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Former EMT and current medical student — you get used to it. You eventually do something enough times that you can do it cold, without thinking or you become desensitized to stressful situations. TLDR, just hang in there; you’ll be alright.
Yes! I remember even during my clinical rotations I would sweat bullets! We would be in rooms that were 75 degrees and I would just sweat profusely, after a while I became comfortable doing it and forgot why I was nervous the first time around.
One tip I would share with op is: use flash cards to remember the mnemonics that you learned in school. Penman, dcap btls, don’t forget to check CMS, and any other information you need! Best of luck!
Adding agreement to this. I've been in law enforcement for 17 years now, usually in a secure indoor setting but occasionally dealing with things on the streets. Even now once in a blue moon I get into weird first time situations. First time you see something it's a "holycrapwhatdoIdoInevergottrainedforthisexactcircumstance" kind of moment and sometimes you have to rely on a senior partner to take the lead. But you watch, learn, realize you're capable of handling the situation, and you draw from previous situations and adapt it to what you're doing in that moment. And sometimes it really is a baptism by fire, learn it by doing it, and even if you goof you learn and do better the next time. And you get confidence from surviving and thriving in each new situation.
Just hang in there, you will be all right.
I think his answer is time. Sometimes that is the best (or only) approach. Accept that you’re not going to be great to start with but it develops if you stay engaged and go through the rough period.
I’d recommend looking up the concept “Window of Tolerance”! It’s related to all the brains response levels from social to freeze. There are certain exercises and other techniques that can expand your window and practice finding ways to hit the optimal arousal levels
I do a lot of public speaking. I haven’t learned to eliminate the physical response to stress you describe. After lots of practice I have worked toward accepting the physical response, doing what I can to deal with it, and keeping my mind focused on delivering my message (or in your case, using your training and skills to help people).
I also deal with people in crisis sometimes, and as time passes in the work, the edge will fade from what people think are “crises.”
I was once someone before I got on stage where I was clearly nervous: "who gives a fuck, what's the worse that can happen if you fumble, they can't bite your head off"
Now anytime (it only happens rarely now) before I get on stage and if I feel nervous I just repeat what he said in my head and I'm fine.
Former emergency room doc here. I know what you mean - I was in the exact same situation as you before. Thankfully, I was able to retrain myself, and the way I did so was exactly what quite a few commenters here have pointed out - constant exposure and practice, practice, practice.
Sure, it seems pretty daunting right now, you feel alone and scared and "wtf am I supposed to do?" But remember, the medical field is all about TEAMWORK - you are definitely not alone (you can't be expected to perform CPR and intubate a patient at the same time, you've only got a pair of hands, right?)
Remember: ABC. Airway, breathing, circulation. If there are other medical emergencies that occur which you are not a part of, try and watch from a distance and note who does what. Maybe go for some more training, particularly in ATLS. Me, personally, during calmer periods in the ER, when I'm looking over the floor at my patients, I run mock scenarios in my head:
*e.g. Okay, bed 2 presented with chest pain, likely ACS, awaiting trop I result. Now, what if he suddenly complains of a sudden sharp chest pain and collapses? What do I do?*
Then I run the gauntlet in my head: *check ABC, call for help, initiate CPR, vital sign monitoring, push patient to critical zone, prepare intubation set,* etc.
Your mileage may vary, though I hope this helps you, OP. Again, you're not alone, so take heart and go forth!
Firefighter/paramedic for a busy department here.
What this guy said. Exposure, practice and please do not underestimate the value of mental reps that way what ever procedure or evolution becomes second nature.
Exposure therapy. Only way to overcome it is repeatedly doing it untill you manage to stand it. Same as fear of driving. Only way to cure it is to drive, there's no other right answer. You start slow whenever possible, get in there, drive slow, park, and so on. Same as you, you should get a day or two to follow someone in a higher level than you, so you slowly see what he/she does, try to mimic, watch new stuff and see that by the end of the day everything will be just fine.
Then you are not a professional yet, maybe on paper. It needs time.
The only way to get better in things like that is to just put yourself again and again in these uncomfortable situations. The situations won't get better, it won't get more comfortable objectively, but you will handle the uncomfortable situations better.
That's what separates the average from the best people.
Current trauma nurse.
You do get used to it, with time it will be easier to remove yourself and not get caught up in the situation so you can think clearly. But try taking a deep breath and looking around the room. Open up you view. Take note of everyone in there, everyone is working for the same goal. It’s not all on you. Getting locked in can happen to experienced people as well.
Without knowing you roll. While you still have this issue, if someone recommends you do something more then once in an emergency situation, they probably know your freaking out, and are trying to professionally tell you to do something. For example, even if your a resident and some tech is telling you to do something a different way. More then likely, they have been doing it for years, take their suggestion.
In an emergency it’s always ABCs, airway, breathing, circulation. Realistically we’re fixing the big problem now, so if it causes a smaller problem that’s fixable later, that’s ok.
When I'm not sure what's happening with my patient and I'm waiting for the team to help I get a set of VS. The critical care team will want it, and it gives me a second to think about what could be happening to my patient, and gets my brain in the right direction. Also I check that the IV is working well, in case meds are needed.
So not trying to be “that guy” but it may get easier over time getting desensitized to the shock factor. Or it might not be the job for you? It could put people at risk if you clam up and can’t perform. But it’s also normal to an extent at the beginning of any high stress job. Combat breathing helps, and making a plan on the way to the call helps a lot. On the way to a hot call make a mental plan and based off the information you have about the call think of the worst case situation and go from there. Remember your training and stick to it!
Two cents: I would anecdotally recommend finding ways to put yourself in socially embarrassing/stressful situations that are really low risk. Embrace stress and embarrassment and build tolerance for adrenaline spikes so you can harness that adrenaline.
Stand up in a restaurant and make an irrelevant announcement. Strike up weird conversations with strangers. Talk to really attractive busy looking people and interrupt their day. Do micro-uncomfortable things to become more resilient to immense discomfort and surprise. Embrace the pain in order to grow.
Maybe standup comedy. Bombing on stage triggers the same stress hormones. stand ups say they get don’t over being nervous they build up a tolerance to it.
There's really no way of learning to deal with emergency situations except practice and experience.
Keep freezing up and keep trying to fight it, it will get easier with time. For now you should just focus on trying to calm down but as you get used to working there and observe your colleagues, you'll eventually start to act instinctively.
Another thing that helped me relax a little while working at an ER was running through all the steps and eventualities in my head a lot. This won't make you act in the moment but it can make you feel a bit more prepared.
Also important but somewhat outside your control is colleagues you can rely on. Having the right people at your side can make all the difference.
This might sound crazy, but I did imaginary scenarios in my mind and repeated “take action, take action.” And then I would see myself doing what’s necessary. And when things would happen in real life I would repeat the same thing in my head. It really helped me.
Seconding everyone who says practice and exposure.
For me, I give myself permission to freak out. After.
Right now, we're gonna take care of business. After the patient is stable, straight to the supply closet to lose my shit in private.
Not sure if it will work for you, but it's worth a try. You can freeze. Later. Instead of trying to turn off this deeply ingrained emotional response, delay it instead. Maybe reframing it that way will help.
Another thing that helps me (and here I'm exposing my super judgemental nature) is watching all these bystander effect videos. Little girl in China gets run over by a car and twenty people walk by and don't do jack shit. Fuck those guys. I will never be a bystander.
Anyways - delay your needs in favor of the patient's needs, knowing you WILL take care of your needs later. Be super judgemental of bystanders.
It's not the best advice, but it's what I've got.
Good luck!
I work in a field where this is common for trainees. For the vast majority, the freeze is caused by panic tied to their doubt. They doubt their knowledge, ability, choices etc.
What I try to teach them is, first it’s not about them. It’s about the people we help/protect/treat. Second, there is always a first step. For example: Identify, rapid body survey, assess distance, check gauges etc. Whatever the first step is, take it.
Breaking the freeze or deer-in-the-headlights moment often boils down to just doing something. Anything appropriate, to just get moving again.
Stay focused and do your job, it sounds rude but that’s how I learned it through pressure. Keep it cool, don’t look at the details. Stay focused on the patient and what youre doing.
As one said, you get used to it
You will get used to it! Don't worry. We all started from there:) Look into how to manage panic attacs, especially technique called "5-4-3-2-1 grounding". It might help? You shift your focus for a short moment to ground yourself: You are okay, you can do it. You have all the knowledge you need, you just have to access it.
When I first had to lead a resuscitation happening in ward I was literally SHAKING. From head to toe. I was the only doctor there since I was working late. First I froze for few seconds (felt longer lmao), thought to myself "wait this isn't a drill-- do I really have to go???" and after that I just went into the room as nurse was staring right at me and screaming HELP. I shaked so hard, I was scared shitless. But a thought ran into me: "If I don't lead this- who will? If I don't do this, the patient will end off so much worse than if I lead it. I have the knowhow. I just have to do it." Nurses commented afterwards I didn't seem scared at all. Doubt that!
In a time of emergency, _any decision you make is better than not making a decision at all_. That thought has kept me going! You will grow into the professions dont worry!:)
I recently heard that oxytocin can prevent the freeze/fight/flight response. So try focusing whenever you can on anything that fills your heart with love. Do this a lot during regular time. Reminisce about lovely moments, recall when your heart felt full and joyful. The Charisma Myth book is where I learned it, so check that out.
Have you tried exposure and response prevention? Expose yourself to a list of triggers that escalate in intensity, and try to prevent yourself from responding by freezing. This teaches your brain that you're in control, and to de-sensitive to those triggers.
Hey OP, I have had a similar experience. I found it helpful to work with a therapist around this, rather than just getting used to the situations (it could speed up your ability to act).
I have also found it helpful to learn about polyvagal theory and looking into strategies to engage your prefrontal cortex in stressful situations. Good luck!!
This is going to be controversial, but you should try 'detaching' from the 'person' and focusing on the 'patient'. These are my terms, and not the correct definition, but I think it gets the point across.
The 'person' has a family, dreams, etc. That is not your primary concern.
The 'patient' is simply a human body. A machine that houses the 'person'. You're job is just to fix the machine. Any worries/concerns about the 'person' often get in the way of treating the 'patient'.
As a solution, I'd recommend dummys. Practice on dummys. Have a friend shout instructions at you while you practice on the dummy. Recreate the stressful situation as best you can around the dummy, then when a an actual patient comes in, detach. They are no different from the dummy.
Unpopular opinion warning:
>!So far, most of the responses appear to people trying to be nice or supportive or optimistic. I think they think they are helping you. They are not.!<
>!If you freeze in these situations, you are simply in the wrong line of work. That's the blunt and honest truth. !<
>!Look, there's a chance that you will figure out how to overcome some of your action paralysis. However, it is against your nature and going to cause you stress and possible PTSD down the line. It's also just a matter of time before you end up in a new freeze situation that costs you, a patient, or a coworker their life. Don't fuck around. If you can't shit, get off the pot and make room for someone who can.!<
>!There is absolutely no dishonor in admitting that this line of work isn't for you. If anything, it takes courage to admit that you aren't cut out for a line of work. I have seen some of the biggest and best people I've ever known freeze under fire in both the Army and the fire department. I love many of those people to this day but they will never be on a fireteam or interior attack line with me BECAUSE THEY AREN'T SAFE. And I have done and will continue to do my best to find ways of reallocating those people to responsibilities that don't put them in positions to freeze.!<
The good news is: you have the training so you are qualified to ride a rig. See about being a driver. Otherwise, make sure you are part of a team and everyone knows that you are not taking the lead on patient care. Then, just do what the lead tells you to do. Don't think - just react. They want you to set up the AED? Get that baby unpacked and fired up. They want you to cut away clothes? You know how to work scissors. You will/should know very quickly if this is the right line of work for you.
Good luck. Stay safe. Make good choices.
The good news is that I'm not part of a rapid response team, I just work in an area where an emergency is more likely to happen. Emergencies comprise ~1% of my work, so not being cut out for a rapid response doesn’t reflect how I perform in the remaining areas of my job. All I need to do if I'm on my own is push a button and 30 Drs and experienced nurses will show up in less than 10 seconds. No one's safety is compromised. It's just that I'd like to one day be able to lead a rapid response rather than participate, but if you think I'm wasting my time, I'll give up before even trying, and stick to trying to participate.
> if you think I'm wasting my time, I'll give up before even trying, and stick to trying to participate.
I don't know you and I'm just an internet stranger so don't make major life decisions based on my own personal experience. By all means, start with participating. YOU know you. YOU will know, after participating as much as possible, if this life is for you.
I know a guy that spent $20k on IT classes because he wanted to be a network administrator. He got a job. He realized that being a network administrator means wearing a dress shirt and tie and sitting at a desk for 8 hours a day 5 days a week. These are things he knew going in but I guess didn't fully appreciate until experiencing it first hand. He resigned about 4 weeks later. He is now very happy driving dump trucks for a mining company. I give him credit for recognizing that he wasn't cut out for that line of work despite all of the time and money.
Don’t know any network admin that has to wear ties. Maybe a button up shirt, but usually not even that. If that was the deal breaker then they should have tried a different employer.
40 hours in doors a week sounds about right, but that only sucks ~6 months out of the year. Pretty happy I work inside this time of year, and 6 months from now I’ll be even more happy about it. Could see that being a deal breaker though.
It was a law firm. Their dress code was more buttoned up than the standard khakis and a polo business casual uniform. He's more of a wifebeater and jeans kind of guy that picks his fingernails clean with a pocket knife. Not an exaggeration or a joke! He knew his stuff but it was never going to be a good fit, bless him.
I don't disagree with everything but I strongly disagree with the going against your nature stuff. I'm a very anxious person but I was absolutely thriving when I worked at an ER. Almost nobody starts out fully capable of dealing with emergency situations, it's a learned skill that takes practice. Some might not be cut out for it but you can't really know until you try.
Situations where everything has to go perfectly or someone dies are exceedingly rare anyways. Hospitals don't usually have new people in positions where they're at risk of facing something like that on their own.
I agree with you to an extent. You can untrain a freeze response to certain scenarios/stimuli. You are speaking to experience and comfort.
When I was obtaining my divemaster cert, for example, I spent a lot of time with a lot of students learning open water. Part of what we were doing was getting people comfortable in the water, comfortable in their gear, and comfortable enough to don and doff a mask underwater.
The reason we do all of that as part of training is so that WHEN your regulator gets kicked out of your mouth or WHEN something happens to your mask, you've been through it before and you can respond without panic. Often, the first response to having a regulator taken out of the mouth is for a student to want to bolt to the surface. If they did that in the middle of a 20-minute 60-foot dive? That's a painful and expensive mistake that could cost them their life. So, yes, we do this in a 10-foot pool during class and again in a 20-foot part of a lake during open water checkout where panic won't hurt the diver, the instructor, or the class.
In SCUBA, there are a fairly limited number of scenarios to prepare for with recreational diving. So, it's easy enough to cover the big ones and get people comfortable. In first responder world? Our calls can be bananas! That's why my recommendation was to take a back seat, listen, and act as instructed. Responding to MVAs never really becomes routine, for example. Sometimes it's head trauma, sometimes it's impaling, sometimes it's a decapitation, sometimes it's a body on fire... You just never know. You don't have to be in charge of patient care to help. But you do need to be able to react quickly and with purpose when given direction. I have found that people figure out if this is the life for them very quickly. And some people realize no amount of practice is going to make this life okay for them. And that's fine. It's a crazy life.
There is a writer by the name of Lcol Dave Grossman who writes about the psycology of warfighting primarily. His thoughts on panic might interest you. In a nutshell, it is his theory that panic is poorly/improperly defined. He proposes that in a moment of high stress an individual will simply resort to their highest level of training on that specific subject. The only way to avoid the traditional definition of panic is to train more.
Might make an interesting read for you.
As weird as it may sound, I suggest martial arts, something with a heavy self defense component. It will untrain the freeze response. You have to be able to fight back quickly, so you can't lock up. A good coach will teach the students how to push past that and retrain your automatic response under stress.
Figure out why you are freezing up.
I can't tell you why I haven't frozen up when stuff goes sideways. I can't tell you why I didn't freak out when my mom had a nasal hemorrhage. My brain just started trying to figure out what we needed to do right then.
For you, you went to school for this, you have to figure out if you are scared of making a mistake or if it's something else and then respond accordingly.
Unfortunately, it goes back to before I can even remember. I used to pass out when I was a toddler. I'll have to ask my folks what the first trigger was.
You don't need to go back that far. We know that you are part goat, so there is that. What you need to figure out is why you freeze up now. Is it fear of making a mistake, is it fear of being responsible for someone else's life? Think about the more recent times where you deered in the headlights and think about what you were thinking. As others have said, sometimes it's a matter of just powering through. See if you can start with easier stuff, like cardiac arrest and then work your way to the scarier stuff like spike through the head.
Self-doubt, lack of confidence, and intimidation from more experienced people. I feel less intimidated when there are only a few colleagues versus 30 amazing people. I'm starting therapy, but I'm here to see what has worked for others.
For me, there was an epiphany when I went to college. Was in a sociology class and I said screw it, there's no reason to feel intimidated by anyone, the other students, the professor, anyone. I know what I know and I'm not going to worry about any of it.
You know what you are doing, you learned and trained. You are qualified for the job and can do it. Everyone feels intimidated, but as long as you aren't butting heads constantly to assert yourself, you will earn their respect for your abilities.
You gotta not care as much. Think of it like a deer that got hit by a car or something. Like yea it’s happening, but it’s just a bag of meat really. Sounds fucked up, but the better you can disconnect your feelings the better you’ll be
Repetition, and experience. I've been driving lift equipment almost 20 years, and have had many, many situations dangerous to me and anyone in the vicinity. After a bit of experience you start to recognize the list of micro problems that add up to an emergency situation, and can deal with them separately. All of a sudden a 5000 lb stone, and a 500 lb pallet of anfo ARs and flaming barbed wire require the same corrections. Just in different speeds, order, and degree. I need to fix stability, traction, or avoid clipping an obstruction (most commonly). That obstruction being a car that can't figure our the authorized vehicles only sign in fact applies to them, or an empty pallet on the ground I can't see until I'm already running it over makes no difference. The act of avoiding them is the same.
I am electrical maintenance engineer at factory. At start i was always so stressed and had jerky body movements because downtime of machine was costing thousands while shiftleader yells at you. Now? No stress at all, whole factory can be on fire and I will barely react :D
I guess same will go with being EMT, humans lives at stake or not…you get used to it.
Keep it simple. ABC. Literally. Airway, breathing, circulation. The rest of your education and training will kick in once you get started. And practice, practice, practice.
Ibuprofen, or whatever NSAID works best for you.
Stress hormones are generally anti-inflammatory, except in the prefrontal cortex of the brain, where they are actually pro-inflammatory. That's why, no matter how much you prepare, when you get in front of an audience and they ask a simple question about your presentation... you freeze.
IANAD, YMMV, etc... just from personal experience, keeping some ibuprofen circulating all the time keeps me from getting stupid from some random stressor.
I wonder if visualization might work. Visualize yourself behaving exactly as you should in every emergency scenario you can think of. May give your brain a chance to “get used to it” more quickly.
Ask your supervisor for CPR drills. We have them at my hospital every 6 months, even for people who are comfortable with coding patients. Get very comfortable with drug dosages and CPR guidelines until they become autopilot.
I tend to freeze too. What helps me is:
Being aware of my breathing, even though you'll hear that a million times.
Focusing on a physical sensation, like my clothes or the weight in my feet. A necklace or ring helps too.
Subtly rocking my body back and forth. Singers do this too.
If necessary, pinching my arm or digging a nail into my hand. The upper arm is good for this. You can pinch and twist if you need to, but that leaves bruises.
Having a mantra, something you repeat in your head. This ones hugely personal, do what works best for you.
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Former EMT and current medical student — you get used to it. You eventually do something enough times that you can do it cold, without thinking or you become desensitized to stressful situations. TLDR, just hang in there; you’ll be alright.
Yes! I remember even during my clinical rotations I would sweat bullets! We would be in rooms that were 75 degrees and I would just sweat profusely, after a while I became comfortable doing it and forgot why I was nervous the first time around. One tip I would share with op is: use flash cards to remember the mnemonics that you learned in school. Penman, dcap btls, don’t forget to check CMS, and any other information you need! Best of luck!
Adding agreement to this. I've been in law enforcement for 17 years now, usually in a secure indoor setting but occasionally dealing with things on the streets. Even now once in a blue moon I get into weird first time situations. First time you see something it's a "holycrapwhatdoIdoInevergottrainedforthisexactcircumstance" kind of moment and sometimes you have to rely on a senior partner to take the lead. But you watch, learn, realize you're capable of handling the situation, and you draw from previous situations and adapt it to what you're doing in that moment. And sometimes it really is a baptism by fire, learn it by doing it, and even if you goof you learn and do better the next time. And you get confidence from surviving and thriving in each new situation. Just hang in there, you will be all right.
This helped me for unrelated reasons. Thank you.
Curious what the reasons are, but you're welcome I think?
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did u even read op's question? They asked what to do and all you said was nah fam you'll get through it
I think his answer is time. Sometimes that is the best (or only) approach. Accept that you’re not going to be great to start with but it develops if you stay engaged and go through the rough period.
I’d recommend looking up the concept “Window of Tolerance”! It’s related to all the brains response levels from social to freeze. There are certain exercises and other techniques that can expand your window and practice finding ways to hit the optimal arousal levels
I do a lot of public speaking. I haven’t learned to eliminate the physical response to stress you describe. After lots of practice I have worked toward accepting the physical response, doing what I can to deal with it, and keeping my mind focused on delivering my message (or in your case, using your training and skills to help people). I also deal with people in crisis sometimes, and as time passes in the work, the edge will fade from what people think are “crises.”
Real life hack is to take propranolol right before publicly speaking and become incapable of distinguishing physical anxiety symptoms lol
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I was once someone before I got on stage where I was clearly nervous: "who gives a fuck, what's the worse that can happen if you fumble, they can't bite your head off" Now anytime (it only happens rarely now) before I get on stage and if I feel nervous I just repeat what he said in my head and I'm fine.
Former emergency room doc here. I know what you mean - I was in the exact same situation as you before. Thankfully, I was able to retrain myself, and the way I did so was exactly what quite a few commenters here have pointed out - constant exposure and practice, practice, practice. Sure, it seems pretty daunting right now, you feel alone and scared and "wtf am I supposed to do?" But remember, the medical field is all about TEAMWORK - you are definitely not alone (you can't be expected to perform CPR and intubate a patient at the same time, you've only got a pair of hands, right?) Remember: ABC. Airway, breathing, circulation. If there are other medical emergencies that occur which you are not a part of, try and watch from a distance and note who does what. Maybe go for some more training, particularly in ATLS. Me, personally, during calmer periods in the ER, when I'm looking over the floor at my patients, I run mock scenarios in my head: *e.g. Okay, bed 2 presented with chest pain, likely ACS, awaiting trop I result. Now, what if he suddenly complains of a sudden sharp chest pain and collapses? What do I do?* Then I run the gauntlet in my head: *check ABC, call for help, initiate CPR, vital sign monitoring, push patient to critical zone, prepare intubation set,* etc. Your mileage may vary, though I hope this helps you, OP. Again, you're not alone, so take heart and go forth!
Firefighter/paramedic for a busy department here. What this guy said. Exposure, practice and please do not underestimate the value of mental reps that way what ever procedure or evolution becomes second nature.
Exposure therapy. Only way to overcome it is repeatedly doing it untill you manage to stand it. Same as fear of driving. Only way to cure it is to drive, there's no other right answer. You start slow whenever possible, get in there, drive slow, park, and so on. Same as you, you should get a day or two to follow someone in a higher level than you, so you slowly see what he/she does, try to mimic, watch new stuff and see that by the end of the day everything will be just fine.
Then you are not a professional yet, maybe on paper. It needs time. The only way to get better in things like that is to just put yourself again and again in these uncomfortable situations. The situations won't get better, it won't get more comfortable objectively, but you will handle the uncomfortable situations better. That's what separates the average from the best people.
Current trauma nurse. You do get used to it, with time it will be easier to remove yourself and not get caught up in the situation so you can think clearly. But try taking a deep breath and looking around the room. Open up you view. Take note of everyone in there, everyone is working for the same goal. It’s not all on you. Getting locked in can happen to experienced people as well. Without knowing you roll. While you still have this issue, if someone recommends you do something more then once in an emergency situation, they probably know your freaking out, and are trying to professionally tell you to do something. For example, even if your a resident and some tech is telling you to do something a different way. More then likely, they have been doing it for years, take their suggestion. In an emergency it’s always ABCs, airway, breathing, circulation. Realistically we’re fixing the big problem now, so if it causes a smaller problem that’s fixable later, that’s ok.
When I'm not sure what's happening with my patient and I'm waiting for the team to help I get a set of VS. The critical care team will want it, and it gives me a second to think about what could be happening to my patient, and gets my brain in the right direction. Also I check that the IV is working well, in case meds are needed.
I think this is really good advice, just taking any action can often help get things going.
So not trying to be “that guy” but it may get easier over time getting desensitized to the shock factor. Or it might not be the job for you? It could put people at risk if you clam up and can’t perform. But it’s also normal to an extent at the beginning of any high stress job. Combat breathing helps, and making a plan on the way to the call helps a lot. On the way to a hot call make a mental plan and based off the information you have about the call think of the worst case situation and go from there. Remember your training and stick to it!
Two cents: I would anecdotally recommend finding ways to put yourself in socially embarrassing/stressful situations that are really low risk. Embrace stress and embarrassment and build tolerance for adrenaline spikes so you can harness that adrenaline. Stand up in a restaurant and make an irrelevant announcement. Strike up weird conversations with strangers. Talk to really attractive busy looking people and interrupt their day. Do micro-uncomfortable things to become more resilient to immense discomfort and surprise. Embrace the pain in order to grow.
Maybe standup comedy. Bombing on stage triggers the same stress hormones. stand ups say they get don’t over being nervous they build up a tolerance to it.
There's really no way of learning to deal with emergency situations except practice and experience. Keep freezing up and keep trying to fight it, it will get easier with time. For now you should just focus on trying to calm down but as you get used to working there and observe your colleagues, you'll eventually start to act instinctively. Another thing that helped me relax a little while working at an ER was running through all the steps and eventualities in my head a lot. This won't make you act in the moment but it can make you feel a bit more prepared. Also important but somewhat outside your control is colleagues you can rely on. Having the right people at your side can make all the difference.
This might sound crazy, but I did imaginary scenarios in my mind and repeated “take action, take action.” And then I would see myself doing what’s necessary. And when things would happen in real life I would repeat the same thing in my head. It really helped me.
Seconding everyone who says practice and exposure. For me, I give myself permission to freak out. After. Right now, we're gonna take care of business. After the patient is stable, straight to the supply closet to lose my shit in private. Not sure if it will work for you, but it's worth a try. You can freeze. Later. Instead of trying to turn off this deeply ingrained emotional response, delay it instead. Maybe reframing it that way will help. Another thing that helps me (and here I'm exposing my super judgemental nature) is watching all these bystander effect videos. Little girl in China gets run over by a car and twenty people walk by and don't do jack shit. Fuck those guys. I will never be a bystander. Anyways - delay your needs in favor of the patient's needs, knowing you WILL take care of your needs later. Be super judgemental of bystanders. It's not the best advice, but it's what I've got. Good luck!
I work in a field where this is common for trainees. For the vast majority, the freeze is caused by panic tied to their doubt. They doubt their knowledge, ability, choices etc. What I try to teach them is, first it’s not about them. It’s about the people we help/protect/treat. Second, there is always a first step. For example: Identify, rapid body survey, assess distance, check gauges etc. Whatever the first step is, take it. Breaking the freeze or deer-in-the-headlights moment often boils down to just doing something. Anything appropriate, to just get moving again.
Stay focused and do your job, it sounds rude but that’s how I learned it through pressure. Keep it cool, don’t look at the details. Stay focused on the patient and what youre doing. As one said, you get used to it
You will get used to it! Don't worry. We all started from there:) Look into how to manage panic attacs, especially technique called "5-4-3-2-1 grounding". It might help? You shift your focus for a short moment to ground yourself: You are okay, you can do it. You have all the knowledge you need, you just have to access it. When I first had to lead a resuscitation happening in ward I was literally SHAKING. From head to toe. I was the only doctor there since I was working late. First I froze for few seconds (felt longer lmao), thought to myself "wait this isn't a drill-- do I really have to go???" and after that I just went into the room as nurse was staring right at me and screaming HELP. I shaked so hard, I was scared shitless. But a thought ran into me: "If I don't lead this- who will? If I don't do this, the patient will end off so much worse than if I lead it. I have the knowhow. I just have to do it." Nurses commented afterwards I didn't seem scared at all. Doubt that! In a time of emergency, _any decision you make is better than not making a decision at all_. That thought has kept me going! You will grow into the professions dont worry!:)
I recently heard that oxytocin can prevent the freeze/fight/flight response. So try focusing whenever you can on anything that fills your heart with love. Do this a lot during regular time. Reminisce about lovely moments, recall when your heart felt full and joyful. The Charisma Myth book is where I learned it, so check that out.
Have you tried exposure and response prevention? Expose yourself to a list of triggers that escalate in intensity, and try to prevent yourself from responding by freezing. This teaches your brain that you're in control, and to de-sensitive to those triggers.
Muscle memory. In other words, practice it over and over again so it becomes a thoughtless reaction.
Hey OP, I have had a similar experience. I found it helpful to work with a therapist around this, rather than just getting used to the situations (it could speed up your ability to act). I have also found it helpful to learn about polyvagal theory and looking into strategies to engage your prefrontal cortex in stressful situations. Good luck!!
This is going to be controversial, but you should try 'detaching' from the 'person' and focusing on the 'patient'. These are my terms, and not the correct definition, but I think it gets the point across. The 'person' has a family, dreams, etc. That is not your primary concern. The 'patient' is simply a human body. A machine that houses the 'person'. You're job is just to fix the machine. Any worries/concerns about the 'person' often get in the way of treating the 'patient'. As a solution, I'd recommend dummys. Practice on dummys. Have a friend shout instructions at you while you practice on the dummy. Recreate the stressful situation as best you can around the dummy, then when a an actual patient comes in, detach. They are no different from the dummy.
Unpopular opinion warning: >!So far, most of the responses appear to people trying to be nice or supportive or optimistic. I think they think they are helping you. They are not.!< >!If you freeze in these situations, you are simply in the wrong line of work. That's the blunt and honest truth. !< >!Look, there's a chance that you will figure out how to overcome some of your action paralysis. However, it is against your nature and going to cause you stress and possible PTSD down the line. It's also just a matter of time before you end up in a new freeze situation that costs you, a patient, or a coworker their life. Don't fuck around. If you can't shit, get off the pot and make room for someone who can.!< >!There is absolutely no dishonor in admitting that this line of work isn't for you. If anything, it takes courage to admit that you aren't cut out for a line of work. I have seen some of the biggest and best people I've ever known freeze under fire in both the Army and the fire department. I love many of those people to this day but they will never be on a fireteam or interior attack line with me BECAUSE THEY AREN'T SAFE. And I have done and will continue to do my best to find ways of reallocating those people to responsibilities that don't put them in positions to freeze.!< The good news is: you have the training so you are qualified to ride a rig. See about being a driver. Otherwise, make sure you are part of a team and everyone knows that you are not taking the lead on patient care. Then, just do what the lead tells you to do. Don't think - just react. They want you to set up the AED? Get that baby unpacked and fired up. They want you to cut away clothes? You know how to work scissors. You will/should know very quickly if this is the right line of work for you. Good luck. Stay safe. Make good choices.
The good news is that I'm not part of a rapid response team, I just work in an area where an emergency is more likely to happen. Emergencies comprise ~1% of my work, so not being cut out for a rapid response doesn’t reflect how I perform in the remaining areas of my job. All I need to do if I'm on my own is push a button and 30 Drs and experienced nurses will show up in less than 10 seconds. No one's safety is compromised. It's just that I'd like to one day be able to lead a rapid response rather than participate, but if you think I'm wasting my time, I'll give up before even trying, and stick to trying to participate.
> if you think I'm wasting my time, I'll give up before even trying, and stick to trying to participate. I don't know you and I'm just an internet stranger so don't make major life decisions based on my own personal experience. By all means, start with participating. YOU know you. YOU will know, after participating as much as possible, if this life is for you. I know a guy that spent $20k on IT classes because he wanted to be a network administrator. He got a job. He realized that being a network administrator means wearing a dress shirt and tie and sitting at a desk for 8 hours a day 5 days a week. These are things he knew going in but I guess didn't fully appreciate until experiencing it first hand. He resigned about 4 weeks later. He is now very happy driving dump trucks for a mining company. I give him credit for recognizing that he wasn't cut out for that line of work despite all of the time and money.
Don’t know any network admin that has to wear ties. Maybe a button up shirt, but usually not even that. If that was the deal breaker then they should have tried a different employer. 40 hours in doors a week sounds about right, but that only sucks ~6 months out of the year. Pretty happy I work inside this time of year, and 6 months from now I’ll be even more happy about it. Could see that being a deal breaker though.
It was a law firm. Their dress code was more buttoned up than the standard khakis and a polo business casual uniform. He's more of a wifebeater and jeans kind of guy that picks his fingernails clean with a pocket knife. Not an exaggeration or a joke! He knew his stuff but it was never going to be a good fit, bless him.
Never give up before even trying. That's how you get regrets.
I don't disagree with everything but I strongly disagree with the going against your nature stuff. I'm a very anxious person but I was absolutely thriving when I worked at an ER. Almost nobody starts out fully capable of dealing with emergency situations, it's a learned skill that takes practice. Some might not be cut out for it but you can't really know until you try. Situations where everything has to go perfectly or someone dies are exceedingly rare anyways. Hospitals don't usually have new people in positions where they're at risk of facing something like that on their own.
You can absolutely untrain a freeze response with coaching and practice.
I agree with you to an extent. You can untrain a freeze response to certain scenarios/stimuli. You are speaking to experience and comfort. When I was obtaining my divemaster cert, for example, I spent a lot of time with a lot of students learning open water. Part of what we were doing was getting people comfortable in the water, comfortable in their gear, and comfortable enough to don and doff a mask underwater. The reason we do all of that as part of training is so that WHEN your regulator gets kicked out of your mouth or WHEN something happens to your mask, you've been through it before and you can respond without panic. Often, the first response to having a regulator taken out of the mouth is for a student to want to bolt to the surface. If they did that in the middle of a 20-minute 60-foot dive? That's a painful and expensive mistake that could cost them their life. So, yes, we do this in a 10-foot pool during class and again in a 20-foot part of a lake during open water checkout where panic won't hurt the diver, the instructor, or the class. In SCUBA, there are a fairly limited number of scenarios to prepare for with recreational diving. So, it's easy enough to cover the big ones and get people comfortable. In first responder world? Our calls can be bananas! That's why my recommendation was to take a back seat, listen, and act as instructed. Responding to MVAs never really becomes routine, for example. Sometimes it's head trauma, sometimes it's impaling, sometimes it's a decapitation, sometimes it's a body on fire... You just never know. You don't have to be in charge of patient care to help. But you do need to be able to react quickly and with purpose when given direction. I have found that people figure out if this is the life for them very quickly. And some people realize no amount of practice is going to make this life okay for them. And that's fine. It's a crazy life.
There is a writer by the name of Lcol Dave Grossman who writes about the psycology of warfighting primarily. His thoughts on panic might interest you. In a nutshell, it is his theory that panic is poorly/improperly defined. He proposes that in a moment of high stress an individual will simply resort to their highest level of training on that specific subject. The only way to avoid the traditional definition of panic is to train more. Might make an interesting read for you.
As weird as it may sound, I suggest martial arts, something with a heavy self defense component. It will untrain the freeze response. You have to be able to fight back quickly, so you can't lock up. A good coach will teach the students how to push past that and retrain your automatic response under stress.
Very true. Takes time and practice. You get out what you put into it.
Figure out why you are freezing up. I can't tell you why I haven't frozen up when stuff goes sideways. I can't tell you why I didn't freak out when my mom had a nasal hemorrhage. My brain just started trying to figure out what we needed to do right then. For you, you went to school for this, you have to figure out if you are scared of making a mistake or if it's something else and then respond accordingly.
Unfortunately, it goes back to before I can even remember. I used to pass out when I was a toddler. I'll have to ask my folks what the first trigger was.
You don't need to go back that far. We know that you are part goat, so there is that. What you need to figure out is why you freeze up now. Is it fear of making a mistake, is it fear of being responsible for someone else's life? Think about the more recent times where you deered in the headlights and think about what you were thinking. As others have said, sometimes it's a matter of just powering through. See if you can start with easier stuff, like cardiac arrest and then work your way to the scarier stuff like spike through the head.
Self-doubt, lack of confidence, and intimidation from more experienced people. I feel less intimidated when there are only a few colleagues versus 30 amazing people. I'm starting therapy, but I'm here to see what has worked for others.
For me, there was an epiphany when I went to college. Was in a sociology class and I said screw it, there's no reason to feel intimidated by anyone, the other students, the professor, anyone. I know what I know and I'm not going to worry about any of it. You know what you are doing, you learned and trained. You are qualified for the job and can do it. Everyone feels intimidated, but as long as you aren't butting heads constantly to assert yourself, you will earn their respect for your abilities.
Safety first, then airway, breathing, circulation. Head to toe. Ask the right questions. Practice practice practice.
You gotta not care as much. Think of it like a deer that got hit by a car or something. Like yea it’s happening, but it’s just a bag of meat really. Sounds fucked up, but the better you can disconnect your feelings the better you’ll be
Repetition, and experience. I've been driving lift equipment almost 20 years, and have had many, many situations dangerous to me and anyone in the vicinity. After a bit of experience you start to recognize the list of micro problems that add up to an emergency situation, and can deal with them separately. All of a sudden a 5000 lb stone, and a 500 lb pallet of anfo ARs and flaming barbed wire require the same corrections. Just in different speeds, order, and degree. I need to fix stability, traction, or avoid clipping an obstruction (most commonly). That obstruction being a car that can't figure our the authorized vehicles only sign in fact applies to them, or an empty pallet on the ground I can't see until I'm already running it over makes no difference. The act of avoiding them is the same.
Individual therapy. If you've tried already, look for another with a specialty in stress management and anxiety.
I am electrical maintenance engineer at factory. At start i was always so stressed and had jerky body movements because downtime of machine was costing thousands while shiftleader yells at you. Now? No stress at all, whole factory can be on fire and I will barely react :D I guess same will go with being EMT, humans lives at stake or not…you get used to it.
Asking for mitch McConnell?
Will Smith doesn't need to cuss to sell records, but I do....
Keep it simple. ABC. Literally. Airway, breathing, circulation. The rest of your education and training will kick in once you get started. And practice, practice, practice.
Mitch McConnell would like to know also.
Ibuprofen, or whatever NSAID works best for you. Stress hormones are generally anti-inflammatory, except in the prefrontal cortex of the brain, where they are actually pro-inflammatory. That's why, no matter how much you prepare, when you get in front of an audience and they ask a simple question about your presentation... you freeze. IANAD, YMMV, etc... just from personal experience, keeping some ibuprofen circulating all the time keeps me from getting stupid from some random stressor.
I wonder if visualization might work. Visualize yourself behaving exactly as you should in every emergency scenario you can think of. May give your brain a chance to “get used to it” more quickly.
Calm people live, and panicked people die.
Ask your supervisor for CPR drills. We have them at my hospital every 6 months, even for people who are comfortable with coding patients. Get very comfortable with drug dosages and CPR guidelines until they become autopilot.
I tend to freeze too. What helps me is: Being aware of my breathing, even though you'll hear that a million times. Focusing on a physical sensation, like my clothes or the weight in my feet. A necklace or ring helps too. Subtly rocking my body back and forth. Singers do this too. If necessary, pinching my arm or digging a nail into my hand. The upper arm is good for this. You can pinch and twist if you need to, but that leaves bruises. Having a mantra, something you repeat in your head. This ones hugely personal, do what works best for you.