Insights from Leissan Sadykova

Submitted 2022-11-02

It can be difficult to find the time to take care of yourself physically and mentally. Successfully performing in emergency situations requires preparation that beings long before the workday begins and continues throughout the workday. Emergencies by definition can occur at any moment, so it is imperative that I do what I can ahead of time, so I am ready when these moments arise.

Physical Preparation

Physically preparing for an emergency requires taking care of your body’s needs. This includes exercising and eating a healthy diet. Equally important is getting the proper amount sleep, which can be aided by investing in a quality mattress, ensuring that the room is dark and quiet, and that the temperature is comfortable. Air pollution can be mitigated with air purifiers. Water filters can remove harmful chemicals such as PFOS and PFAS. There are numerous studies that highlight the way these factors contribute to superior cognitive functioning, memory, and emotional regulation, all of which are essential in emergency situations.

Learn what resources are available in the hospital and the surrounding region. You should be aware of the capabilities and limitations of your department so that when you need to reach out for help, you know where to go and who to call. As an example of how this knowledge can be useful, a pediatric patient arrived at the ED where I was scribing who was experiencing her first diabetic ketoacidosis (DKA) event. Although we did not have a pediatric emergency unit to treat the patient, the doctor knew where she should be sent. We quickly transferred her to another hospital that was equipped to properly treat this complication.

At the hospital, it is important to prepare the environment for any emergency. Patient rooms need to be properly stocked with medications and supplies. An item may seem trivial, but in the chaos of an operation, it may become lifesaving. For example, a stool may not appear to have any special significance, but it can help ensure proper positioning for shorter personnel if chest compressions become necessary.

Another way to physically prepare for an emergency is to post reference information around the department that can be readily accessed. This may include things that are easy to forget, easily missed, essential for success, mistakes that are trending up, standard operating procedures, and reference materials. Take the initiative and recommend that these items be posted if they are not posted already.

Objects need to be clearly labeled, clean, serviceable, and in their proper place. In one instance I observed, a physician was about to pronounce a patient dead when he noticed a printout of the patient’s ECG on the floor, which led the doctor to pursue a different treatment. Fortunately, the room was stocked with all the supplies necessary to implement the alternative treatment and the patient made a full recovery. If the ECG had been in its proper place, the correct treatment could have been started much earlier.

Mental Preparation

Mental preparation starts at home. You can’t take care of others if you aren’t taking care of yourself first. At the start of each week, I organize the tasks and chores I need to accomplish so I don’t bring those distractions to work with me. Food prepping, paying bills on time, keeping my vehicle well-maintained, and sticking to a budget helps me avoid unnecessary anxiety so I can remain calm and focused while at work. I always set aside a fun budget for hobbies and other activities that allow me to decompress and recharge. A strong support network of friends and family also contributes to my mental wellbeing. Living a healthy and happy life sets a good example for my patients and keeps me energized throughout the workday.

Mentally preparing for emergency situations at the hospital requires a thorough understanding of the population that you are servicing. Take time to understand the various cultures and holidays that are common in your community. This can help you anticipate the types of emergencies you might encounter. For example, on the 4th of July there may be more instances of burns, alcohol poisoning, and falls. During Ramadan, fainting may be more common due to periods of fasting. Question assumptions and biases so that you don’t jump to conclusions.

Mentally visualizing the procedures I will implement and my response to complications helps to build muscle memory which decreases response times should those contingencies arise. Thinking through my actions, like what I will do, how I will position my body, and where things are located means that I have performed a procedure multiple times in my mind before actually performing it on a patient, thereby reducing error rates.

During an emergency, it is essential to focus on the patient and the situation at hand. Distractions must be eliminated. Conversations must be related to the patient. During the emergency response, everyone should have clear roles, responsibilities, and expectations which are communicated ahead of time. Proper communication is vital for successful emergency responses. Ask questions if something is unclear, be open to answering questions that are asked of you. Never assume that someone saw what you did. It is best to overcommunicate so that there are no ambiguities. Foster a culture of openness that encourages input and suggestions from all members of the team and strive for continuous improvement. Attend trainings and educational opportunities to learn about the latest best practices because medical information is constantly evolving due to ongoing research.

After working in the emergency department, I noticed how much I took life for granted. I have seen people lose close family members and friends. The realization of how quickly things can change has made me a better daughter, granddaughter, and friend. It has forced me to take better care of myself physically and mentally, both in and out of the hospital. These mental and physical preparations help ensure that I will be ready to respond to emergency situations at full strength.