Coping with a mass-casualty incident as a student nurse

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A mass-casualty incident is any event that may cause multiple victims to require medical attention at the same time. Whether it is a pileup on the freeway, fire or natural disaster (such as a hurricane), certain incidents can lead to injuries ranging from mild to life-threatening. If you are working as a student nurse and have to deal with a mass-casualty incident, it can be an intensive learning experience.

What happens during a mass-casualty incident?

Although many hospitals are used to busy periods and treating several patients simultaneously, a mass-casualty incident is different. A larger number of patients may be brought to your facility all at once, which can strain resources. As a result, the hospital may operate differently during this type of crisis.

All medical facilities need to have policies in place to deal with a mass-casualty incident. Your supervisor on your unit will likely be in charge of nurses and student nurses during an incident. Most hospitals will occasionally have drills to teach nurses and other staff how to deal with a sudden influx of patients during a mass-casualty incident. If you are able to attend one of these drills as a student nurse, you should.

There are several factors which need to be taken into consideration when dealing with a mass-casualty incident. For example, the number of patients that will arrive at the hospital is a critical factor. In addition, knowing the type of incident may provide insight into what type of injuries are likely to have occurred. 

Usually, a command center will be set up and certain staff members will take on roles as supervisors. If you are not told what to do, ask your supervising nurse for direction. At some point, you may be asked to help with the incoming patients in the emergency room or to go to another department to help. When it comes to your original assignment, try to go with the flow. Keep in mind that a mass-casualty incident requires teamwork and flexibility.

How can you help?

A student learning how to take a patient's blood pressure in a local Tanzanian hospital.From the standpoint of a student nurse, the first thing to remember is to remain calm. It is normal to get caught up in the emotions of the situation, but while you are working you need to stay focused and perform your duties. You will have time to deal with your feelings later, but it’s not the time to break down when you’re on the job 

Student nurses need to balance assisting during a mass-casualty incident with not overstepping their level of knowledge. Keep in mind that, as a student, you should not be asked to perform tasks which you are not trained to do or allowed to do without direct supervision from a licensed nurse.

Things can get hectic, and staff can become overwhelmed and may push the limits regarding how much you can do as a student. Additionally, you may be working with staff who don’t know you are a student. A mass-casualty incident is not the time to be timid. Don’t be afraid to speak up. Let someone know if you are unfamiliar with something or are not allowed to perform a certain task.

Although you may have some limits as a student, there are still many things you can do in order to help out. Ask your supervising nurse what you can do. Tasks like taking vital signs, getting blankets, moving equipment and getting supplies are examples of things you may be asked to do. Follow the policies of your school and hospital when it comes to student nursing duties, such as applying dressings and assessing patients.

Remember the basics

When you are dealing with multiple patients coming into the hospital at the same time, prioritizing responsibilities is essential. Rely on the skills you have learned and don’t hesitate to ask questions. Remember you are still learning and not expected to know everything. 

It is normal for things to be chaotic during a mass-casualty incident, but remember to stick to the basics. For example, if you are allowed to treat patients, make sure you verify orders and check a patient’s identifying wristband. Be sensitive to the patient’s emotional state. Patients may be confused, anxious or in shock. Use terms patients will understand and communicate clearly. Introduce yourself and explain what you will be doing.

Take a step back

Incidents that result in mass-casualties are not only challenging medically, but can leave you feeling angry or scared. Healthcare workers see a lot of suffering in difficult situations, and this can be upsetting. Medical personnel are trained to deal with various situations, but they are still human and need to learn to cope with their own emotions.

After the incident is over or things have calmed down, take some downtime to deal with your feelings. A mass-casualty incident can be traumatic for all those involved, including medical workers. As a student nurse, you may not have a lot of experience dealing with tragedies, and it can be tough.

Some healthcare facilities may have a debriefing after a mass-casualty incident to determine how well the hospital handled the situation. This is also a chance for workers to talk about how they feel and learn how to handle their emotions during a crisis. Counselors and hospital chaplains may be available to help you express how you feel and sort things out.

While it is normal to have an emotional reaction to a tragedy, you want to be sure the event is not causing lasting problems. Be aware of problems sleeping, concentrating or feeling depressed, which can all be signs of stress. In addition, if you are anxious about returning to work, it can also be a sign you still need to work through things. Don’t hesitate getting the help you need. 

Although it can be one of the biggest challenges you will face as a nursing student, a mass-casualty incident is also a time to come together as a team and help those who need it most. 

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