The rush and confusion of a trauma can be...well, traumatic. Unexpected accidents, unnerving violence and unpredictable illness bring a natural amount of chaos and panic to any emergent situation.

Kacie Klein eats chaos and panic for breakfast.

“I’ll still be an emergency room nurse 10 years from now,” Klein said. “I can’t imagine doing anything else. Every day, I have to expect the unexpected, and every day, I see something new.”

The Coeur d’Alene nurse has been working the emergency room at Kootenai Health for the past eight years. Part of her job means standing by the hospital’s south entrance, waiting for an ambulance to deliver whichever unknown victim needs help. That anticipation can be the one nudge that pushes an ER nurse’s nerves over the edge. Klein said she relies on a quote from one of her old mentors to keep herself calm in the face of a storm.

“As an ER nurse,” she said, “you always check your pulse before checking someone else’s. It’s one of the best pieces of advice I’ve ever had in this job.”

Klein said she was always interested in science but thought she’d originally go into pharmacy work. After volunteering at a Spokane hospital, however, the Washington State University graduate with her bachelor’s in nursing said she quickly changed direction, diving headfirst into the emergency room as she started down an advanced track in emergency nursing.

“It’s in the ER,” she said, “that you get the most patient contact. I’m a people person, as well as a science person. I find that interaction with people — especially helping people through some of their most vulnerable moments — is very rewarding.”

Klein serves as a relief charge nurse in the emergency room, as well as a floor nurse. She said some of her most important work comes from a more challenging role as Sexual Assault Nurse Examiner for Kootenai Health. In that capacity, her job means juggling three important roles: treating a patient, supporting a victim and collecting evidence, all at once.

“It’s a really hard process for the patient,” she said. “It’s very important that we give the patient time. Give the patient as much time as she needs. Often times, after an assault, they won’t trust anyone, which is understandable, so you have to be empathetic and understanding and build that trust.”

That trust is something that doesn’t stop after those first moments in the ER.

“You have to advocate for them,” Klein said. “You’re their first point of contact, so outside of family, you’re the person they’re most likely to connect with. We’re fortunate at Kootenai [Health] to partner with so many local resources like Safe Passage. It’s our job to reach out to those resources and really advocate for your patient.”

All the while, Klein collects evidence for local law enforcement, taking great care to document what she finds while taking equal care not to contaminate any clues. She said the balance between evidence collection and patient care are some of the hardest moments of her job.

“For those cases that hit us the hardest, we really come together as a family,” Klein said. “Kootenai [Health] really reminds me of a family. We’re always supportive of each other, but more important, we lean on each other when we need to. We talk to each other, and that really helps us through the tough times.”

Not all times, she admitted with a smile, are tough.

“I remember we had this one patient come through here,” she recalled. “He was — I don’t know — eight or 10 years old, and we had to send him up for surgery, and he was naturally scared. We put him under sedation, he didn’t quite fall asleep at first. But he went from being really upset to really happy, because he was smiling and happy and talking about Legoland. He went on and on about it. He thought he was in Legoland, and he was so happy about it. So we just said, ‘Hey, he’s happy. Let’s just let him be happy.’”

When asked what she wished people knew about the job, she swallowed hard in pause before talking about family again.

“We all have family,” Klein eventually answered. “We all come from somewhere. We all have family, and a lot of us know what it’s like to be in that waiting room with a loved one in the middle of a serious medical concern. They want to know their loved one’s condition, just like we’re trying to figure out where they’re at. We’re trying to figure out their condition, as well.

“A lot of people think that, because we’re not necessarily seeing their family members right away, they think we don’t care,” she continued. “Every family thinks their mom or dad or child is the worst-off trauma, and I understand why. I’ve felt that to. I don’t want my family in that situation. I don’t want anybody in that situation. I’d want people to know that we want to help everyone as soon as possible. We do. But we have to triage people based on the most severe. It’s not personal, and we’re not playing favorites. It’s whoever is the worst off gets seen first.”

When asked if that frustration from families ever deters her from the job, she shook her head and smiled once again.

“Never,” she said. “This is the best job in the world. I’ll be doing this forever.”