Helping the acutely ill is not about who I am, neither is about who is in trouble. It’s about what the victim is going through and what I can do about it regardless of compensations. These selfless deeds were around long before the birth of emergency departments. This shows you what at the core of emergency care is… humanity. Thanks to the Ethiopian society that brought me up, I believe in giving hands to those in need. Whoever they are, wherever they are. Emergency care medicine is backing up that humanly instinct of helping those in jeopardy with an organized body of knowledge. Among others, the variety of patients and problems make this department of medical care unique and, therefore, deemed to require unique qualities and skills of many specialists from its providers.
Our professor said something that I live by. “Emergency care doesn’t start with the ABC’s, it starts with preparation.” Working on myself to prepare my mind and body, I think, is the first most important thing that I can do for my patients. I have to be competent enough and ready for the rush and accelerated pace, my autonomic responses to anxiety, unexpected findings, and things that could go wrong. Readily organizing the right equipment and personnel is essential because I don’t want to interrupt compressions and go looking for suction as my patient vomits in the middle of a CPR. One time, I was appointed as a team-leader in a simulation case of a child with acute exacerbation of asthma. It was at that time that I appreciated how my success in saving lives largely depends on my academic know-how including familiarity with the Pediatric Advanced Life Support (PALS), the algorithms, and resuscitation skills. That’s why I give a special place for being competent. Updating oneself with the ever expanding understanding of medical care is important. Albeit working on a doll, that moment put me in a stress which should be amplified when I encounter a bone and flesh human being in distress. Not to crack under the pressure when facing flood of external information in a brief time period, I need emotional intelligence, focus, confidence, courage and critical thinking. Sudden arrival of new patients without any medical records at inconvenient times can be frustrating. I must think fast and make quick, aggressive decisions. When lacking a skill, I must be willing to admit limitations and ask for help because my pride is insignificant in the face of a life.
In medicine, and in EM in particular, we are co-dependent; we are family. This team-oriented and failure-predisposed emergency care needs skills of many specialists and I should be ready to play my part whether as a team leader or a member. Being visionary, assertive, dedicated, flexible, magnanimous, open and calm amidst chaos makes one a good team leader. Creative leader is able to manage a specific patient, in the specific moment, with the specific resources and people available at hand. Giving my undivided attention and focus on comprehensive care of the patient is vital. I also have to be aware of my limitations and be willing to learn from failure instead of being offended and taking things personally. After doing what I’m humanly capable of, I may go on and celebrate my success or learn from my failure. Favoring empathy over sympathy and using good coping skills, I have to know when to stop and continue to my next patient. Keeping all those good qualities throughout the work hours may be difficult and needs perseverance and higher energy levels. Remaining calm and understanding their acute medical conditions can help me in managing “difficult” patients.
Standing in front of a patient, a medical personnel is not a fiancé to their girlfriend or a daughter to their father. They are the patient’s hope to breathe another day. Because, at that moment, nothing else matters. That must be a huge responsibility, and also a great privilege. Lifesaving requires skills that span from intense preparation, through massive action and to efficient de-briefing. Emergency care is demanding, mentally and physically. And I have to supply. Preparedness, individual competence and efficient teamwork are at the core of Advanced Cardiovascular Life Support (ACLS). A good heart goes a long way but is not enough in providing all-inclusive care for the acutely ill, I have to practice my brains. The basics of the lifesaving skills should be possessed by every human being but I, a 23-year-old 5th year medical student, should strive to be fully acquainted with greater expertise than the next layperson. I must have qualities of a good caregiver and play my part in building a high performance team through the promotion of effective leadership, efficient communication, role clarity and mutual respect.