Nicole Marie Ignacio Sims, OMS-I submitted 2020-07-21

I chose to pursue medicine while working in two local Oregon emergency departments as a medical scribe. My years with these departments opened my mind to what “healing” truly means. Exposed to a wide range of cases, I formed new ideas of how emergencies present and what we classify as an emergency. Not only is the inability to breathe, or the obstruction of blood flow, a medical emergency, but so are events of abuse, rape, child neglect, and drug overdosing. The emergency department gave me exposure to invasive life saving techniques such as intubations and ACLS, which everyone is familiar with from watching television and reality hospital shows. What was truly eye-opening to me was how health care providers, nurses, and technicians go above and beyond to solve problems for people in stressful social situations. This is the “hidden” work of the emergency department. Nurses and doctors ask all the right questions to figure out if someone is being abused or neglected in their home, while maintaining confidentiality. They never fail to search for a plethora of community resources to provide to those who are homeless or who struggle to afford their medications. The staff I worked with treated every situation as an emergency to be resolved. This level of care for every patient is what I hope to provide in my future practice.

I believe that any healthcare professional, when asked why they wanted to become involved in medicine, would sincerely answer that they want to help people. My purpose for entering medicine has always been basic: to train at the ability to heal anyone, anywhere, at any time. Emergency providers, nurses, and technicians are not only equipped with comprehensive life-saving techniques, but are also trained to act as a support system for their patients. This training, almost unrecognizably, makes healthcare professionals proficient in communicating and supporting their team members to tackle acute emergencies. While this may seem more political than scientific, it is necessary to ensure that the entire healthcare team is effective in treating their patient.

When we watch professional sports, we see quick and simple plays that observers only think of as awe-inspiring miracles, or hail Mary passes. But listening to the players during the post-game interviews, we hear about how long they practiced with their teammates to perform seamless plays. I like to think similarly about the emergency room staff and trauma teams who train with each other every day to ensure that their cohesive actions save lives. Not only is a strong team the answer to success, but medical teammates are capable of debriefing with each other to properly process the trauma they have just witnessed. As an emergency medical scribe, my role of documenting the encounter may have seemed small at the time, but doing my job to the best of my ability made the post-critical care work much easier for the doctors and nurses. Small efforts from each teammate, rather than large efforts of independent people, make these emergency and trauma teams successful. It is necessary to work with teammates who can relieve you of your role performing chest compressions, but are also comfortable addressing your anxiety or panic over what has just happened.

As humans, we absolutely have mental and physical limits that can hinder us. Entering my first year of medical school, I know I will have to stretch these limits to become a great physician. In the future, I will need to stretch these limits and emotional capabilities to treat any person in need because I must also undertake the role of patient advocate and supporter. To do this however, I must surround myself with a strong support system and an excellent team of colleagues.

Science has shown that continual stress causes physical strain, manifesting chronic health diseases like hypertension, hormonal imbalance, mental health disorders, and substance abuse, to name a few. While COVID-19 ravages across the globe and grips the lives of Americans, we are all overtaken by a feeling of unease because our normal lives are continually changing. We find ourselves in a state of emergency every day, with stress and the threat of disease looming around every corner. Creating a new “normal” life is essential to surviving in the constant state of emergency we live in today. This new life involves lots of adjustments to our everyday actions, but the stress created by these changes can be ameliorated by keeping yourself mentally and physically healthy. Along with performing my role as a supportive team member, I always try to keep myself on a regular schedule regarding my sleeping and exercising habits. More importantly though, I believe everyone should consider the importance of having an outlet for their mental health. This does not necessarily mean that every person needs to seek psychiatric professionals to talk with; this simply means that everyone, especially those continually performing under stress, should have a friend, co-worker, or family member with whom you feel comfortable talking with about difficult topics. Often, we need another lens to look at things though and it does no harm to bring others into your mental space if it means ensuring you can perform in a stressful situation.

To future medical professionals, I say this: You may not know what challenge will come next in your training or what patient you will need to heal, but what you can control is the team you surround yourself with and your general well-being. Cultivating this emergency response team to support you physically and mentally will only enhance your ability to care for others.