The first time I encountered myself in a hospital, as a medicine student, l was in the emergency room. I had already studied for three years at the university and it was time for me to begin my medical practice. It all started with the basics: interviewing patients, reviewing medical records, doing physical examinations. I was learning and being all new experiences, it was exciting.
These beginners’ activities might had been easy, as we weren’t prepared yet to manage code red emergencies, nevertheless, the emergency room was small enough for us to witness those other cases being handled.
My academic program included three years of theory, two more years of theory along medical practices, a full year of hospital internship and the last year as the medical lead in minor, rural, healthcare facilities. Therefore, I knew that, someday, in a rather medium term, it would be me attending any sort of emergencies.
The first thing one must have to be prepared is knowledge. To be certain that what you’re doing is going to help the patient, or in the worst scenario, that you’re not causing more harm than what they already present. Primarily, knowing the steps for Basic Life Support and Advanced Cardiovascular Life Support. Identifying the equipment available in the hospital, their conditions and their locations.
You have to be conscious that this field, the medical field, demands from you to study constantly, to be update about the guidelines for medical diagnosis, treatments, to be attentive about the medicines available and the upcoming ones. It’s a habit you must build.
I also learned a lot just from observing in my first medical practices. Doctors and nurses work as a team. Everyone knows which role they have, their scopes and limitations, the dos and the don’ts, all based in guidelines and experience. So, you must know how to work in a team. To manage these emergencies as fast as it can be, it’s essential to relay on your team.
Another important thing is the physical condition you have. One must be as awaken as one can be, with the energy and physical condition to perform chest compressions, to operate the equipment and to pay attention to the team leader. It is equally important to dress with comfortable clothing and shoes, usually a scrub, due to the long working time an intern is exposed. I would also recommend wearing compression socks or stockings, to help your leg’s blood circulation.
Being in an emergency room, one is exposed to a lot of circumstances, in between the patients, their families, the rest of the hospital staff, the academic homework. Is imperative to be aware of the mental state you’re in and to take care of yourself in that regard. It’s impossible to be prepared for every situation, because it can happen the most unimaginable things, but you must arm yourself with all the emotional skills you can, whether you assist to a therapist, read a book about the management of emotions, watch videos, listen to podcasts about it, even talking to a friend or colleague.
Be kind. To your colleagues, to endure the hard times together and enjoy the good ones. Be kind to your hospital staff, create a harmonious work environment, help each other and trust each other, avoid the fights. Mostly, be kind to your patients and their families. They are already through a rough moment, they might be sad, desperate, angry, even resigned, but they all trust that you are going to perform your best. So, you do, be polite even if you are tired, try to be reassuring to them, because at the end of the day, your reward is the health of the patients and the tranquility of their families.
I know there are going to be incredibly difficult situations. I know the first times you hear the noise of a patient entering to the critical room, the first time someone ask you to do chest compressions, you are going to be stressed. Remain calm, trust in your knowledge, trust in all the effort you have put to be there. The position you are in, you have gained it, but you will have to continue to prove you deserve it. It’s a true privilege to be confided of the people’s health.
I also know the downfalls of it. When you have bad news and you face the death and you can’t do nothing about it, let yourself grieve. Feel anything you have to feel, but don’t carry all the weight of guilt. Be there to your patient’s family members, seek comfort if the situation affects you. It’s OK, we are all humans.
And because of that same reason, let yourself feel joy when the time comes. When you bring back a patient from a cardiac arrest, when you hold a newborn, when you comfort a child, when you calm a worried parent, when you give good news.
We do this for the people, so let’s avoid to completely separate us from them. Let’s live the process along all the humans around us. Let’s be there for each other.