo in Florida because on our last five visits I’ve been to the agency room three times.

People come again.

Well, luckily it wasn’t for my kid. Every time it was for me to act like I was young and skim boarding and all her story broke my foot.

So so Rick what is your best tip then for how parents can be prepared for the unknown.

You know knowing where the hospital is a good thing.

It’s very easy these days to just google a map.

Sure you could just quickly and I’ve done this. I am proud to say that on my refrigerator in my purse and in the car. I googled a map from this address to children’s hospital because I’ve never I’ve never been had to go.

So that is one thing that I’ve done as well as listed a different poison or you know is good to have the primary care physicians number is good to have. If it’s not a real you know immediate emergency you can always call your primary care physician whoever’s on call for that practice and obviously call you back and give you some guidance which may save you a trip to the emergency room or you can load them in the car and go knowing how to get there is a big help.

Let’s see what else would be simple things like medicine so that people keep her on the housekeeping caps on them. We’ve had kids that have come in and the parents have caught them you know drinking out of a bottle of scented you know alcohol rubbing alcohol or you know helping himself to a bowl of Flintstone vitamins and keeping caps on keeping medicine that matter.

Because I mean sometimes they may take ibuprofen or one of them is sort of got a sweet coating on it so a little taste like candy. But if they get too many of those in them I mean they can really cause themselves some serious some serious problems.

Tylenol will destroy your liver. Too much of it.

All right. Well, parents often think well I’m home all the time more they’re never left alone. I only have one child.

But accidents still happen when it comes to poisons in cleaning supplies and medicine.

The pediatrician had my youngest at the pediatrician lives with about two months ago I had her on the on the exam table I literally turned around for two seconds and she was in the process of crawling off. Now she didn’t fall but it was you know caught her right at the edge. And generally, take the fact that I didn’t do it.

Well, I know and I feel like you know here I’m telling everybody I’ve been at the hospital a lot and I have actually called poison control twice the first time I wasn’t sure that I needed to call but I had the bottle or it was like eye drops that my folks use. And I called just in case. And I will tell you that they are so nice they don’t make you feel like you’re an idiot. Why was your child unintended. You know they ask you for what do you think they could have ingested. How much do you think it could be. This is possibly what could happen. Keep an eye on this. They were really nice and I have that number very handy because you know it could need it.

It’s a simple avoidable thing like that like getting into medicines and you know crawling upstairs that aren’t gated or being in a car seat properly. You know that car seat is either put in the car wrong or the child is strapped into the car seat wrong which you know we kind of take for granted that things are so simple now. You just put them in and you strap them in and clip it into the latch system in the car and that’s all there is to it. But some people just don’t have those assets and resources so you know being mindful of the community you live in if you have a fire department nearby usually what they’ll do is free of charge for residents you can take your car and your car seat up there and they will install it properly because believe it or not it’s a 40-year-old. These guys are specifically certified in car seat installation. It takes some 40 hours to do so. I mean do you think that you could spend 40 hours talking about how to install RC properly 40 hours.

It makes me feel like I’ve done it wrong.

But you know little things like that. I mean we’ve had kids in car wrecks where they’ve been in the car seat with the car seat hasn’t been strapped and it’s just been loose in the back seat or in the car seat strapped in with the kids just sitting in it. You know it just it’s not could do any good unless it’s properly used things like bicycle helmets. You know earlier we mentioned TVs motorbikes. No child should ever be allowed on an ATV or a motorbike with or without a helmet. It’s just as dangerous. You’re asking for a major thoracic trauma head trauma with the injuries it just is going to help.

Hi, my name is Van and I’m a mother of three. Living and what really matters.

My question is What are some simple things that I can do to prevent accidents at home.

Give us more tips. These are good things you can do at home to prevent injuries from happening in ways to be prepared for that emergency Gates on your stairways making sure that the gates you’re using are properly installed and are in the right position.

You can’t put one of those accordion gates at the top of the staircase. They’re not meant to be there.

Follow the man. The manufacturer’s directions on installing them properly making sure that you have all the plug covers the little Hummers having your cabinets with the childproof locks on them putting the safety things on the stove.

I know there are some things you can install on the front of the top of the stove so they can actually get their hands up to pull things off using burners right using the back burner site. When you’re cooking just commonsense things that are going to be inconvenient for us to initially do.

But I think over time you just kind of well you can do.

Every time I get a turn on my gas stove I get a pop off that little cap. And those are all kind of for younger kids. What about like older children that are starting to get into sports and stuff like that do you see a lot of sports injuries that fall into football especially.

I never I started working here really never realized it could be for you know eight nine-year-olds and we’re talking femur fractures and you know broken wrists and you know well aren’t kids even younger than that when they start.

I feel like I see five-year-olds running around with big helmets on their head and cautions.

And we’ve had some serious life-threatening injuries come in from high school age to middle school age kids and it’s just the level of violence is just in my opinion unnecessary. And these are injuries that are going to scar them for life. Wow. I was kind of thinking the other is like whatever happened to flag football. I mean kids are out there trying to literally kill each other while and parents are starting kids.

I’m so much younger. I mean I know that there are 3-year-olds playing soccer and soccer you think well it’s not full contact but you’re talking three-year-olds too. I mean you know I mean they get a kid walking around their house can be full contact when you’re talking to a 3-year-old.

Wrap them in bubble wrap in a helmet frame either. But it’s you know it’s pretty simple avoidable things and just what to be prepared for. Pride just keep a basic first aid kit around and keep some antiseptics around some topical antibiotics band-aids. You know if they fall at home in the extremity looks deformed you know you can take a basic first aid class and they can teach you how to splint that in place because if you’ve got the kid breaks his arm really bad and it looks like there’s a big you know you in the arm that looks unstable and you can learn how to splint that for the injury doesn’t get worse or you call 911. And they’re trained for that.

You know you mentioned first aid kit. I’m glad he brought that up. Yeah. Some first aid kits can be very expensive and I have kind of noticed that there’s kind of stuff in there that you really don’t need. And sometimes there’s not the stuff that you need. You mentioned some of the basics. Maybe we could put a list on an early stage have a site about maybe Rick could you make us a list of what needs to be in a basic first aid kit. Just basic pads and band-aids.

I mean if you’ve got something that’s a heavy bleeder you’re going to want to put some thick gauze pads on hold pressure on it just you know something it’s going to be able to handle something more than a band-aid.

Now Syria is out. Right. Are they increasing their parents not to include is different.

I wouldn’t include that there are different schools of thought on that because if you don’t know what your child ingested and having them throw it back up can actually cause more damage. And there’s that concern about aspirating things into their lungs too. So people think they’ve kind of gotten away from syrup with them. If they get an ingestion that’s you know either unknown or unknown. I mean some things they can give them what’s called activated charcoal which is exactly what it sounds like it’s liquefied charcoal and they make them drink it and it absorbs it.

Yeah, the carbon bombs to whatever the poison is that they’ve eaten or drank and it sort of neutralizes it. It’s nasty dirty stuff and it stains.

So a good tip would be to grow it up. So a good tip would be just to have the poison control number handy. Exactly.

And now first in 9/11 921 I kind of feel like we have just started touching on so many topics it feels like this could be an endless conversation.

It sounds like we might have to have Rick back but on a less serious note, a question I think everybody would like to know is how does your experience in the E.R. room compare to all these TV shows out there.

Well nobody that I run into so far sleeping with everybody else I know.

So there’s not as much sex going on as there is on the show. Darren by first show Zach.

Are they far-fetched or are they kind of accurate?

You know what I mean some of them they try and keep it accurate as they can on TV. I mean you’ll hear some of the jargon in the lingo.

I mean they try and keep it. You know I guess as real as possible with the consultants they have on this show. But I think like any workplace you get into you’re going to find that it all has its sort of quirkiness to it and there’s going to be the little clicks and there’s going to be you know so and so’s some level of drama going on there.

So you watch it.

You know you’re kind of like I think like the older mash now or it’s just it’s not as now it’s not as interesting anymore.

Maybe it’s just because I’ve been doing this for how long.

But it’s different to you when you watch a show that’s about something that you know about. Yeah, I get away from work. Yeah yeah well and you can kind of pick out all that stuff that’s not true.

We were talking last night just when we weren’t really busy. But you know you kind of talking about when you see a lot of this gory do you see a lot of this misery that comes through and you can’t see it.

You know I mean you kind of long for those days when you could you know kind of go about your business and you know not know what you know a kid that’s been shot four times looks like or a kid that’s been beaten to death and you know you just you can’t get that image out of your head and you just you know you know it’s almost nice to be a little bit unaware and some ups.

But you go home every night and you give your girls your wife a big hug and kiss it makes you realize that yeah.