submitted 2017-08-19 00:00:00 -0400
I have worked as a registered nurse for 10 years on a busy heart and vascular unit. All the staff are required to achieve BLS and ACLS training. We have emergency situations on our nursing unit frequently and utilize the ACLS skills involving bradycardias and tachy-arrhythmias. Our hospital has protocols for STEMI and stroke patients that reinforce the concepts learned from ACLS training. The patient population on my nursing unit can be unpredictable and have sudden changes that require emergent care. When these situations arise, we use our BLS and ACLS skills until the code team arrives, and then the team works together to try and save that life.
One of the most critical aspects to successful life saving measures is the effectiveness of teamwork. Everyone works together on the same goal, but nobody can do it alone. Effective communication of the person running the code it critical. There can be situations where there are too many people trying to be involved in the emergency. This can negatively impact communication, cause confusion or just take up valuable space in the room. This can be prevented by assigning roles. When roles are assigned appropriately, communication is improved and more effective. It is important to have the right people within the team to contribute ideas and suggestions as the code situation is happening. These people would include the patient’s current nurse to communicate the situation, other nurses from the floor who know where to find items quickly, a nurse to administer meds and manage the IV, a respiratory therapist to manage the airway, and the physician.
In the last 10 years, I have experienced both the stressful and tremendously rewarding aspects of nursing. I have had times when I have broken down in tears at the end of my 12-hour shift and felt completed defeated. Then had to wake up the next morning, come back to do the same thing over. There have been many times when I thought “how am I going to do this”, but somehow it always works out and you come back and don’t give up because you know that the patients and the team need you. The stressful, tearful moments are usually strong memories, but much more focus should be placed on the countless other wonderfully rewarding situations. The situations when you do something that seems so small, but it was the most important thing to that patient in that moment and it was perfect. These moments can occur when you teach patients, when you’re just there listening to their story, when walking with them in the hallway and they share about their life, or just before a patient is sent for heart surgery and there is the opportunity for some final words of encouragement and assurance. These are the moments that make nursing great and one of the most unique professions.
Unfortunately, the stressful moments are strong memories and can linger and effect a person long-term. That is why it is important to adopt coping strategies and have the right support systems in place for when these events occur. Some things that have helped me cope over the years has been having a routine when I enter and exit the workplace. The routine is not very unusual, but it just helps to stay organized and prepare my mind to take care of my patients. It is also important to have a supportive group of peers and managers. This support group should understand how these stressful situations feel, and therefore can help debrief and acknowledge these feelings so that they don’t lead to negative consequences. Some negative consequences could be physical effects likes depression, feeling sick, or consequences as severe as nurses leaving the profession. These negative consequences can also effect patient care causing poor patient outcomes.
Stressful situations can also deeply affect new nurses. New nurses might think that their feelings regarding difficult emergency situations are not normal or can indicate weakness. These feelings need to be acknowledged and new nurses should be mentored through them to prevent negative consequences.
Some other ways that I cope with stressful feelings about patient’s situations is by taking care of myself. I try to exercise regularly, eat healthy and get rest. That can sometimes be very difficult especially when working long hours, not having enough time to buy healthy food, or being too tired to exercise after walking up and down long hallways all day. Although it seems impossible sometimes, it really does make a difference in how your body feels when it has the good things it needs. In addition to taking care of oneself physically, attention should be paid also to spirituality. I truly believe that there are so many things that happen in the medical field that cannot be explained by medicine, and that we should recognize a higher power that which we have no control over. For the last 10 years every time I enter work I say a prayer for strength and competence. This is part of my routine and I believe that it has changed me and helped me be the best nurse I can every shift.