Steady, nurse: How to keep calm in chaos

"If you can keep your head when all about you/Are losing theirs..."

These lines from Rudyard Kipling's poem "If" should probably go on most nurses' headstones, scrubs, or, at the very least, their job descriptions.

But have you ever noticed how everyone sort of expects nurses to stay calm in chaos?

Being able to stay calm under pressure "not only has a calming effect on others but also inspires confidence. It is considered evidence of emotional intelligence," according to The Enterprisers Project. While it's nice knowing that keeping your cool might indicate you could move into management at work, it's even more useful for the job you have now.

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If you'd like to boost your own abilities in knowing how to act and what to say when it is, in fact, your circus, follow this calm advice from a nursing peer and management experts:

Look calm. Registered nurse Nelson Long has 29 years of experience responding calmly to chaos, most recently as a flight nurse in a mid-size city in the Southeast. He says most of the trick is "appearing calm when everything else is not. Usually, when people call us they are already in a bind. If they see us stressed, they are going to ratchet it up. Truly we have to be a calm in the storm, no matter how we are feeling on the inside."

Work the plan. You can cope with high-stress situations much more readily if you have a plan in place, noted Anne Grady, author of "Strong Enough: Choosing Courage, Resilience, and Triumph." "That begins by identifying what types of things will set you off," she told the Enterprisers Project. "While it sounds easy, this is anything but. The best way to identify your triggers is to pay attention to your emotions and physiology. When you are triggered, how do you know? Does your heart race? Do your palms sweat? Do your shoulders tighten? Do you begin to feel anxiety? Once you can identify how you react when you've been triggered and what tends to trigger you, you can proactively create a plan to manage those responses."

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Remember whose emergency this is. "One of the two things I remember from training is a supervisor who told us, 'It's not your emergency,'" Long remembers. "If you make it your emergency you are not going to be able to function. Because as that same supervisor said, 'Logic and emotion compete for the same space in your brain. You can deal with emotion later. While you're with a patient, you have to focus on the logic.'"

Ask questions. When you want to react, or even scream, settle for asking questions. "That is a great way to make other people feel heard and for you to learn more about a situation, as long as they are non-judgmental questions," Margery Myers, a consultant and coach with Bates Communications, told the Enterprisers Project. "It is also a way to put a pause in the situation and buy some time to think."

See if you can't distract the others. While it's no time for a joke involving three people who walk into a bar, a mildly humorous remark can sometimes help take everyone's mind off the emergency, Long says. "Everyone has that tunnel vision of what's going wrong, so you have to say something to take everybody out of that."

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Be reassuring. This is not the time to tell others who are falling apart that they have good reason to be doing so, according to Long, who has extensive experience with this mindset when his crew is picking up or delivering critical patients. "In an emergency department, everything is kind of falling apart by definition. It helps if you can reassure people, 'We're going to handle it from here. You did the right thing.' If you let them know they did the right thing in calling you or getting the patient where they can receive medical attention, it goes a long way towards calming the situation."

The same goes for fellow nurses, who may occasionally flip out in a crisis situation, though hopefully just for a second or two. "Just remind everybody, 'We're doing our jobs, we're following our protocols, we're doing the right thing,'" Long added.