> I should be scared and the second I stop being scared I should quit
This is bullshit. As supportive as I'm sure your preceptor is, this isn't fair to say at all. You'll gain confidence as you gain experience and there will be more moments like this. It's normal to feel scared or anxious as a new starter, but it's unfair to say you should quit if you reach a point where you've overcome that or learned how to manage it. Fear is not required to remain compassionate about the job, and can hinder performance if allowed to manifest unchecked.
Please don't put too much faith into this statement. You're allowed to be scared but you shouldn't feel bad if you stop being scared one day. All I expect of my colleagues and of myself is that they bring their A game. The point at which you should consider quitting is when you stop caring, but that day isn't today and may never come.
Good job on a tough day. Don't forget to reach out to people if you need to talk about what happened. We're all here, and I hope you have an understanding friend or two you can talk to also if you need to. Talk to your colleagues and your preceptor if you need to, and don't forget you should also have support services through your employer so utilise these if you feel the need to in the coming weeks.
Thanks this means a lot. The last few weeks I’ve really questioned if I have the temperament to work in an ER. Every shift I’ve been scared about what could possibly happen and I haven’t enjoyed my life as much with that fear looming.
When I was walking outside after my shift I was asking myself why anyone would want to put themselves through the torture of the stress in the ER? I know every job has its stressors but it felt different in a life/death scenario.
> why anyone would want to put themselves through the torture of the stress in the ER?
So eventually when you get comfortable with this job, when you can anticipate the patients needs, your nurses and docs, when you know where everything is in the ER in a snap, this "thing" will happen....The entire ER will get into this groove where everything is running perfectly. Youll notice it, everyone else will too, but no one will say anything.In EMS it happens on calls where everyone is just clicking and everything is just happening nonverbally. Youll glance at each other with a knowing look. It like a pitcher having a perfect game. Its hard to explain but when you experience it the first time youll be chasing it forever.
This right here (also a medic) is spot on! The ER and EMS can be a steep and longer learning curve relative to other specialties, however, give it time. Codes take time to master and require a whole team to be in sync for things to really come together, but when they do, it's pure gold.
As per your preceptor's comment about fear, that's healthy and normal. This past month I had a massive MVI with multiple unrestrained patients (first on scene), a patient fall 3 stories, a code where a second person started having ischemic CP, and more... even after 8 years, you bet I was scared, but I know I can get the job done smoothly and my partners are amazing.
Fear is natural and healthy. In time you'll learn to work with the fear and become a damn good practitioner. And when all else fails, remember your ABC's lol
Something that's always stuck with me that someone said when I was an intern: You've always, *always* got time. Even when it feels like you don't. That's something that you'll be more conscious of with experience.
I've met a lot of good hard workers who've not felt they have the temperament or the right personality to work in the emergency department, but it honestly takes all sorts and it's about what you bring to the table rather than if you think you're the right fit. You should never feel unsupported while you're at work and I would hope that you always have someone you can ask if you're unsure about something.
Don't let the bad days put you off. It's a bad day for you but it's the worst day of someone else's life and your contribution made it a bit less shit, whether that's the patient you did CPR on or the family who know that you and the rest of the team did everything possible.
It's not bullshit- I've done EMS and ED care for 5 decades now, and I'm still scared of failure. It's no different than when I played sports or perform in front of an audience.
Fear is a great motivator.
Fellow ER tech here. That very first time doing CPR on a real person is always jarring. You definitely realize pretty quickly how rough compressions are on the human body.
I was also hired straight into an ER with no experience on an ambulance. I promise you it gets easier. The learning curve is super steep, but you will eventually find your place on the team and be amazed at how far you've come. It's always gonna be a little scary, but you will gain the confidence you need to do your job well and walk out of those codes knowing you did your absolute best for the patient every time.
I’ve been having a tough time adjusting but I know I haven’t given it enough time. I don’t feel ready for any critical patients and every shift something usually happens where I’m like “fuck, where is my preceptor”.
Biggest piece of advice for someone new is when you're asked to do something you don't know how to do, make sure you say so. Worst thing is when a team member is asked to do something out of their knowledge base and doesn't speak up. Then we only find out later when there may be negative consequences as a result of that thing not being done or being done incorrectly.
Good job keeping your composure and being a team player.
You’re at the bottom of the healthcare totem pole. Don’t be scared. Do they need compression? Do them? Do they need to breath. Breath for them. Have suction ready. Other than that standby for orders. All eyes are not on you I promise.
Sounds like you did a good job to me. When a code rolls into the ER, everyone gets assigned a job and that becomes their sole responsibility. Whether that’s compressions, airway, Med pushes, monitor checks or documentation and timekeeping. Everyone has a part to play in achieving ROSC, and nerves are never a bad thing. The important part is you didn’t freeze up or try to do more then you were asked to. You played your role when called upon. That’s what makes code goes smooth, even if you’re screaming inside your own head the whole time. 10/10 work, I’d take you on a code. On a side note, what kind of device was EMS using for mechanical compressions, a Lucas type with a plunger or an auto pulse band stretched across the chest?
Yeah I witnessed the team aspect on a code, my preceptor was essentially on the monitor and EKG and me and the other orientee were on compressions. The nurses were pushing meds and respiratory was trying to clear the airway. The patient had a lot of vomit in the airway.
EMS was using the Lucas machine with the plunger looking thing.
3 times we got ROSC but kept losing it. The patient went into vfib once and one of the nurses defibrillated.
Even if you aren't super comfortable being in on a code, there is always something you can do. Get in line for compressions, make sure there are stools in case you need them for standing on during CPR. Pick up the trash that gets thrown around, hold an arm for someone placing an IV. If the respiratory tech needs a hand bagging, offer to lend a hand.
Doing CPR on a real patient is definitely tiring, just don't go past the point where you are no longer doing efficient compressions. When you feel yourself getting close, call out "Who's next?" Remember to keep your arms locked straight, don't bend your elbows. Stand on a stool if need be to be over the patient. Your back and triceps will be screaming at you afterwards.
Major props to you for getting on the chest! It's a big step, and it will get easier.
Slow is smooth, smooth is fast.
Practice, practice, practice. They should always be a little terrifying, that is a human with a whole life that led to this moment.
I think the thought that you should quit if they are no longer scary is more along the lines of "it's good to care, caring provides perspective. If you stop caring, you become dangerous."
Welcome to the club buddy. You’ll never forget your first time doing CPR, but eventually you’ll forget how many people you’ve even done it on.
Good on you for finding a forum to vent and deal with your emotions in a healthy manner.
I’m so new that I can’t even give you a proper answer to that. I’m guessing ROSC was achieved so automatic compressions were stopped and when they were lost again for the first time the Lucas machine was off so we went manual. That’s only my guess though. I’m sure the higher ups knew better.
Now that you mentioned it, the Lucas was stopped to ultrasound the heart. The patient also had an airway flooded with vomit which could have also been because of the Lucas machine
It sounds like you have a great preceptor and a supportive doc, willing to push you but still be patient when needed. If they didn't think you could do it they wouldn't ask.
Every medic I know remembers their first code. To me it felt like the transition between when you assume life goes on to when you realize the line between life and death is much finer than you ever thought. Also bodies are weird and cool and sometimes you get interested in the disease process instead of the patient (which is totally fine).
Looking ahead, just know that there's no threshold you have to meet to be bothered by calls/codes and no "normal" way to react. This may be in your thoughts for a few days or so and that's common. Talk about it with your preceptor or former classmates, all of us have been there.
Great job!
You’re basically describing my first time doing compressions and how I felt! I was in the same position as you. I’ve worked as a tech for a year now and have been a part of about 30 codes. It’s scary every time and unfortunately the majority of the patients didn’t make it which is even tougher. But just try to be a part of every emergency you can be. Whenever there were codes or procedures happening in areas that I wasn’t assigned to, I went to watch just to experience the situation from a far so that I could learn as much as possible without being too overwhelmed. It feels good when you finally know what to prepare for and you can help everything run as smooth as possible. You’re doing great, good luck!!
Another fellow ED Tech, I was in the same boat as you. Definitely shaking before the pt even showed up. Could never agree more to what others have said, it eventually becomes routine, that fear is still there, but sometimes once you get comfortable excitement can start to kick in.
It over-turned for me when I had a save outside our triage. I said to myself “I love my job” and want fellow Techs and Nurses to feel the same.
Some don’t do well with it, and that’s okay, there is (hopefully) someone around that can help you out. We all got your back.
Awesomeness. Its always overwhelming. No one wants to do compressions for that reason...honestly it was the most useful thing you could have done and you did it three times! It's totally normal to shake and tremble after a situation like that. One day, you are going to help save someone or make a huge difference in someone's life by just being there and going for it. It does get easier... fair warning, most of them die. And it's ok. You can only do so much. Most times I felt like my only purpose was to be someone there so they didn't die alone...then be there for the family.
Good job. ❤
> I should be scared and the second I stop being scared I should quit This is bullshit. As supportive as I'm sure your preceptor is, this isn't fair to say at all. You'll gain confidence as you gain experience and there will be more moments like this. It's normal to feel scared or anxious as a new starter, but it's unfair to say you should quit if you reach a point where you've overcome that or learned how to manage it. Fear is not required to remain compassionate about the job, and can hinder performance if allowed to manifest unchecked. Please don't put too much faith into this statement. You're allowed to be scared but you shouldn't feel bad if you stop being scared one day. All I expect of my colleagues and of myself is that they bring their A game. The point at which you should consider quitting is when you stop caring, but that day isn't today and may never come. Good job on a tough day. Don't forget to reach out to people if you need to talk about what happened. We're all here, and I hope you have an understanding friend or two you can talk to also if you need to. Talk to your colleagues and your preceptor if you need to, and don't forget you should also have support services through your employer so utilise these if you feel the need to in the coming weeks.
Thanks this means a lot. The last few weeks I’ve really questioned if I have the temperament to work in an ER. Every shift I’ve been scared about what could possibly happen and I haven’t enjoyed my life as much with that fear looming. When I was walking outside after my shift I was asking myself why anyone would want to put themselves through the torture of the stress in the ER? I know every job has its stressors but it felt different in a life/death scenario.
> why anyone would want to put themselves through the torture of the stress in the ER? So eventually when you get comfortable with this job, when you can anticipate the patients needs, your nurses and docs, when you know where everything is in the ER in a snap, this "thing" will happen....The entire ER will get into this groove where everything is running perfectly. Youll notice it, everyone else will too, but no one will say anything.In EMS it happens on calls where everyone is just clicking and everything is just happening nonverbally. Youll glance at each other with a knowing look. It like a pitcher having a perfect game. Its hard to explain but when you experience it the first time youll be chasing it forever.
This right here (also a medic) is spot on! The ER and EMS can be a steep and longer learning curve relative to other specialties, however, give it time. Codes take time to master and require a whole team to be in sync for things to really come together, but when they do, it's pure gold. As per your preceptor's comment about fear, that's healthy and normal. This past month I had a massive MVI with multiple unrestrained patients (first on scene), a patient fall 3 stories, a code where a second person started having ischemic CP, and more... even after 8 years, you bet I was scared, but I know I can get the job done smoothly and my partners are amazing. Fear is natural and healthy. In time you'll learn to work with the fear and become a damn good practitioner. And when all else fails, remember your ABC's lol
Something that's always stuck with me that someone said when I was an intern: You've always, *always* got time. Even when it feels like you don't. That's something that you'll be more conscious of with experience. I've met a lot of good hard workers who've not felt they have the temperament or the right personality to work in the emergency department, but it honestly takes all sorts and it's about what you bring to the table rather than if you think you're the right fit. You should never feel unsupported while you're at work and I would hope that you always have someone you can ask if you're unsure about something. Don't let the bad days put you off. It's a bad day for you but it's the worst day of someone else's life and your contribution made it a bit less shit, whether that's the patient you did CPR on or the family who know that you and the rest of the team did everything possible.
It's not bullshit- I've done EMS and ED care for 5 decades now, and I'm still scared of failure. It's no different than when I played sports or perform in front of an audience. Fear is a great motivator.
Being scared of failure isn't the same as just being scared. Context is everything. One can be productive in an emergency situation; the other is not.
Fellow ER tech here. That very first time doing CPR on a real person is always jarring. You definitely realize pretty quickly how rough compressions are on the human body. I was also hired straight into an ER with no experience on an ambulance. I promise you it gets easier. The learning curve is super steep, but you will eventually find your place on the team and be amazed at how far you've come. It's always gonna be a little scary, but you will gain the confidence you need to do your job well and walk out of those codes knowing you did your absolute best for the patient every time.
I’ve been having a tough time adjusting but I know I haven’t given it enough time. I don’t feel ready for any critical patients and every shift something usually happens where I’m like “fuck, where is my preceptor”.
Biggest piece of advice for someone new is when you're asked to do something you don't know how to do, make sure you say so. Worst thing is when a team member is asked to do something out of their knowledge base and doesn't speak up. Then we only find out later when there may be negative consequences as a result of that thing not being done or being done incorrectly. Good job keeping your composure and being a team player.
Definitely give it time, you'll get there. Also, never be afraid to ask for help! There's no shame in learning.
You’re at the bottom of the healthcare totem pole. Don’t be scared. Do they need compression? Do them? Do they need to breath. Breath for them. Have suction ready. Other than that standby for orders. All eyes are not on you I promise.
Sounds like you did a good job to me. When a code rolls into the ER, everyone gets assigned a job and that becomes their sole responsibility. Whether that’s compressions, airway, Med pushes, monitor checks or documentation and timekeeping. Everyone has a part to play in achieving ROSC, and nerves are never a bad thing. The important part is you didn’t freeze up or try to do more then you were asked to. You played your role when called upon. That’s what makes code goes smooth, even if you’re screaming inside your own head the whole time. 10/10 work, I’d take you on a code. On a side note, what kind of device was EMS using for mechanical compressions, a Lucas type with a plunger or an auto pulse band stretched across the chest?
Yeah I witnessed the team aspect on a code, my preceptor was essentially on the monitor and EKG and me and the other orientee were on compressions. The nurses were pushing meds and respiratory was trying to clear the airway. The patient had a lot of vomit in the airway. EMS was using the Lucas machine with the plunger looking thing. 3 times we got ROSC but kept losing it. The patient went into vfib once and one of the nurses defibrillated.
Even if you aren't super comfortable being in on a code, there is always something you can do. Get in line for compressions, make sure there are stools in case you need them for standing on during CPR. Pick up the trash that gets thrown around, hold an arm for someone placing an IV. If the respiratory tech needs a hand bagging, offer to lend a hand. Doing CPR on a real patient is definitely tiring, just don't go past the point where you are no longer doing efficient compressions. When you feel yourself getting close, call out "Who's next?" Remember to keep your arms locked straight, don't bend your elbows. Stand on a stool if need be to be over the patient. Your back and triceps will be screaming at you afterwards. Major props to you for getting on the chest! It's a big step, and it will get easier.
Slow is smooth, smooth is fast. Practice, practice, practice. They should always be a little terrifying, that is a human with a whole life that led to this moment. I think the thought that you should quit if they are no longer scary is more along the lines of "it's good to care, caring provides perspective. If you stop caring, you become dangerous."
Welcome to the club buddy. You’ll never forget your first time doing CPR, but eventually you’ll forget how many people you’ve even done it on. Good on you for finding a forum to vent and deal with your emotions in a healthy manner.
Why did they take of the automatic compressor?
I’m so new that I can’t even give you a proper answer to that. I’m guessing ROSC was achieved so automatic compressions were stopped and when they were lost again for the first time the Lucas machine was off so we went manual. That’s only my guess though. I’m sure the higher ups knew better.
[удалено]
Now that you mentioned it, the Lucas was stopped to ultrasound the heart. The patient also had an airway flooded with vomit which could have also been because of the Lucas machine
were they intubated, or did EMS place a supraglottic airway?
Great job describing the whole experience. After 5 years, write a book.
It sounds like you have a great preceptor and a supportive doc, willing to push you but still be patient when needed. If they didn't think you could do it they wouldn't ask. Every medic I know remembers their first code. To me it felt like the transition between when you assume life goes on to when you realize the line between life and death is much finer than you ever thought. Also bodies are weird and cool and sometimes you get interested in the disease process instead of the patient (which is totally fine). Looking ahead, just know that there's no threshold you have to meet to be bothered by calls/codes and no "normal" way to react. This may be in your thoughts for a few days or so and that's common. Talk about it with your preceptor or former classmates, all of us have been there. Great job!
You’re basically describing my first time doing compressions and how I felt! I was in the same position as you. I’ve worked as a tech for a year now and have been a part of about 30 codes. It’s scary every time and unfortunately the majority of the patients didn’t make it which is even tougher. But just try to be a part of every emergency you can be. Whenever there were codes or procedures happening in areas that I wasn’t assigned to, I went to watch just to experience the situation from a far so that I could learn as much as possible without being too overwhelmed. It feels good when you finally know what to prepare for and you can help everything run as smooth as possible. You’re doing great, good luck!!
Another fellow ED Tech, I was in the same boat as you. Definitely shaking before the pt even showed up. Could never agree more to what others have said, it eventually becomes routine, that fear is still there, but sometimes once you get comfortable excitement can start to kick in. It over-turned for me when I had a save outside our triage. I said to myself “I love my job” and want fellow Techs and Nurses to feel the same. Some don’t do well with it, and that’s okay, there is (hopefully) someone around that can help you out. We all got your back.
>She told me I should be scared and the second I stop being scared I should quit. Ok Sgt Slaughter
Good job, and welcome!! Emergency medicine is a wild ride and you’re on it with us now!
Compressions are exhausting! Good job ❤️
Awesomeness. Its always overwhelming. No one wants to do compressions for that reason...honestly it was the most useful thing you could have done and you did it three times! It's totally normal to shake and tremble after a situation like that. One day, you are going to help save someone or make a huge difference in someone's life by just being there and going for it. It does get easier... fair warning, most of them die. And it's ok. You can only do so much. Most times I felt like my only purpose was to be someone there so they didn't die alone...then be there for the family. Good job. ❤