I spent last week as a camp nurse in the Upper Peninsula of Michigan. For the most part, I spent my days giving kids their meds, removing splinters, putting band-aids on scrapes, and generally being a mom. It didn't take as much skill as a ready smile and encouraging word.
Then Wednesday night hit. It was the beginning of a 24-hour period that had my adrenaline in overdrive. One thing after another kept happening, and I was at my wits end by Thursday night.
Here is a brief overview:
The camp pastor fell on a horseshoe stake and injured his leg.
A 12-year-old boy fell off a 10-foot platform face first.
A 10-year-old boy was brought in on a back board after injuring his neck inner-tubing.
Another 10-year-old boy fell and injured his arm and ended up in the ER.
Now, between these injuries were several bee stings, a sprained ankle, a minor eye injury, and all the minor stuff mentioned above. Those were easily dealt with and forgotten moments after they happened (for me, if not the patients).
It was the others that had me reeling a bit. Three of them I was alerted to before I saw the victim. The fourth happened in front of me. I watched the fall through the lens of my camera.
In each case, my stomached dropped. Remember, I'm a Family Practice nurse, NOT an ER nurse. It's amazing what comes to your mind when everyone is looking to you to deal with an injury. Honestly, after the "Oh crap" thought left my head, I went into an immediate prayer. It went something like this: "God, please help me to be sufficient for this situation." Short and sweet.
I was completely aware that I might not have the experience needed to care for the injured party, but I was all they had in that moment.
I am smart enough to know that my very first responsibility is to remain calm. If I don't, no one else will either. It's all an act, of course, but they don't have to know that. Beyond that, I just start doing whatever comes naturally (or supernaturally in some cases). I take control, ask questions, and pretend they are in extremely capable hands as I start attending to whatever need they have.
If you've been reading this blog for a while, you may remember that my first camp nurse experience didn't go so well. Actually 99% of it went fine. It was the 1% named Tony that was the killer. Tony was electrocuted by a fan in the camp kitchen and died. He was 17. I did everything I knew to do, but he died anyway.
We all face situations as nurses where we aren't sure our abilities will be enough. Where we don't know if we know enough. Where we feel insufficient. Sometimes, in fact, it's the truth. But more than likely, we have everything we need to do the right thing for the patient. Tony died because he was electrocuted, not because I did anything wrong.
And our patients deserve our confidence. What could be worse than feeling terrible and have the person who's supposed to be taking care of you acting like they don't know if they can? Talk about adding insult to injury!
So the next time you have to do something you aren't sure you can, fake it. Even if you have to get some help, ask for it in the most confident tone you can muster. You are a professional. Other people assume you're qualified. Act like you are. And if you're still a little uncertain, you can always try my approach and pray. Who wouldn't want to believe there is a higher power who can bridge the gap between what they have and what they need?
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July 16th, 2009 at 10:09 am
I couldn’t have said that better myself.
July 16th, 2009 at 10:49 am
I am still a student but frequently follow the fake it to make it idea – especially around patients. I do what is needed to remain calm and collected in front of the patient – give a reasonable excuse to leave what I am doing – then find someone qualified for advice and help.
I have worked with a few nurses who have gone into mini panics when things have gone wrong. While I recognise it is natural to feel out of your depth I don’t believe the patient should see or experience this. It doesn’t help the patient to trust us if they feel we don’t trust ourselves or our abilities.
July 16th, 2009 at 1:28 pm
I’m a camp nurse too, and sometimes you just have to improvise with what you have and can do right in that moment, you know? You don’t have a pulse ox. machine; you give meds. you would normally do much more assmt./monitoring with; you deal with parents, kids, staff; play mom, and friend. Sometimes it gets really hectic – though I’ve never had so many ‘bad’ things happen in one day! Remaining calm is the most important thing – even if you’re not exactly sure what to do right away – because others are looking to you to ‘stay cool.’
I’m a new nurse, so I feel like I have to ‘fake confidence’ a lot. Like, when I go in to do a cath., I just act like I’ve done it a thousand times, even though I can count the number of times I’ve actually done it on my fingers. The first IV I started, I got it on the first shot, and then the pt. said, “Have you done that before? That was good.” “HA HA! NOPE!” I said, “You were the first one!” 🙂 FAKE IT ‘TIL YOU MAKE IT is a little advice I was told once. I works, I usually them crumble once I get home… 🙂 Good luck camp nursing!
July 17th, 2009 at 9:21 am
I can appreciate the point you are trying to make on remaining calm and putting on a strong front in order to handle a situation, but I disagree with the use of the prhase “faking it.”
It’s called courage, bravery, determination and believing in yourself… which the blogger obviously did, and did well, but please be careful about sending a message to new or perhaps unexperienced RNs about faking it when they don’t know.
The asking for help part is great, and a prayer never hurts, but I encourage a EMS EMT or first responder class or an emergency nurse crash course for those that want to be more prepared. There is no worse feeling for ANY RN than the feeling after a bad situation that we should have known more or did more, but even worse is faking something and not getting it right.
Thanks for the story. I enjoy reading these.
=L
July 17th, 2009 at 5:10 pm
you did amazing, but have to agree that faking it is the wrong term. I done my time in ER and am now a boarding school nurse, so it’s a bit like an extended camp, especially during ski season (the school is in a ski resort). Staying calm is key, and removing histerical teachers/students is also key. I’ve been very diassapointed by the actions of the teacher body as they are bloody useless, worse than the kids even. Having a calm person to be crowd control is a big help.
Anyway, good job, and good post.
July 17th, 2009 at 9:06 pm
I have done camp nursing and it is some of the hardest and tiring work in the nursing world-You did a GREAT job! I do not believe you “faked it” (and also agree that it is a less than optimal term). What you did do is behave exactly the way a professional health care provider should behave under the circumstances. And I hope that you also looked up what you didn’t know after things calmed down.
October 25th, 2010 at 1:44 am
“So the next time you have to do something you aren’t sure you can, fake it.”
I generally like what you say, but I believe this statement isn’t quite what you meant, at least I hope. What I hope you meant is putting on a front of confidence for those looking to you for help and not doing things that you really shouldn’t.
April 11th, 2011 at 5:37 pm
I WOULD LOVE TO BE A CAMP NURSE IN THE U.P. CAN YOU GIVE ME THE NAME OF THAT CAMP AND ANY OTHERS THAT YOU KNOW OF. HOW DID YOU FIND IT? DO YOU KNOW OF ANY GOOD SITES TO FIND CAMP NURSE JOBS ON?
THANX!