How Does Witnessing and Performing CPR Affect Nurses?

Football fans and players witnessed CPR in real-time during Monday Night Football. Witnessing these traumatic events has sparked conversations about mental health and processing feelings surrounding life and death moments. Are there implications for nurses and hospital staff who not only witness but perform these tasks on a regular basis?

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  • Specializes in Nurse education, NICU, psych. Has 22 years experience.

After the cardiac arrest suffered by Demar Hamlin on Monday night, the NFL made the decision to cancel the Buffalo-Cincinnati game. In a statement Friday by NFL Commissioner Roger Goodell called the incident extraordinary and went on to state, "We saw the collective humanity of the coaches and players on the field Monday night. I cannot enough about Coach McDermott and Coach Taylor who led their teams with sensitivity and compassion. All that mattered was Damar, and the emotional health of the players1. The first indication the game would not continue was the equipment staff preparing to pack up team gear along the sidelines.

As I watched the events unfolding with my son and husband, it was the contrast between my reaction watching this and theirs. They stood around like many of the fans with furrowed brows and arms folded while I sat in absolute confusion. I was genuinely surprised the game was cancelled because of this. I was surprised to see these tough men in tears, seemingly paralyzed with fear and sadness from witnessing these traumatic events.  I heard a sportscaster describe the CPR given as "aggressive" and thought, is there any other kind? I realized then it was my reaction that was strange.

As nurses, we witness and perform CPR as part of our assigned duties. Occasionally, assignments will rearrange as this patient gets upgraded to an ICU bed or requires a 1:1 status or, sadly, expires and requires post-mortem care. In any of these instances, family support is expected in the form of explanations, comforting, and answering questions. Often, due to the nature of the hospital world, the room will need to be turned over quickly for a patient who has waited 10-plus hours for a bed. The idea is the same; the nurse must carry on and move forward in the care of the patient assignment. Most of us, if not all, have found a supply room or a favorite bathroom where we can hide for a few minutes to "gather ourselves" by allowing tears to fall, drying them, having a silent moment to ourselves, and literally (and figuratively) catching our breath. Some of us, including myself, have learned "the art" of choking back the tears and carrying on until we clock out and sit alone in our cars to go home. Is the emotion felt at Monday night's game different for me because I am in scrubs and on the clock? Is this just something we signed up for and part of an expected performance ethic? In a statement to the American Psychological Association, sports psychologist and consultant to the Cleveland Browns, Sam Maniar, PhD stated, "We know that if you don't process these emotions, they are going to fester up and build up and bubble up to the surface in ways we don't want them to2.”

What are the implications for nursing and other hospital staff involved in these precious life-and-death moments? The players were not allowed to return to work because the conditions could lead to possible injuries due to the distraction. Is it different because this was a teammate? What about a patient we have cared for and bonded with? Does this fester and bubble up for hospital staff in ways we don't want them to? I have worked for a few systems that offered chaplain services for staff, employee meditation rooms, and some that simply offered it was "just part of the job". Are there best practices for these situations?

I am grateful Damar Hamlin appears to be on the mend, and there has been a renewal of interest for the public to learn basic CPR. Though traumatic to witness and perform, this seemingly favorable outcome has highlighted the miracles that occur in healthcare settings daily.


References/Resources

1NFL Commissioner Roger Goodell statement on Damar Hamlin, AFC playoffs

2Damar Hamlin's collapse offers mental health lessons in trauma, vulnerability for NFL players and fans

Jaye Orzabal is a master's prepared nurse educator licensed in Texas. She has worked across several areas of nursing including neonatal intensive care, inpatient psych, nurse education and clinical documentation. She now writes professionally as a medical freelance writer.

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RNNPICU, BSN, RN

1,261 Posts

Specializes in PICU. Has 17 years experience.

I agree. I think because I have had to perform CPR and witnessed it being performed on many patients that I was not as shocked.  I do feel that calls for the Athletic Trainer to be inducted into the Hall of Fame is outrageous because those actions are daily life for many healthcare workers.  The trainer and team were performing a job that they are trained to do.  This was not a solo job rather every member of the team played a part. They are trained to deal with sports emergencies and injuries.   CPR and emergencies occur many times in the lives of paramedics, EMTs, RNs, RTs, MDs, APPs, etc.  This is something that is part of the job in many situations.  

Many healthcare workers may have to perform CPR on their patient, once stablized, move on to the next, there is no stoppage of work.  

Tweety, BSN, RN

32,588 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 31 years experience.

I go on automatic pilot during CPR and shut my mind off and then process it later so I can perform optimally.  I can understand it's traumatic for the lay person to watch, especially when a teammate and such a young person.

Usually CPR affects me when it's unexcepted and/or the patient is young.  I beat myself up "what did I miss", "was it something I did".  Other times it's "their suffering is over and that's a good thing".   Talking it over with peers afterwards helps.

Specializes in Ortho, CMSRN. Has 9 years experience.

Having one of my 95 yo med-surg patients code right after surgery to remove colon cancer is one of the precipitating factors to my leaving a regular hospital and to an ortho only. It was horrible and I would just start crying randomly for a week or so after. Things still happen at an ortho hospital, but this case was the perfect storm of terrible. They still send us to the big hospital if we're overstaffed and our sister hospital is short staffed (when are they not) and it's always horrible there, but at least I spend most of my time at a place where things are pretty much routine. I couldn't ever go back to med-surg. 

JBMmom, MSN, NP

4 Articles; 2,348 Posts

Specializes in New Critical care NP, Critical care, Med-surg, LTC. Has 11 years experience.

I was heading to bed when the football incident happened and my 18 year old ran into my room to tell me they were doing CPR. My response was "I can't really help much from here", I really wasn't sure why he was telling me. Then I realized that while my family has heard me recount codes happening, none of them have ever really seen it. He thought I would want to come and see it unfolding- which I did not. I can understand why the game was cancelled because even for people that have taken BLS, we all know that being trained and really doing it in a life or death situation, are totally different. And for teammates, family and fans, it might have seemed traumatic. 

I've been involved with CPR dozens of times and there have been some that shook me a little more than others for sure. But every time I have either had to return to my assignment, if I was the responding rapid response nurse, or take care of my other patients if it was my patient in the unit. You have no choice but to get over it quickly and move on. Sometimes there's processing to do in the down moments later in the shift- or after a shift is over, but in the moment you just move on and do what has to be done. 

Specializes in Cardiac PCU, Clinical Instructor. Has 10 years experience.

I may be slightly jaded, but I felt like the world got to experience a glimpse of the stress I go through every shift.  Nurses aren't mindless numb robots, you are definitely psychologically changed.  Just trying to unwind after a shift is challenging, falling asleep to wake up for another crazy shift to work.  Poor World for being traumatized,  welcome to my life.