A Critical Incident During Attachment Session at the National Hospital - Case Study Example

Order#:369310: Work based learning Introduction This paper reports a critical incident that happened to me once and made me learn a great deal. In the observations made by Silke and Brandon (2007), a critical incident can be any disturbing episode that results in strong emotional reactions in individuals experiencing the same. Similarly, Eddie (2006) claims that among the most stressful episodes include deaths of people conducting their daily assignments, a close acquaintance committing suicide or casualty related incidents among many others. For the purpose of this report, the author wishes to define a critical incident as any distressful event either physically, emotionally or psychologically. In this regard, the said episode is known to have the potential to interfere with the victim’s ability to function either at the crisis scene or away from it (Nixon, 2008). For easier presentation, the current author has opted to divide the report into sections covering the context, details, thoughts, feelings, concerns and demands of the incident as well as its impact on both my studies and career. Context of the incident This report will describe a critical incident that occurred to me during my attachment session at the national hospital in my final year as a medical student. My supervisor had been very observant of my contact at the facility and once commended that I was most withdrawn from my work. He further commended that for a medical student to fare well in the career, one had to be active in the practical sessions. Explanation for his concerns was that my introverted character was disturbing unlike what is expected of a medical practitioner. Moreover, my faculty needed to get feedback on the performance of all students on attachment from the specific hospital authorities. For this reason, my supervisor had to have something tangible about me for positive profiling. In the views of Honey (2003), details of a profiling exercise must be handled carefully to have the right information about an individual’s true picture. During my attachment at the facility, I was forwarded to the casualty department where many traumatized patients visited to be assisted in managing their stressful experiences. This function is accomplished by a group of staff skilled in critical incident stress management, which is considered a fundamental requirement of the medical field. Critical incident stress management is a process aimed at providing an enabling environment for sufferers to overcome their problems. According to experts, the purpose of critical incident stress management is to rehabilitate victims back to their previous lifestyles at the possible earliest time without exposing them to post-traumatic stress disorders (Silke and Brandon, 2007). Research has proven that individuals directly involved with the management of traumatic incidents risk developing posttraumatic stress disorder more than any other category (Silke and Brandon). This is most common with emergency services personnel where l was working. On the said date, three bodies were carted into the emergency department just a few minutes to the end of my night shift. The badly mangled bodies belonged to the beloved family of the chief surgeon in the hospital I was attached. His wife and two daughters had been hit by a speeding car at the hands of a drunk driver. On seeing the dismembered body remains of his beloved family, Dr. Richards went into uncontrollable frenzy and fainted. I was at the scene to assist my supervisor in putting the chief surgeon to sleep. Details of the incident The ensuing situation presented a dilemma to the meager hospital personnel available at the moment. The ranting and very violent chief surgeon needed attention as much as the three bodies on the hospital trolleys. After addressing the immediate need of sedating the traumatized chief surgeon, attention turned to the three bodies to establish whether any was alive or not. I remembered my basics in emergency preparedness particularly in the area of the essentials required. Sorensen and Hertz (2005) argue that an emergency service provider should have an essential first aid kit and some knowledge in life support skills. One of the three bodies was dead while the remaining two were alive. My supervisor directed that I handle one of the bodies while he busied himself with the other body. It is common knowledge that the immediate care given to an injured person is crucial and can avert irreparable damage until professional help becomes available (Nixon, 2008). It is critical to offer a victim basic first aid to ensure that the situation is stabilized without any risk of further injury before accessing assistance from a trained personnel. I worked with unequalled concentration to ensure that my victim was comfortable and in no danger of developing complications. My supervisor advised me to ensure minimum movements of the victim while at the same time establishing whether there was evidence of a pulse or presence of an open and unobstructed airway (Barrows and Silver, 2006). Difficulty breathing and severe bleeding were all hallmarks of a serious situation as explained by my supervisor. He further explained to me that in the absence of a pulse and normal breathing, I had to act immediately to restore circulation with chest compressions (Silke and Brandon, 2007) and breathing by clearing the blocked airway. Moreover, it was fundamental to stop bleeding from open wounds by applying direct pressure with the aid of sterile dressing. My determination to save the life of my victim energized me to work with such precision and speed I never thought I could marshal. I effectively stopped the bleeding from open wounds by applying heavy bandaging and elevating the wound higher than the heart as directed by my supervisor as both of us worked tirelessly. Study findings show that arterial bleeding is characterized by bright red blood spurting out of an open wound as opposed to venous bleeding. A situation of arterial bleeding is considered life-threatening and addressing should be very professional. Where an assistant medical practitioner is involved, it is always advisable to seek the direction of a qualified physician in arresting arterial bleeding. But somehow I managed to stop the bleeding and gently cleaned the wound using antibiotic ointment and dressed it with clean sterile bandages (Barrows and Silver, 2006). My success in this tasking case is attributed to my sheer determination to succeed and constant consultation with my supervisor throughout the entire exercise. Thoughts, feelings and concerns While still addressing this incident, many emotions were running through me as I worked tirelessly and with utmost concentration. I was particularly concerned with my success in this testing moment to built or break my career. I was particularly aware that my supervisor had noticed and mentioned my lack of interest in my hands-on activities as well as my introvert nature which was contrary to the medical profession. Based on this, I agonized on the prospect of my supervisor commending negatively about my ability. With this in mind, I worked magically to prove my worth. Although I realized contrary to my supervisor’s opinions, I proved myself astute in practical activities. Looking at me as I worked, one could only wonder what had prevented me from displaying such vigour earlier. This was also an unfamiliar situation for me because as an introvert, I had always excelled in theory work as opposed to the exemplified character practically. My realization of the dismal performance I had showed earlier in my practical work could have acted as a motivation at this point in time. Demands Considering the critical incident at hand, I found it very demanding in that it forced me to acknowledge an area where I didn’t know that I had full potential. Firstly, the situation was quite abnormal even though Nixon (2008) argues that normal is different for everyone since it can not be easily quantified. Silke and Brandon (2007) argue traumatic episodes heighten stress levels in individuals spontaneously but take too long to drop after successful treatment. The level attained after treating the victim is never back to the original on before the event. Eddie (2006) says that the intervention process is aimed at lowering the new normal stress levels further closer to the previous ones before the incident. Under normal circumstances, the national hospital usually has enough personnel standby to deal with the normal flow of emergency cases. On this particular night, the incident was very demanding owing to the fact the present staff was under pressure to cope with the high numbers of patients. Additionally, the normal process of summoning extra staff both within and without the hospital premises was forgotten further making the incident more demanding. Apart from the presence of my supervisor, the presence of emergency medicine physicians with training to deal with critical incidences was resoundingly absent. Other than the foregoing observation, my situation demands that other physical infrastructure for handling emergencies follow the basic protocol of the medical field. Handling most emergencies requires the medical practitioner responsible to first check the victim’s blood pressure and oxygen supply to determine the actual cause of the emergency (Silke and Brandon, 2007). In the case of the traumatized chief surgeon, the incident demanded that the right intervention processes be adhered to accordingly. Thus, debriefing should be priority in the list of events as it concerns a specific technique designed to assist victims in dealing with their reactions associated with traumatic exposure. Debriefing on one hand allows victims of critical incident to process the event and reflect on its impact (Nixon, 2008). Additionally, debriefing assists in the recovery and rehabilitation of trauma victims. It is important to thoroughly investigate the events surrounding a particular traumatic incident so as to initiate a successful healing program (Silke and Brandon, 2007). Secondly, trauma victims should be given time to expel their accumulated feelings and views associated with the critical event (Eddie, 2006). These two events should be provided immediately and not after 72 hours of the critical event. Because the longer it takes to implement help, the least effective it becomes. In this respect, help should be contingent to the event. Study findings show that individuals who receive help immediately after experiencing the critical incident suffer reduced effects of psychological trauma (Barrows and Silver, 2006). Subsequently, people involved in emergency evacuation and those surviving from traumatic incidents are likely to develop posttraumatic symptoms if they are not accorded ideal help. There are laid down procedures and processes to follow when assisting people involved in a critical incident (Eddie, 2006). Impact on studies This incident was a turning point in my academic work. It really pressurized me within the shortest time I was in the emergency room with the unconscious girl in her teens. The outcome of the results of my efforts with the crash victim helped me discover my inherent potential to perform practical activities in the field of medicine as opposed to earlier misdemeanor observed and commended by my supervisor (Nixon, 2008). The aftermath of the fiasco in the emergency room saw my supervisor go out of his way to encourage me to believe more in myself and take my capability more seriously. In regards to this argument, I resolved to work very hard towards improving my studies so as to manage critical incidents in future. The incident further helped me learn that critical incident stress management is capable of helping people deal with their trauma head-on and free of criticism. Moreover, the program is driven by peers and draws its staff from all members of the society particularly the first responders. According to the study findings by Silke and Brandon (2007), all interventions involved in critical incident stress management programme are strictly confidential. But the person doing the intervention is allowed to determine the prevailing situation of the beneficiary. In such cases, the information can then be exposed. Nixon (2008) explains that the main purpose of intervention is to ensure the victims’ safety and restoring their normal lives. Secondly, the issue of rehabilitating a traumatized victim of a critical incident adopts the clearly laid down protocol stated in the foregoing. It is my strong believe that the narrated incident was fundamental to my studies because I would still be introverted and unable to use my hands-on skills without it. Consequently, this would have elicited very negative written recommendations from my supervisor in my portfolio and probably impacted adversely in my placement. More importantly, the incident has helped me to acknowledge my potential and work towards exploiting it fully to improve all beneficial aspects of my course. Developing greater confidence at employing my manipulative skills on the whole may lead me to attaining high grades in my examinations. It may also lead to me feeling more in control of my situations and handling traumatic events diligently without any misgivings. Impact on career My supervisor was right in his observation about my hidden ability to carry out hands-on activities as required of medical practitioners. Other than this aspect, a medical practitioner must be able to express opinions clearly and confidently. Additionally, good communication skills are essential in nearly all aspects of medicine. For this reason, it became obvious that I was geared towards becoming a very competent doctor. This really gave me the prospect of dealing confidently with my patients in the future and more particularly in taking the history of a patient. Being able to express my astute skills in the medical field can help me win the confidence and trust of my patients. My observed success in this incident made me carry my head high with the promise to improve my skills in the medical field as a complete doctor. It also changed my whole personality especially self esteem making me more of an extrovert interested in embracing teamwork. Similarly, having to handle an emergency on my own was a great turning point in my career because I learned the significance of consulting with my supervisors for guidance. In view of this, it was critical for me to learn that debriefing is an essential step in rehabilitating a traumatized person who experienced a critical incident. Research has indicated that helping trauma victims requires an approach that incorporates one or more aspects of a seven-part model suggested by Eddie (2006). The suggested model begins by outlining the importance of assessing an individual’s situation as far as the critical incident is concerned. Personal differences among victims may result in totally different responses based on their developmental understanding of the critical event (Barrows and Silver, 2006). The model also recognizes those issues surrounding safety and security of children who are most vulnerable to lives shattered by tragedy and loss. The model further stipulates that critical incident victim requires ventilation and validation which both allows the individual to open up and show emotions. In this way, the traumatized individuals are capable of sharing and discussing their exposure to the event. It is also important to assist all those involved in critical incidents to predict future events. This, according to Nixon (2008) involves educating vulnerable groups about the possible effects of traumatic exposure. In the whole, this incident proved to be amiable in the advancement of my studies and prospective future career. References Barrows, H. S. and Silver, C. E., 2006. Goals and strategies of a problem-based learning facilitator. Interdisciplinary Journal of Problem-based Learning, 1. 21-39. Eddie, B., 2006. A History of Firefighting in Cambridgeshire, Huddersfield: Jeremy Mills Publishing. Honey, P., 2003. Improving the quality of workplace learning, Training Journal, UK. Nixon, I., 2008. Work-based Learning: Impact Study. Higher Education Academy. Silke, A. P. and Brandon, S. E., 2007. “Near- and long-term psychological effects of exposure to terrorist attacks”. Psychology of terrorism. (pp. 175-193). New York: Oxford University Press. Sorensen, L. S. and Hertz, K. D., 2005. Test method for spalling of fire exposed concrete. Fire Safety Journal, 40(5), p.466-476. 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