Off the back of my recent post about stress responses, I found myself the only HCP amongst a host of volunteer first aiders recently. As a team we’d managed and packaged the sort of patient that gave me the shivers, the type of patient who clearly thinks that they’re dying, asks if they’re dying and I am unable to answer honestly.
Volunteer first aiders train for this sort of thing to an extent and I have to say that the group I found myself inadvertently leading were slick and proficient. They did exactly what I said when I said it and stopped when instructed to do so. They performed tasks that were far beyond what they anticipated on their first aid duty.
One held a young man’s head in her lap and told him he’d be fine, to just keep breathing and try to relax.
Another was improvising dressings from a first aid kit that was never intended to treat injuries such as this and she kept her cool when I snapped at her to “just open fucking everything”.
One guy was standing over us, handling the burgeoning crowd and organising marshalls to bring an ambulance immediately to our side.
And the fourth was opposite me, kneeling in mud and piss up to our thighs. She had her hands under mine, my fingers moulding and turning hers just so and pressing them down. She was pushing onto parts of a human body she’d probably never seen before, let alone held, hot and wet and twitching in her grasp.
Aware that five sets of eyes were expecting me to know exactly what to do, I wasn’t about to let on that I’d only ever seen that body part before on an autopsy table.
The patient shipped out on an ambulance, we reconvened as a group. Reactions were interesting. One was talkative, jabbering excitedly that she’d never seen multi-trauma. Her excitement lasted half an hour before she dissolved into embarrassed tears . The coordinator was grim-faced, though the water in his drinking bottle trembled when he lifted it. My equipment specialist was cold and analytical, asking pertinent questions about her performance and the patient’s prognosis. And the fourth was silent, fascinated by her shoes.
My brain swung into “bad job” mode, automatically playing the cards that we do at work, that just a few weeks ago I’d been analysing amongst my colleagues and myself. My arms swung out, clapping shoulders, touching arms and shaking hands. I dropped my paw around the shoulder of number four and she stiffened at my touch. The team fractured into a one, two, one formation.
I gave them a minute and cracked a joke; humour didn’t go down well and I realised that the rest of the group were not only unaware of how we decompress, but that they mistook my attempts to do so as crass and degrading.
And I, recognising the offence I was causing, backed away from the process and joined them in their brooding.
For me there was no reset. I did my best to warn people about adrenaline come-down, to ensure that they would get home safe and be looked after by friends. I tried to explain about questioning your own performance and realising that finding out the patient’s outcome may be impossible. I strove to make people see that what they’d done was amazing, had probably saved the young man’s life and encouraged them to take comfort from that thought.
It was only on the following evening, when I gathered with like minded friends, that I was able to hammer through the stages, to get my quota of physical contact, to make flippant remarks about a horrendous situation and to clink beer bottles together and agree that things had gone well.
We all have our rituals, developed through years of experience, trial and error.
Until you know what works, you have no choice but to have a go at decompressing through any means you can conceive.
Find a your system and employ it when you need it.
Just realise that it’s a personal or collegiate decision.
And it may not translate beyond borders.