As someone whom has been in healthcare for over twenty years, I have played many roles such as a radiology technologist, CT technologist and cardiovascular technologist. My time as a radiology and CT technologist didn’t yield too many life saving procedures performed by myself but when dealing with level one traumas such as suicide attempts, street violence and child abuse, there were still mental and physical burdens I experienced.
The unfortunate thing is as a student, I was not taught how to process the trauma we may have seen or come in contact with while working. There were two incidents early on in my career that touched me mentally and physically. The first incident was a young mother whom was driving and was struck by a drunk driver going the wrong way on the highway. As I was completing the trauma films, she was alert and begging me not to leave her because she feared she was dying. I comforted her to the best of my ability and let her know the orthopedic surgeon was getting ready for her in the operating room. Soon after her transfer to the OR, a chilling code came over the intercom. My heart sunk as I knew it was her. She didn’t make it and to this very day, I think about our conversation as she lay on the x-ray table.
The second experience involved an eight year old boy, whom had been sexually abused by his mothers boyfriend. As he lay lifeless and in shock on the CT table, tears built up in my eyes. My very own trauma from my childhood was resurfacing and the choler that I felt was indescribable. In that moment, I had to remove myself from the room and retreat to the bathroom. From a healthcare standpoint, I could not separate my emotions from this young boy and therefore could not provide him the appropriate care.
It wasn’t until my time as a cardiovascular technologist that I began to learn healthy coping mechanisms while taking care of some of the most critically ill patients I’ve seen. The Cath lab was a completely different beast than what I encountered before. Many of the procedures performed are on patients categorized as high-acuity. The chaotic environment often requires performance of CPR, intubation, left ventricular support device placement, arterial/venous access, temporary pacemaker placement and the use of a manual defibrillator. Whether adverse events occur from a routine procedure or an emergent procedure, life saving measures are activated on a consistent basis. Another aspect of dealing with mental and physical anguish comes from having to communicate with the loved ones of an individual that did not survive. It is extremely difficult to watch families breakdown and kiss their deceased relative and then continue on with scheduled procedures.
So, how have I prepared both mentally and physically to survive in a world where I encounter the sickest of patients? I believe one of the most crucial words of advice is to accept the fact there may be adverse events, despite the life saving measures provided. I accept and now know that I cannot save all patients. This may sound insensitive to some, however I know based on conversations with my colleagues, this has been a saving grace for many in our field. Another mental strength I have come to adopt is to avoid being swivet. When I am in a panic, there is an increased chance I will not exercise the best decision making, therefore, it is utterly important to demonstrate calmness.
With Cath lab hours and on call days, I can be at work for eighteen hours and be called back at the very moment I walk through my door. Being physically prepared to perform life saving measures starts with adequate nutrition. There isn’t always time to take a lunch so I make sure to pack food that is easily accessible and can be eaten in less than fifteen minutes. Protein bars, fresh vegetables and fruits, along with protein shakes are the typical foods I take along with me. Sleep and rest is imperative however, as mentioned above, long grueling hours and interruption of sleep is imminent in the lab. I combat this by resting a lot on the days I’m not in the lab. Exercise is another important way to be physically prepared to intervene in an emergency. Working in the lab can be taxing on the body. I have to wear lead shields in order to protect me from radiation exposure. Also, CPR is exhausting in itself but to perform such a task while wearing lead and protective equipment increases the level of exhaustion.
While I’ve listed my ways of preparing mentally and physically to perform life saving measures, the environment in which one works can also play a large part in how one prepares for such incidents. For instance, after a STEMI (ST elevation myocardial infarction) we debrief as a group and talk about what went well, what we could have done better individually and as a team. This is also a time to process and express emotions if the patient did not survive. A strong well supported team will increase the positive work environment which is directly proportional to how each individual responds to life saving situations.
Again, to reiterate the importance of personal care when it comes to the mental and physical demands of performing life saving procedures on individuals, the top two mental strengths for me are: understanding that I cannot save everyone and to remain calm and focused when critical thinking and actions are needed. Physically the best way I have found to prepare for these incidents are in short to take care of my body by providing energizing nutrition, resting and exercise. Also, I find it valuable when there is cohesiveness within the team and debriefing is used in emergent situations.