man riding a wave

ER Specialists Share Tips for Keeping Calm Amid Chaos

By Marisa Cohen
February 09, 2023

You know those days when everything seems to reach a crisis point all at once? Your work deadlines are pushed up, your family needs your attention, a major appliance goes on the fritz, and then the dog throws up. For emergency medicine workers, every day is like that. Staying calm and focused when chaos is swirling around can literally be a matter of life or death. So we asked ER doctors, nurses, and paramedics with nerves of steel their tips for staying calm in the middle of a storm.

Mindfully Attend to One Task at a Time

“I usually love chaos—I have six kids and work in the ER! But when you’re an ER doctor, you can sometimes get interrupted 25 times in an hour. You need to pay attention to what the nurse is telling you, but then you might get distracted from the medical order you’re writing. I’ve discovered there is no such thing as multitasking—instead, there is task-switching. I will stop what I’m doing and mindfully pay attention to the other task for five minutes, and then go back and mindfully pay attention to what I was doing before. I used to keep everything in my head, but now I keep a piece of paper to jot down what I was thinking about, so I can go right back to it.”

—Teresa Murray Amato, M.D., director of Emergency Medicine, Northwell Health Long Island Jewish Forest Hills Hospital, New York

Prioritize Your Focus and Find Time

"When you’re in the middle of a stressful situation, focus first on the things you know you can do. After taking care of those problems, the situation often appears less complex. This is particularly true for doing things like complex laceration repair. You put together the parts that you can see for sure need to go together, and then you can see how the rest comes together. I also play the piano to unwind and swim three times a week. When I was doing long shifts in the ER, I found that going into my office for just 10 minutes and repeating a mantra to myself over and over until my battery was recharged helped me center myself and gave me four more good hours.”

—Charles Boursier, M.D., recently retired ER doctor in East Peoria, IL

Make a List and Check it Twice

“I’m a big list maker—the physical act of making a list, and then checking off something that has to be done is very satisfying. If something happens, it helps to talk it through with my colleagues, going back and forth about what we did right and what we can do differently next time—it really helps release the stress after that moment. I’m also a big fan of ‘This too shall pass. I remind myself that at the end of the day, I get to leave work behind and go home and cuddle my 6-month-old baby.”

—Aarika Pakulski, R.N., Mercy Medical Emergency Department, Baltimore, MD

Lean on Your Team

“I’m usually very talkative, but when I walk into a situation where things are bad, I internally flip that switch and just focus on my team and what we need to do for the patient. Delegation is so important. EMTs do what they need to do, then we do what we need to do, then we get the patient to the hospital and let the doctors take over and do what they need to do.

—Larry Morgenlander, paramedic, NYU Langone Hospitals, NY

Preparation Brings Calm

"Practice is so important—we do mock codes and mock emergency drills, and that helps everyone stay calm when the real thing happens. Even as I'm driving into work, I'm running through different scenarios in my mind—‘What would I do if a child comes in suffering from cardiac arrest?’ or if “What if someone fell down the stairs and hit their head?’ My mentor once said, “Your attitude will end up saving someone’s life one day.” In a stressful situation, people gravitate to the calmest person in the room, so you want to be pragmatic, prepared, and in control of the situation."

—Brian Burrows, M.D., chair and medical director of the Emergency Department at Duke Regional Hospital, Durham, NC

Separate the Noise of Work from the Peace of Home

“I try not to bring work home with me—work is work, and home is home. At work, it’s really loud, there’s always a lot of beeping and yelling, so when I come home, everyone knows it’s my quiet time. It can also feel like a casino in the ER, since there are no windows, so I make sure to get outside, take lots of walks, and get plenty of fresh air when I’m home. When work is really stressful, I use my commute time to calm down by listening to podcasts that have nothing to do with medicine—my favorites are 99% Invisible and Criminal. The storytelling aspect is really relaxing.”

—Samantha Selesny, M.D., ER resident, Jacobi Medical Center, Bronx, NY

You May Also Like: