Stroke, anaphylaxis, myocardial infarction: These are a few of the many life-threatening medical conditions that require immediate emergency care. The importance of quick action is emphasized in the stroke warning signs acronym FAST: Face drooping, Arm weakness, Slurred speech, Timing. In order to save a patient’s life in such a situation, healthcare professionals must act quickly and expertly, maintaining their calm despite the burden of knowing that the patient’s life is literally in their hands. A healthcare professional needs to prepare him/herself mentally and physically before entering such a situation.
To be physically prepared, you must be knowledgeable about delivering emergency medical care. As a beginning nursing student, most of my current experience is from textbooks and simulated activities in the lab with mannequins, which are designed to help educate nursing students on how to function in an emergency situation. Additionally, the required Basic Life Support (BLS) training for nursing students helps us to understand what BLS entails and expected actions to take in emergency situations. Other supplementary emergency classes available for health care professional include ACLS, PALS, and NRP. These programs better prepare medical students and professionals to be equipped to render emergency care. Often employers provide in-service training and conferences for their employees in order to ensure that they are well equipped and informed on the latest evidence-based emergency medical care practices to provide effective and efficient care to patients. Moreover, hospitals/clinics often have their own emergency protocols for certain situations, such as a live shooter in a populated area. Further along in the nursing program, I will begin to gain clinical experience in various hospital departments. Outside of lectures, lab practical, and clinical experiences, volunteering at local nursing homes and/or hospitals/clinics can further aid a student to develop his/her skills. Again, these institutions usually provide department/area-specific training.
Knowledge builds one’s confidence in emergency situations. Familiarization with triage situations, drugs, or automated external defibrillator (AED), are important skills that a nurse needs to be able to perform in certain emergency situations. Additionally, the required equipment must be readily accessible. For instance, if a person is exhibiting signs of stroke, s/he will need to receive tissue plasminogen activator (TPA, a drug that dissolves blood clots impeding blood flow to the brain) or aspirin (to reduce blood clotting) as soon as possible, if necessary. A more familiar example is a person with a food allergy; s/he must receive an epinephrine injection immediately to prevent anaphylaxis.
Mental preparation and fortitude are essential attributes for a healthcare provider. If a healthcare provider is not in the appropriate mindset that will negatively affect his/her ability to function in an emergency situation, possibly resulting in fatal outcomes. Mental preparedness is a factor in eliminating potential physical ineptness when providing emergency care. Instead of being flummoxed or overwhelmed by the situation, the healthcare professional needs to remain calm and in control during stressful situations. The nurse must act confidently but circumspectly; be observant so that life-saving signs are not overlooked; and carefully determine the nature of the emergency. The first priority in an emergency is to ensure that the surroundings are safe to enter into and begin providing care, so as to avoid harming yourself and/or others. Whether you are in the ambulance driving to the scene of an accident or an emergency room nurse preparing for a patient, it may be helpful to frame the case as a regular patient visit, just accelerated and focused on the major and/or underlying medical condition. To keep yourself grounded, remind yourself of the possibility of the patient’s death if you do not act accurately and quickly. While some may be further frightened by this thought, for others, this reminder may instigate the “fight” stress response, instead of the “flight” stress response, resulting in an epinephrine (adrenaline) surge that temporarily increases your mental and physical acuity. Studies have shown that moderate levels of stress allow you to perform better in high-stakes situations (i.e. exams): too little stress and you do not as well or as quickly as you should; too high stress and you are incapacitated. The same balance must be found in emergency medical care situations, and avoidance of overconfidence is essential.
No matter in which department you work, you will encounter emergency medical care situations. Emergencies are stressful, and emotionally and physically taxing. You must prepare physically by practicing often the basic skills and the emergency skills needed to save a person’s life. You must know your healthcare facility’s safety and emergency protocol for various situations. Also, the appropriate equipment needs to be available and easily accessible, as knowledge is futile if it cannot be translated into effective emergency action. Before acting, however, you must be sure that you are approaching the emergency care situation with an appropriate mindset and attitude. While some nervousness is to be expected, you cannot allow your fear and worry overwhelm you and prevent you from doing what needs to be done in the moment. Remain calm and frame the situation in a way that prevents you from being overcome by the awesome responsibility of another person’s life. A balance must be found between controlled composure and the stress of the situation. Developing these skills and attributes take many years of experience. Nonetheless, with the appropriate mindset – the middle ground between stress-induced fear/worry and confidence – and the requisite knowledge, training, and equipment, one will be as prepared as possible for an emergency medical care situation.