How to be more mild mannered like doctors in stressful circumstances?

Double-Helix, BSN, RN · Feb 3, 2017

Can you be more specific about what types of situations you want to be more comfortable in? Medical emergencies/codes? Performing nursing skills? Counseling patients who just received bad news? Managing angry family members?

I gather from your previous posts that you are likely still a student. No matter what area you're trying to gain confidence, the answer is 1. Experience and 2. Anticipation.

If you freeze up in emergency situations, learn about what to do, and practice doing it. Code teams can respond calmly and effectively because they have practiced. They know their jobs and they are confident that they know what to do and how to do it. Read the BLS/ACLS guidelines. Participate in mock codes. Observe codes and rapid responses when other patients are involved or watch educational videos online. Make flash cards to learn your emergency drugs and doses until you're confident you've got them down. And then, anticipate. Think about potentially bad situations and how to respond in advance. You've got a patient newly post-op from a hip replacement? What are your main concerns? What signs and symptoms would indicate to you that she has, say, gotten a pulmonary embolism? And if you think she has a PE, what are your first steps and what equipment do you need to have immediately available? Thinking about what could go wrong in advance, when you're calm, is going to make it much easier to respond correctly if that emergency occurs.

The same applies to performing a nursing skill- 1. Experience: practice the skill you're confident in your technique. 2. Anticipate: Think about how to perform the skill and what equipment you need before you start.

Talking to patients in difficult situations- 1. Experience: Observe other individuals have these conversations. Take a therapeutic communication class, watch educational videos, and read books on the topic. Ask friends/family to role play so you can practice your responses to difficult questions and give you feedback. 2. Anticipate. If you know your patient has just gotten a new diagnosis, or think they might ask you some tough questions, think about how you're going to respond to them before it happens. If you have time, ask a co-worker how they have responded in similar situations.

See the trend? In each case, maintaining your cool comes from learning what to do and preparing in advance. As a student, you have time to learn, and it's a great time to observe those around you. If you see someone who manages a tough situation with calm confidence, ask them how they got there. I guarantee you that they didn't start out that way.

P.S. Have a life. Nursing school and the nursing career is not so demanding that you don't have time to cut loose and enjoy life once in a while. Committing all your time to studying at the total expense of your social life is a great recipe for burn out.

AliNajaCat · Feb 3, 2017

Excuse me... "more mild mannered like doctors"? Watching too much TV.

"Fake it 'til you make it" has nothing whatsoever to do with lying. Think about that. Not being able to lie is OK ("I didn't cut down that cherry tree, Pop, honest!"). Not being able to mask your feelings and project calm for the benefit of those around you isn't.

People, all people, are calm in emergency situations when they are prepared and confident in their ability to do what's needed. If you are able to be calm in the face of the unexpected at home (e.g., the dishwasher starts spewing water all over the floor, the dog barfs on your good rug, you come out of the house to find your car has a flat, etc.) then realize it's because you don't take it personally and you know what to do (turn off the water and call the repair guy; clean up the rug; change the tire or call AAA to come do it for you). You don't feel out of control because you know what's going on and how to fix it.

Likewise, remember that the emergency situation at work isn't about you personally either. (The Fat Man's Laws #4: The patient is the one with the disease.) (Laws of the House of God | Wanderings). It's your job. You will get better at doing it the more experience you have, and then lo and behold, one day you'll look up in the middle of working with a bleeding hot mess to see a nursing student standing in the door with her eyes wide thinking to herself that she could never be like you.

roser13, ASN, RN · Feb 3, 2017

"how do I become more mild mannered [like doctors] in unexpected circumstances?"

Doctors mild-mannered?! You have given yourself away. Your level of inexperience is showing.

Slow down and just make your way through nursing school. You don't have to "immerse (yourself) 100-200%" to the exclusion of a healthy balance in your life. No career is worth that. In other words, get a life now, not later.

And ps, no need to try to turn yourself into a liar. Nurses don't make a practice of lying.

Libby1987 · Feb 3, 2017

I love the above 2 posts!

AceOfHearts<3 · Feb 3, 2017

I plan on fully immersing myself into nursing like 100-200%, aside from family the med field will hold precedence over dating, having a life.

Well that's a recipe for disaster and burnout- it's all about balance.

Have you heard of the saying "you can't take care of others if you don't take care of yourself"? It's a cliche for a reason.

rearviewmirror, BSN, RN · Feb 3, 2017

Not much way around it... exposure and repetition. It's better if you are in environment that has higher frequency of chaos and critical situations, like ER and ICU (i.e codes, trauma, stemi, stroke, etc). I remember pooping bricks while doing cpr, fresh in ED. I was new in ED from floor. Once got adjusted to it, was eating granola bars and yogurt at nursing station while EMS and triage poured in. Exposure and repetition. At some point, you stop caring, because you know you can handle it.

Ruby Vee, BSN · Feb 3, 2017

Hi,
I'm trying to improve myself. I plan on fully immersing myself into nursing like 100-200%, aside from family the med field will hold precedence over dating, having a life.
Anyways, how do I become more mild mannered in unexpected circumstances?
I've never been the fake it til you make it nurse, I have to know exactly what I'm doing to feel comfortable. I have no clue how some people do that because

I know you have to have a poker face sometimes but I'm awful at lying!

I think perhaps the expression you're looking for is "how do I become more calm in unexpected circumstances?"

Being calm or having a poker face is not the same as lying. Being awful at lying is not a bad thing.

You become calmer by pausing to take a deep breath before reacting, and then react to the issue, not to the emotions it evokes. Your car breaks down -- throwing a fit isn't going to fix it, but calling AAA might be a start. Your patient codes? You've practiced BLS and how to call a code, so take a breath, call the code and start CPR. Getting upset rarely solves a problem and it makes most problems worse.

As far as lying . . . behaving as if you have more confidence than you actually feel is not lying. It helps everyone in the situation to be more calm. One day, you'll realize that you actually feel the confidence you were pretending to.

TheCommuter, BSN, RN · Feb 4, 2017

Moved to the Nurse Colleague / Patient Relations forum.

Cat365 · Feb 18, 2017

It isn't lying. I am an awful lier but I'm great at not showing how nervous I am.

Ill prepare ahead of time for anything I can but if I can't, or I'm still nervous, I just hold my head high, calm my voice, and look people in the eyes.

If all else fails. I fall back on my animal training lessons. Never show fear. Animals can smell it and it can provoke an attack. It's not lying it's self control and it usually is something you develope through practice and self confidence.

calivianya, BSN, RN · Feb 22, 2017

I'd say immersing yourself in a real life outside of healthcare will help a lot in making you more mild-mannered. The more emotionally balanced you are, the better you'll be able to stay calm. Getting too invested will make you more high strung, not less.

Also, study if there's something in particular you're worried about. You will be more relaxed if you know what you're doing.

jaderook01, BSN, RN · Mar 9, 2017

I didn't read the whole thread here, but I've witnessed a few frazzled and stressed out doctors and some calm, chill, and very competent nurses in action during 'stressful circumstances'. In fact, I've seen some of those nurses try to 'guide' the frazzled doctors. Those nurses that are part of the rapid response team do that all the time, whereas the doctor in question may not.