Kevin Carlyle Strickland submitted 2020-05-20
I was first certified in Basic Life Support as a teenage boy scout, but had no idea the value of the skillset I was learning. As a healthcare provider for over six years and currently in New York City working with the COVID-19 crisis, BLS and ACLS are skills that I utilize regularly. From being a pharmacy technician, to a rapid-response nurse and current Doctor of Nursing Anesthesia student, there are techniques I have found helpful in responding to an emergent situation. I have now utilized these skills in innumerable situations, both inside and outside of the hospital. The value of the knowledge to know what to do in an emergent situation cannot be understated. However, responding effectively requires more than just academic knowledge, but also the mental preparedness to do so.
The foundational Basic Life Support, and corresponding advanced and pediatric courses, are crucial knowledge in all facets of healthcare. The mental discipline to function effectively in an emergent situation is not an inherent trait, but can be learned through diligent effort and experience. Nothing I can state in this essay will holistically prepare you for the moment when you are forced to utilize your medical training to help save a life. No words can serve as adequate descriptors for the sheer mental and physical exhaustion that will follow once it is over. What I can provide is insight on how I prepare for that moment when it inevitably arrives, and how to approach the emotional aftermath. This brings me to my first point: act as if you are training for an impending medical emergency.
I have realized during my adult and pediatric recertification classes that if I visualize real-life scenarios, I am more prepared to respond in an effective manner when an event does occur. To act as if I am learning and training for a situation that will occur transitions my learning in a way that engages my emotions. It provides the motivation and reasoning for why I chose to learn these skills and holds me accountable. Subsequently, this leads to a more successful academic recall and helps ingrain muscle memory for procedures when I am emergently responding. This helps me to function optimally in my role and reduces the amount of anxiety I feel during and after an emergency.
To elaborate on the emotional aspects of coordinating an emergency response effort, the feeling of anxiety when realizing your skills are needed, must be highlighted. This anxiety is unfortunately an innate part of emergency medicine, but when dealt with effectively, can contribute to a successful response. Anxiety is a natural phenomenon that is concurrent with your heart rate, blood pressure and respiratory rate increasing. This is a direct consequence of your adrenal glands releasing catecholamines and cortisol in response to the mental stress you are experiencing. When this anxiety is fostered effectively, it can be utilized for adept focus, alertness and physical dexterity. When allowed to run rampant, the anxiety can cause the inability to respond in a successful manner. I have learned through experience that the best way for me to control the anxiety is simply, to breathe. Deep breathing in a controlled manner has been shown to lower the heart rate, stabilize blood pressure and reduce the overall subjective feeling of stress. I say this with the caveat of understanding that deep breathing in an emergent situation will not alleviate the stress entirely, but that it can be used as a quick tool to reduce its impact.
Along with this anxiety, it should be known that when acting in a team, tensions can run high among teammates. I have found a means to circumvent most discord among teammates is to effectively communicate. A closed-loop communication style can be implemented by the team to instill a seamless exchange of information while acting through an emergency. It should be noted that it is important to focus on your role and pay attention to the task at hand. If you notice a team member who is not performing appropriately, offer clear and concise guidance, and provide the rationale. The circumstances of an emergency are often complex and involve a plethora of human emotions. This can place a great deal of stress on the team members involved.
In the emotional wake of an emergency, I recommend having a formal debriefing with the team. The debriefing should highlight the effectiveness of the response and find areas that may need improvement. The whirlwind of emotions you may feel after an emergency are normal. I have always taken this opportunity to express my emotions, learn something from the experience so that I can better perform in the future, and lastly to be proud of my effort. I feel it is never too early to develop a support system for healthcare workers who are exposed to the realities of emergency medicine. This system can be made up of coworkers, friends or family, and will allow the individual to be provided with unbiased support, respect, and care.
In conclusion, I would like to urge all those interested in the pursuit of healthcare to fully realize their goals. It is a rewarding field that is constantly transforming. It would behoove you to mentally and physically prepare yourself for possible emergencies, and I hope you can find my recommendations useful when the time comes.