Seconds count. Someone else’s life is in your hands and the decisions you make in the next moments will have a lasting impact on another person’s life. This can be a daunting realization, no matter your level of training and expertise. As an ER nurse, a paramedic, and a pre-med student; dealing with emergencies and time critical situations is a way of life for myself and others in my field. In this career seconds may count, but training does too.
When in the throws of a full on panic attack because of the seemingly endless list of things that need to be accomplished simultaneously to save the life of the person in front of you, the most important thing to remember is, “This is not your emergency.” At the end of the day, you will go home to your family. You will get dinner. You will take a shower and go to bed. Yes, you may be emotionally and physically drained, but you will make it.
Check a pulse. No, I do not mean the patient’s, although that may need to be the next thing you do. As long as you have a pulse you can still make a difference. The difference you make may be in the lives of the surviving family members, but it is still an impact. Remain calm and professional. Remember that this has the potential to be the worst day of your patient’s life and the way you handle yourself may be something that that person remembers forever. Tensions and emotions are likely running high, so realize that things may not come across as you intend them to. Think about how your words and actions will be received before speaking and reacting.
When all else fails, revert back to your basic training. There is a reason healthcare professionals take BLS classes every year. This class makes “Airway, breathing, circulation,” not only second nature, but a mantra you will find yourself chanting in your sleep. Air goes in and out, blood goes ‘round and ‘round. Any deviation from that is a problem! Take care of your patient’s most basic needs and handle the rest as you are able or as help arrives. There will be time for more advanced skills soon, but none of those will be necessary if your patient has expired.
In the ER, I see a lot of emergencies that are less than emergent. Sometimes it can be challenging to remember that these people still need to feel like they are a priority, regardless of the fact that their dire need of a turkey sandwich is interrupting compressions on the code blue patient next door and the EKG on the patient down the hall having a heart attack. Be compassionate. Just because the chronic leg pain that the patient has had for the past 25 years does not seem critical to you, that does not mean that it is not an emergency for them. Remember, most people have better things to do than go to the doctor or the hospital. If they are there, it is because they feel that they need to be.
Prepare yourself physically every chance you get. Get into the gym on your days off and put in a bit of cardio or weight lifting. The “You must be able to lift 50 pounds,” requirement that is impressed on you during your interview is slightly off the mark as anyone who actually works in medicine for a living well knows. One drug box weighs more than 50 pounds and you’ll typically be pushing a 350 pound patient on a 500 pound bed, carrying the drug box and a monitor, and pushing a few IV poles for good measure. You’ll also be moving all of this to the furthest corner of the hospital possible. When you’re literally running with all of this through the hospital halls, bells and alarms sounding, trying to get to the next room before your patient codes again in the hallway, dripping sweat; you’ll thank me for the workout tips. Bonus tip: If you do compressions on more than 2 patients in a shift, you have a valid excuse to skip your workouts for the rest of the week!
Take a breath and do your best. You will not save everyone, and that is okay. Do not let the ones you lose shape your career. Some will thank you and some will curse at you. Rejoice in the ones that you can help and try to be a positive influence for your peers. Celebrate successes with coworkers and grieve together over difficult near-misses. The stress involved in this field is unlike anything else and your work friends will feel more like family at the end of a rough day. It takes a very uniquely special person to see the things that we do in this line of work and still come back for the next shift. Love it or hate it, this is a calling.