Post-It 07/10/22-That’s why it’s called the practice of medicine

The post-it reads ‘practice makes perfect regarding practicing for emergencies.’

I was driving to work, listening to Fresh Air on NPR, and there was a pediatric neurosurgeon as a guest. He was describing intra-uterine surgery on a fetus. In this case, it was a surgery to ameliorate the effects of spina bifida. This is a birth defect where the skin doesn’t completely cover the spinal column. There are all sorts of developmental, some lifelong, related to this condition.

He was talking about a case where they had opened the uterus and were in the process of beginning the surgery when all of a sudden there was an obstetric emergency. Of course it was all of a sudden, that is what emergencies are. But in this case, the mother’s life and the fetus’s life were in immediate danger. And all he could do was watch as the anesthesia and the OB teams took over and saved their lives. I can imagine that it was a thing of beauty to another healthcare worker and a thing of chaos to an layperson. Organized chaos. Each team danced around each other, each knew exactly what they needed to do to stop the bleeding, deliver the baby, and save the baby, keep them both alive.

And he said something that struck me as both routine and profound. He said that practice makes perfect and this is why healthcare workers practice and drill for emergencies.

And there are many, many drills that hospitals and healthcare workers engage in every month and every year. These are all ‘codes’ that the healthcare organization teaches their employees not only to recognize the codes and know what is going on, but how to respond. The codes are all named different things in different places.

Fire codes. Fire drill in case there is a fire and we have to abandon the floor, or the hospital but still keep the patients safe.

Inclement weather code. This is to alert employees that there is a weather event happening nearby that is capable to impacting the hospital. I’ve had two alerts on my phone from the hospital this week about possible tornados. As a tornado has struck a sister hospital in the last couple of years, this can be a big one.

Active shooter code. This is to alert employees that there is a gunman on site and to follow the protocols that have been drilled into us to decrease the possibility of being shot. This has also been used in the last two years by the organization I work for.

Missing person code. This is to alert employees that there is a missing infant/child/adult on premises. During this code, all available employees are to go to an outside door and keep their eyes open for someone acting suspicious or fits the description of the person. During one of these drills, I was in a stairwell near an outside door. I always take that stairwell for the drills. A leader from another department was walking down, cool as could be, with an oversized bag over their shoulder. I stopped them and asked to see inside the bag. They admitted that I had caught them, showed me the doll they had in the bag, and told my boss what a good job I had done during the drill.

This is why we drill. When something tragic happens we, as healthcare workers, can respond appropriately and quickly. And save a life. Sometimes, it is even our own.

There are many codes and drills that we have to be aware of. They run the gamut of bomb threats, active shooter, code blue where someone is dying, missing person.

We run them over and over and over. We are practicing for when the time comes that it is real. Because practice, and muscle memory, can make the difference in a life.

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