July 13, 2008, 11:36 am

Beyond the Innocence, Your Youth is Gone

Does she look any older than about eighteen?

I had to laugh because (a) I was only 20 when I graduated, (b) her cap is similar to mine – except the wrinkle on the left is inexcusable!, and (c) I used Noxema!

Didn’t everyone use Noxema back then? I don’t even remember any other facial cleanser. You just knew your face was getting cleaner by the second!

I realized I was getting older when I found myself buying Old Oil of Olay instead.


I’m also at the age where I have a hard time understanding.

…Understanding why a young girl would drink so much she passes out, carried into the emergency department by ten of her closest friends who are so worried about her.

Where the hell were they when she was drinking herself into oblivion?

…Understanding why a young girl shows up in the middle of the night for the yeast infection that isn’t a yeast infection at all, but something that she will carry with her the rest of her life. And I’m not talking pregnancy.

What the hell was she thinking when she had unprotected sex with the loser who was cheating on her and brought home a little “gift”?

…Understanding why a young girl would toss a bottle of medication down their throat because they couldn’t stay out until midnight.

Did she really think that seemingly innocuous, ubiquitous pain reliever recommended by nine-out-of-ten hospitals wouldn’t kill her?

What is happening ?


Oh, I can empathize with the desire to be cool, to have fun with friends, to want to believe the guy really loves you, to be angry at what seems like needless restrictions.

I was a teenager once. Around the time Disco was King, in fact. Did stupid stuff in my time, like wear five-inch platforms and bell bottoms so wide you coudn’t see my feet.

But I am astounded at the amount of risk-taking behavior by adolescents I am now seeing in the ER.

And for some reason, it’s the girls that I see most often.


Adolescents think they are invincible, that’s understood.

How do you make them understand that what they do today can have a lasting effect on the rest of their lives?

I don’t know that, as an ER nurse, I can have much influence.

It helps to be non-judgmental, although that isn’t easy. A little kindness can go a long way.


When dealing with ETOH, I talk to the girls about how dangerous it is to be out of control of their behavior and surroundings; that it would be easy for someone, anyone, to take advantage of them in that state and they would never know it.

That usually does not cross their minds.

When it comes to sexual activity, I talk about trusting themselves when it comes to protection from pregnancy and STDs, that they need to take responsibility as they are the ones who will have to live, sometimes for a lifetime, with the consequences.

It never occurs to them that their boyfriend might be lying, or interested in his own pleasure at her expense.

When it comes to overdosing, depending on the situation, I will explain exactly what that non-aspirin pain reliever does to their body and I tell them what death-by-ingestion looks like. I’ve seen it twice, and I don’t spare the details. It’s too important that they know what can happen to them. I reinforce that (a) it was good that they told someone, (b) I am not being punitive when I tell them they have to take certain antidotes or that they are on a psychiatric hold and (c) all we care about is that they are safe.

They have no idea just how dangerous their impulsive action could have been.


Sometimes I wonder if the parents ever really talk to these girls. Or do they talk until they are blue in the face and the kids don’t listen?

They are so eager to grow up. Act older than they are.

They have no idea that beyond the innocence, their youth is gone.

And they can never get it back.


The title of this post was taken from the song, “Ballad of Youth” by Richie Sambora. You can see the video here.


  • Dawn

    July 13, 2008 at 12:21 pm

    Agreed with all of the above. These girls have no idea how lucky they are to have a nurse who cares about their well being enough to discuss this things with them.
    I had a discussion the other day with a friend who went to high school about the same time that I did and I said “I don’t recall high school being so tragic of a time in my life.” Sure we had boyfriends break up with us and girl friends stabbing us in the back over boys…..I just don’t recall anyone being suicidal over it. I wonder what has changed since now and then.

  • NurseExec

    July 13, 2008 at 3:37 pm

    This post really touched me. In my ICU days, I spent a long 48 hours with a young girl who died of liver failure, thanks to that ubiquitous OTC pain reliever. I remember her mom telling me that she was an “A” student, already accepted at an Ivy League school, etc. Her “best friend” said she took the pills to make her boyfriend mad because he was “looking at other girls”. What a pitiful thing to die over. *shakes head*


    July 13, 2008 at 7:53 pm

    It’s not just teens – the post-college years are a time of when the freedoms of adulthood require even more maturity, I see a lot of really stupid behavior, including lots of sexual partners. It’s really so sad…

    Keep up the conversation – You are right that sometimes we in the health profession are the first ones to ask our patients to stop and consider the consequences of their behaviors.

    Best, TBTAM

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  • Jen

    July 14, 2008 at 4:22 am

    Great post.

    I’ve got 2 girls who are 12 now, and the things that they go through are nothing like what I faced when I was their age. (They’re both autistic, but one is so “high-functioning” that she’s in a “regular” class.)

    I was never faced with “boyfriends” in grade 7 who wanted 3somes instead of trying to get to second base, having meth handed to them in the school yard, or being expected to dress (and act) like 18 year olds at that age.

    I’m lucky that I have good communication with both of my daughters, but I see the results every day with their friends who can’t talk to their parents. In one of my daughter’s circle of friends there is a cutter, a bulimic, an anorexic, and one girl who has made numerous suicide attempts with one of those OTC meds that you talk about. And their parents just don’t get that those are incredibly serious situations. These are GOOD girls who are just confused and doing their best to get through pre-puberty, but there is no support for them. We have a great school system which does its best to keep parents involved and informed, but when the parents don’t care enough or aren’t willing to face the fact that the girls need help, the kids are basically screwed. It’s horrendous to watch. I know the doctors and nurses in our ER and know that when one of the girls comes in they always do the appropriate things, but it just never gets through.

    I think that the earliest casualty that I had among my friends was at about age 18, but it’s coming earlier and earlier these days. Parents of boys age 12 that I know have their own concerns, but I haven’t known many of them that are yet dealing with actual life and death matters.

    It’s scary.

  • Alyson

    July 14, 2008 at 8:56 am

    I was one of those out of control teens and I’ll tell you very honestly that by the time my parents started talking to me, I was done listening. I really think that parents have to start early in talking to their kids about these issues, and beyond that they really need to be building a strong bond between them so that their kids will have a strong sense of self and know that they have a great support system. Even to this day I don’t feel that I have any emotional support from my parents. And yes, as an adult I look back and realize just how lucky I am that I’m alive and healthy.

  • Margaret

    July 14, 2008 at 12:06 pm


    I have to say that I disagree with you on some points here.

    >>I don’t understand
    I remember, and I understand. Sad as it is. Have you forgotten all about peer-pressure? Do you think this did not happen when we were young?

    >>What the hell was she thinking when she had unprotected sex with the loser who was cheating on her and brought home a little “gift”?

    You are implying here that:
    1. The girl is not a loser.
    2. The boy knew that he was infected.

    As you stated, it’s a gift for life, and it is not unusual for males to not know they are infected. Nor is it unusual for girls (or their girl ‘friends’) to be the initiators of unprotected sex. So let’s drop the assumption that it’s always the guy who is the loser & the cheater, please? This is a game that is played by both sides.

  • Kim

    July 14, 2008 at 12:51 pm

    Hi Margaret –

    Thanks for the comment! I took some literary license in my examples by combining patient scenarios. I used the female as the patient not because they are any more (or less) culpable than males, but because I have noticed a rash of young women in my department lately.

    I started thinking that I rarely see intoxicated teenage boys brought in, and overdoses among boys are rare in my practice experiences. Now, STDs, yeah we see them. Usually the chief complaint is “abdominal pain” in triage because they are too embarrassed to talk about what is happening but when they get to the room they tell us what they are really concerned about.

    Peer pressure has always been an issue for adolescents; I was lucky not not experience it to the extent the kids have it today. I was also lucky to have kids (male and female) who did not engage is risk-taking behaviors, but a lot of their friends did. It just seems so much more virulent, if that is the word, these days.

    So, in conclusion, I stayed with the female example (a) for consistency, (b) because that is what I have been dealing with lately and (c) took some license with descriptions for literary effect.

    Did not occur to me I was playing into the stereotypical “guy is jerk” scenario, but can see where you would have noted it.

    Thanks for the feedback!

  • Tracey

    July 15, 2008 at 5:59 am

    Nice job Kim!

    As a CCU nurse we see the ETOH and overdoses too. I tend to see them in both sexes though. But it does seem that the things that they are being done for weren’t such big issues in my high school days either.

    I’m not sure what the difference is really. I think society makes it harder on kids these days to grow up and take on adult problems sooner.

    I plan on talking with my 3 kiddos (2 boys, 1 girl) early and often about this stuff but in reality all we can do is give them a good foundation and hope for them to make good decisions. It is scary as a parent though.

  • Placebogirl

    July 15, 2008 at 7:02 am

    I’m glad that these girls get a nurse like you who tries to connect with them, and that you try and encourage them to make better choices. I object, however, to telling them that “they may be taken advantage of” as a consequence of their drinking; there is a word for taking advantage of someone too out of it to consent: Rape. Only one thing can stop rape, and that is rapists not doing it…telling young girls that it is a consequence of their drinking if something like that happens just reinforces the rape myth that the victim is responsible. After all, do we tell young men who drink too much that it is their fault if their wallets get stolen, or they get assaulted?

  • Margaret

    July 15, 2008 at 7:16 am

    @ placebogirl: Uhm, actually, yes I do….. (you were drunk, you wallet got stolen. That was stupid. Next time: don’t drink so much that you cannot keep track of your belongings. Now let’s sit down and call the credit card companies).

    And girls are so much more vulnerable when they’re drunk than when they’re not drunk, and this is true for boys too (I sometimes still test that theory and it’s true regardless of age).
    Part of the problem is that alcohol is not readily available to young people and therefore they don’t have much experience with it. So is it a miracle that they overindulge? I think not. I started drinking (legally) at a much younger age, and did some really stupid stuff in my days. But by the time I was college age I already knew what a toilet bowl looked like after vomiting in, on, and around it, so being #1 in the drinking games simply wasn’t that interesting to me.
    Without getting on the bandwagon of ‘it’s better over there’, here is a website that discusses some of the issues related to raising the drinking age in the US: http://www2.potsdam.edu/hansondj/index.html

  • Kim

    July 15, 2008 at 7:18 am

    Hi Placebogirl!

    Thanks for your comment!

    I hear you on the “rape” scenario. Not intending to tell the girls it is their fault, only that it makes them more vulnerable to exploitation, or rape for another term. Not that it becomes their fault.

    Just as if I walk in a dark parking lot alone, I am more vulnerable to anyone who intends to do me harm, not that I am at fault or asking for the assault, if that makes sense.

    Your point, however, is well taken and thank you for adding it to the discussion!


  • Pox

    July 15, 2008 at 4:37 pm

    I feel the urge to scream out, “SOMETIMES WE HAVE TO LEARN FROM OUR OWN MISTAKES!” Then again, I am one of those girls who actually wanted to never see daylight again, who did think that the boy really loved her (thank god he didn’t give me anything beyond heartache), and who didn’t expect for the nice boy to cop a feel because he didn’t think it would be remembered. I’d heard all the advice before, but none of it really meant anything in a practical sense until I learned it all first-hand, which is the case for many people, both old and young.

    All we can do for people like me (and the girls you described) is inform them about minimizing harm – how to use barrier and hormonal methods of contraception (male or female condoms), how to find toll-free suicide prevention hotlines, how to identify and respond to alcohol poisoning, etc. It’s been proven that saying “don’t drink! don’t have sex! don’t hang out around boys that might have ‘impure’ intentions!” doesn’t work (as evidenced by the fact that these things still happen), so maybe harm-reduction techniques might.

  • mojitogirl

    July 16, 2008 at 11:57 am

    Wonderful post! As both an ER nurse and the mother of a Teen Queen, I constantly hammer her with what I see on a nightly basis at work. Drunk girls, drugged out girls, date-rape drug girls, silly girls who swallow pills in their quest for attention. I hope she’s listening. And I’m glad I’m not the only one who holds the opinion of “What’s the rush in growing up?”

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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