I’ve always been praised for my calm outlook which, for most people who know me, comes as quite a shock. I can be terribly whiny and moany at times, but that’s only about personal stuff, stuff that matters. At work, I’m as calm as, well, a very calm thing. Like those cats who enjoy soaking in warm water and cry when they’re taken out. Calm. Zen. It’s not even being calm but inside freaking out no, it’s just a full state of ‘well, this needs sorting doesn’t it?’ and just sorting it.
So much so, one of my old managers asked if I was popping xannies.
For all who may be concerned, I am not nor ever have.
I suppose my attitude is around the importance of the stuff going wrong. Unless someone is actively dying, stuff can be sorted out. So you missed your train, let’s explain and get the next one. Oh, that file’s gone missing? Let’s print it again. Person screaming in your face? Mentally tune out and sing the American Dad theme tune in your head, bonus for dancing along waaaaaaaay past the point they’ve stopped screaming.
Basically, nothing is worth getting mega stressed about. Not work stuff anyway.
The other month I had manual handling and basic life support training. It was the same old stuff. Lift with legs, don’t yank your back, ankles are not to be abused etc. Life support is the same. Airway breathing circulation look for danger call for help.
The entire session I was applying my nursing knowledge and answering the tutor’s questions. I was happy to help those who had never done first aid before and was chatting away with some of the other student nurses. I exuded confidence and honestly, I felt very much the same calmness about the entire thing. Oh, cardiac arrest in progress? Well, that needs sorting, doesn’t it.
Except when the tutor called us each up to run through the procedure (DRSABC for anyone wondering) with two other people, she made it personal.
‘This is Alan. Alan is 32 years old. He was playing football when someone kicked him in the head, he was conscious in the ambulance but upon arriving at A&E and he’s collapsed.’
D. I approached, ‘Is there any danger?’ I ask.
‘No, the area’s safe.’
I knew what I needed to do. R. Response.
‘HELLO ALAN, HELLO CAN YOU HEAR ME?’ I shout not too loud, but loud enough to rouse someone from a deep sleep. I manoeuvre my fingers under his clavicle, a move that’ll see any man woman or child flinch with pain if they were conscious.
‘He hasn’t responded.’
S. Shout for help. I call for help and my fellow partner ran over. ‘Go get help!’ I say. That’s wrong. It’s wrong. What help is she going to get? Admin? IT? A therapy puppy? First mistake, I totally screwed up. Start again.
S. Shout for help. I call for help again. ‘Call the cardiac team!’ WRONG. So she calls the team, then what? Off she toddles back to her patients? Her cuppa? Start again.
S. Shout for help. I call for help a third time. ‘Call the cardiac team, get the crash trolley and COME BACK!’
A. Airway. I tilt Alan’s head back and check his airway.
‘His airway’s clear.’
I froze. How do I do this again? How do I check for breathing? This is what I ASK THE TUTOR. In front of 20 other people. Like, I’ve done this a thousand times in practice. So many times. I told others how to do it, but now? With Alan in front of me? Alan who was living his life one second and now stands a 90% chance of dying unless I get this right?
B. Breathing. I keep his head tilted back, place my ear over his mouth, my hand on his sternum and watch.
‘He’s not breathing.’
C. Circulation. The body has a small oxygen reserve int he blood hanging around after Alan’s last breath was taken but it’s not moving now. Circulation will serve two purposes: manually beat his heart and assist with microbreaths as I do compressions.
I place my hands on his sternum, lock my elbows and press down with my hips. My partner is back and has the defib pads placed. The machine is checking for any signs of electrical pulses of Alan’s heart. It tells me to move away and I do.
My partner screams for us all to stand clear as a shock is delivered.
No. She took her eyes away from Alan and the team. How did she know someone wasn’t touching the table? Alan’s family are in the room now, his mum’s touching his feet willing his heart to beat. Was she still touching them? We didn’t know.
We try again. ‘STAND CLEAR.’
No. The oxygen wasn’t moved far enough away. One spark and the entire room would be shrouded in flames.
Again. ‘STAND CLEAR.’
We jump back, I start another round of compressions.
I slow down.
I push harder.
’25, 26, 27, 28, 29, 30 BREATHS PLEASE.’
Two rescue breaths are given.
As we start compressions again the defib warns of a shock, but we’re all concentrating so hard my partner fails to tell us to move in time.
We failed. Hard.
We gave it another try, and another before we felt we’d nailed it.
A few weeks later, one of the healthcare assistants came to me, looking pale and pallid. ‘Laura, I’ve tried to wake up Kate but she’s not waking up! I don’t know what to do!’ You can imagine the pant-wetting fear. I wasn’t ready for a code. I wasn’t. I ran to the bed, lump in throat, and called Kates’ name. No response. Dying inside, I pinched between her clavicle and she roused. Thank. Goodness.
Calm? I’ve never felt more nauseating pressure in my life. Remind my why I want to get into emergency medicine again?
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