Ran a code first call of my career

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Wadertater

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hey guys. As I sit here at 2am during my ER clinical in a level IV trauma with a city population of 2000, you can imagine I’ve got several hours to talk and discuss and think. So I ran a code first call of my career at another clinical site. We were toned out for chest pain. We get there to find another responder doing CPR. We got ROSC, and she was flew to a level II trauma. Anyways, for the remainder of the calls during that shift, each time the tone would go off, my stomach would drop and I would just get super nervous, anxious, and sick feeling. How do you guys get over that feeling of suspense while you’re waiting for the tone stop and dispatch to
Come on? Do you still get nervous en route?
 
I took a break from being an EMT and recently came back on. For the first couple weeks or so I would feel the same way I felt when I was new to the job, either being excited or breaking into a cold sweat when the pager goes off. It's been a little under half a year since coming back to the job and I feel nothing now.

My first thought is to say, just keep doing what you need to do, you'll acclimate.

What do you think causes your feeling sick/nervous?
 
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Probably because when I ran the code, we weren’t called for a code. We were called for chest pain. We get there and she is in cardiac arrest. I think I get nervous because I am afraid when I get to a call, even though something common, like chest pain, it will be something far more worse.
 
You will often see what you find on-scene will be different than what you were called for. Treat the patient in front of you, not what you were called for.

It's normal to be nervous in the beginning. It will keep you, your partners and your patients safe. Just remember to breathe.
 
Wadertater, patient care is an unnatural act. It makes sense to me that a 17-year-old would need time to adjust. When I was 17, I was flipping hamburgers and playing hockey -- hardly the kind of contributions you're trying to make.

Being nervous isn't unusual, but if you find you start dreading calls, maybe EMS isn't for you. It's too soon to tell. Don't make life-altering decisions after one call. See if maybe some of that nervousness becomes excitement or anticipation. Also remember that doing your job hardly ever means saving a life. Nobody expects that from you day to day.
 
It’s not that I dread calls. I just finished my ER clinical, and once I saw what the situation was, I calmed down. Maybe it’s just that I’m anxious and dread code calls. I just had a stroke pt come into our level IV trauma 2 hours before i left. Those kinds of things didn’t bother me. Maybe it’s just that a code is life or death in your hands. I do feel that once I get more calls and codes under my belt, I won’t be as nervous.
 
Wadertater said:
It’s not that I dread calls. I just finished my ER clinical, and once I saw what the situation was, I calmed down. Maybe it’s just that I’m anxious and dread code calls. I just had a stroke pt come into our level IV trauma 2 hours before i left. Those kinds of things didn’t bother me. Maybe it’s just that a code is life or death in your hands. I do feel that once I get more calls and codes under my belt, I won’t be as nervous.
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At some calls there's a lot going on, most of which you won't control. You're fixated on cardiac arrests now, so maybe start by thinking of one thing you can contribute that's important at those scenes -- chest compressions, for example. Be the best chest compressor you can be. As that becomes more routine, you'll notice other ways you can help. Gradually, you'll learn to take it all in; to stay ahead of the call mentally. That should help with the nervousness.
 
Time and experience will be your friend. Use what you are dispatched for as a opportunity to review in your head the treatment for that condition, and then be prepared for it to be something totally different. The saying look like a duck, calm on the surface but paddling furiously underneath applies. If you try to look calm you will eventually get on scene and be calm. I've been doing this job 15 years now and I still remember when I would get on scene and be looking nervous, now no matter what's going on on the scene I can look and act calm, no matter what is going on. 90% of this job is patient and bystander interaction, once you master being calm on scene, the rest will be easy. What you're going to strive for is getting on scene and no matter how bad it is, or how much activity is going on, people look at you and it looks like you're just standing there watching a sunset or other such calming activities. Being that you're seventeen it will take you some time, half of what we do with interacting with people is simply learned from doing it over and over.
 
Part if it is just getting used to that stimulous (tones). Often times they are loud and abrupt. That and just getting experience of working critical calls and learning to focus your attention on scene.

Honestly, it isn't a feeling of suspense anymore. I hang out with my partner, read, and just do things I want to do while I'm not on a call. Tones don't get the same reaction simply because I've heard them thousands of times. It's all just a matter of repition. It also doesn't help I don't have those God awful fire station tones that give you tinitis, I'd probably **** my pants if I went back to those.

As far as nervous on the way, not really. If I knew I was going to a bad peds call, probably. But the 99% of what our day to day is are all relatively straight forward situations. Much of what I do is simply respiratory, minor falls, drunks, overdoses, psychiatric issues, etc. Just a little common sense and being a decent person to your patient will get you through those.

That being said, that call is an excellent example of why you let the notes be a guide, not an absolute. You will walk into situations like that and be completely caught off guard by what you find (hopefully still prepared) and others will sound serious and they turn out to be a whole lot of nothing. Chest pain is one to always expect the possibility of a rapid change. I've been in that same situation as have most here probably.

Give it time. You will get to where being dispatched to an arrest doesn't even get you nervous. Learn from past calls and partners, get familiar with how to do the job, always learn more, and you will settle into a groove.
 
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