Cardiac critical care nurse: Stay calm.

The more critical a situation is, the slower and more deliberately I move because mistakes waste time. We have a saying “slow is smooth and smooth is fast.” Validate and verify everything.

Validate monitoring: Is that heart rate or blood pressure really that high or low? Don’t just believe the computer monitor, grab a stethoscope and listen to the chest, grab a manual BP and double check. Does the appearance of the patient correlate with what the numbers say? (ie: does the human being look as sick as those numbers imply?)

Verify interventions: I think to myself “clamp that line, unclamp this line, attach that device, open this lid, engage the safety on this needle” with every action. Repeat out loud to colleagues in the room what you’re going to do, then after you’ve done it, say out loud again what you just did. Especially if you do something out of the ordinary or unexpected.

Like yesterday, we had a patient who suddenly had symptoms of a myocardial infarction (“heart attack”), had some concerning findings on EKG, so we were trying to draw blood labs urgently and having such a hard time that one of the doctors even had a needle trying to help us. I was leaving the room to get more supplies and I took a bunch of trash with me, so I took the 3 seconds to count what I was holding and said out loud, “There are no sharps in the bed, you guys, I have them all,” because we were just laying discarded needles (with safeties engaged) on top of the bed blanket.

Two minutes is an eternity when life is on the line. Slow down, don’t hurry, do things on purpose, double check what you’re doing. That’s a lesson applicable to a surprising number of life situations