Dayna Krywolt - Medical essay | Pacific Medical Training

Submitted 2022-10-04

The Healing Power of Reflection in Advanced Life Support

I remember the atmosphere of the unit so clearly from that day. As I began my Sunday morning rounds, the unit was quiet and calm. Each infant was settled in their crib, the noise machines, and mobiles all bleeding into each other to create a blanket of peaceful white noise. The sun seeping into the windows as the day made it’s break. Before I entered her room, I savored the overwhelming feeling of tranquility on the ward, knowing that it would not be long before the choir of infant cries would begin as they all began to wake each other up. Little did I know, a storm awaited me beyond the door.

As I brushed her eerily cool and clammy arm, my nursing intuition was triggered. I pulled back the blanket and the sea of red before me was nothing short of shocking. I sprang into action. As the emergency alarm sounded, my colleagues and I worked to save the life before us. As I began compressions on her limp body, someone else manned the bagger. Another held pressure, their arms shaking as they put every ounce of strength into stopping the hemorrhaging. Doctors rushing in, pagers going off, adrenaline thick in the air as the code played out. Despite everyone putting forth their best effort, this sweet little girl could not hold on. Though it was not my first code, this one felt particularly traumatizing.

In the moment I remember my actions feeling automatic, the result of my education and nursing training. My brain knew what to do, and my body manifested those actions without a moment wasted. Despite my quick reaction time, my devotion to the principles of BLS – I lost my first patient, though in my mind, there was nothing further that could have been physically done. Despite my technical preparation for this moment in nursing labs, BLS courses and workplace simulations, I did not know at the time that I would exit this code in mental turmoil. It was not until after this incident that I began to prioritize my mental health as a nurse both within and outside the walls of the hospital. While I had the knowledge and skills to respond to a traumatic code, my lack of mental preparation for situations like this one would affect me for months to come. We must take fitness to practice seriously and assess our mental and physical wellbeing prior to each shift. Following this incident, giving myself the grace to take time away from work was integral to my own personal healing, and growth as a nurse.

So, where does a bad outcome like this leave us as nurses? It is all too easy to let this feeling consume us, to place blame upon ourselves and our skills as basic life support providers. A loss such as this one can feel so personal and leave us questioning our career choices. What I have come to understand throughout my career as a young nurse, is that one’s growth as a medical professional is dependent on one’s openness to discuss the trauma that they experience. Following this case, I was driven to shift my perspective on advanced life support scenarios to focus on thorough debriefing following a critical incident. We must be able to talk openly about critical incidents to empower our bodies and minds to handle the trauma of delivering life-saving measures and experience the fulfillment that same trauma can provide us with. Whether we let ourselves be vulnerable among our fellow colleagues, our friends, or our families - reflection is a powerful tool for healing and growth as frontline workers. As you step forward into your medical professional role, look to those around you that you share these potentially traumatic and deeply personal experiences with. Not only is dedicating your time to the precision of your technical skills critical in an advanced life support scenario but prioritizing your mental fitness to practice is equally as important.