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This reflection will use Driscoll’s model of reflection (Driscoll, 2007). What? Whilst on shift today I was asked to accompany a staff nurse to the CT department with her patient. The patient had been involved in an RTC and sustained bilateral tibia and fibula fractures and had deteriorated on the night shift. Before taking her to CT myself and the staff nurse gathered equipment to ensure safe transfer of the patient- portable oxygen cylinder, pulse oximetry monitor and the patient’s medical notes. Once down in CT and settled on the trolley, the radiographer asked myself and the nurse to leave the room due to radiation. Once outside and the CT began, myself and the nurse began to talk and made the decision that she would wear a lead jacket to enable her to be in the CT scanner with the patient and therefore able to monitor her condition and oxygen saturations. A few minutes later, a member of the radiographer team came out and requested a crash call be put out. The HCA with us went to do this and I checked with the nurse if she needed the resus trolley and bought this into the room. So What? The patient’s oxygen saturations had dropped to 30% and so the nurse began to use a bag valve mask (BVM) to ventilate the patient. When available we then commenced the patient on 15L of oxygen via a non-rebreath mask as per the guidelines from paediatric advanced life support [ CITATION Res15 \l 2057 ] At this time I was unsure what to do as we are told as students we are just to observe. However, wanting to help I decided to go and wait for the crash team to arrive in the department and direct them to the room. Once all members of the crash team had arrived I stood and observed. An observation machine was requested so I went across to A&E to get this. The senior sister in A&E was very reluctant to let me use one and made this clear in her communication with me, however eventually allowed me to take one. On return to CT I attached the blood pressure cuff to the patient and did a set of observations. With so many people in the room it was difficult to understand what was happening and the decisions being made. The ICU nurse disagreed with what the consultant wanted the course of action to be and made this clear to the rest of the crash team. In teams, effective leadership is required for them to have a clear sense of purpose of direction, and we all have leadership abilities within us, with the ICU nurse clearly wanting to take leadership in this situation (Crow & Keenan, 2016). However, it is important to recognise that in order to successfully care for patients we need strong and effective teams, encouraging leadership from all team members (Engleberg & Wynn, 2013). Ketamine was given to the patient to minimise pain and to have a sedative effect so we could transfer her from the trolley back to the bed. Once in the MRI anaesthetic room to stabilise the patient, I continued to do obs at 5 minute intervals and documenting this on the PEWs chart. Whilst doing this I was able to observe what the rest of the MDT were doing and discussing. Once stabilised, we took the patient up to the high dependency unit for close monitoring and advanced nursing care. This experience has highlighted the importance of teamwork and communication in nursing and the care of the child in a medical emergency. Being able to observe and get involved allowed me to understand the process of a crash call and apply theory to practice. For example, I was able to see the application of the ABCDE approach in practice. This approach is used for all deteriorating and critically ill patients and involves assessing in the following steps; Airway, Breathing, Circulation, Disability and Exposure (Resuscitation Council UK, 2020). Now What? This experience has allowed me to digest the process of an emergency situation with a child. Along with understanding the importance of communication and teamwork in this situation, it has allowed me to experience first hand what they present as. This has been an invaluable experience for the future as I become a qualified nurse and will need to know how to deal with similar situations myself. I was able to see from the nurse perspective how to react in the situation by observing the staff nurse I was working with, who dealth with it well. Therefore, showing me the importance of remaining calm and collected in emergency situations such as this one.

References Crow, J., & Keenan, I. (2016). Working in teams. In M. Northrop, J. Crow, & S. Kraszewski, Studying for a Foundation Degree in Health (pp. 104-105). Oxon: Routledge. Driscoll, J. (2007). Practising Clinical Supervision: A reflective approach for healthcare professionals. Edinburgh: Balliere Tindall. Engleberg, I. N., & Wynn, D. R. (2013). Think Communication. London: Pearson. Resuscitation Council UK. (2015). Paediatric advanced life support. Retrieved March 2020, from Resuscitation Council UK: https://www.resus.org.uk/resuscitation-guidelines/paediatric-advanced-life-support/ Resuscitation Council UK. (2020). The ABCDE approach. Retrieved March 2020, from Resuscitation Council UK: https://www.resus.org.uk/resuscitation-guidelines/abcde-approach/...