The Role of a Registered Nurse in an MCI (Mass Casualty Incident)

Answer

The Role of a Registered Nurse in an MCI (Mass Casualty Incident)

            In this essay, I do reflect on my thoughts, strengths and weaknesses, and my leadership skills in management of victims of a shooting incident using the principles of triage in a Mass Casualty Incident (MCI) to prioritize patient care. MCI in question involves a shooting incident in Las Vegas that occurred on Oct 02, 2017 when Jason Aldean was performing on the stage. A gunman opened fire, injuring more than 400 people and killing more than 50 people (Akiyoshi, 2017).  The goal of triage in management of a MCI is to save lives and enable rapid restoration of normality after occurrence of an event. Initial priorities to save lives, relieve suffering, and avoid escalation of the incident.  The aim is to ensure that right patients are placed at the right place at the right time (Lowes & Cosgrove, 2016). University Medical Center in Las Vegas received more than 100 victims from the shooting incident and used triage principles to determine urgency of health care needs of various patients. The hospital categorized patients as those who were in critical condition, those who were in need to immediate surgical intervention, and those who were in need of pain management (USA Today, 2017). In the managing the incident, I could have triaged victims by first assessing them for catastrophic hemorrhage, then by assess the severity of the bullet wound injuries, walking or not, airway open or not, unconscious or conscious, respiratory rate, and lastly by assessing patient’s circulation (Lowes & Cosgrove, 2016). Patients who were seriously bleeding, unconscious,   reduced or high respiratory rate, and reduced circulation efficacy will be considered as a matter of priority for immediate care.

            In self-assessment and personal reflection, I have identified certain personal strengths and weakness when working in an emergency department or a busy clinical setting. Some situations may demand for multitasking, fast-paced decision-making, and the ability to work effectively with other staff.

My strengths include the knowledge and ability to utilize principles of triage to set priorities of care for each and every patient, communicate effectively with colleagues and the patient/family, take command and control of a situation, assess safety of a scene, take vital signs within a short period of time, and collaborate with others. However, I have noted some personal weaknesses that require improvement in order to enable me to be an effective Registered Nurse in handling of MCIs. The first weakness is that I do get sympathetic to patients who are complaining of severe pain and this may make me to forego or ignore the immediate healthcare needs of other patients such as those with respiratory obstructions or unconscious ones who may be in need to more immediate healthcare intervention compared to those who are complaining of patient. In addition, I have a tendency to be emotionally drowned and saddened by the sight of the death in a given mass incident situation rather than focusing on saving the lives of victims whose lives are hanging on the line. I should focus my energy, efforts, and services towards the living but in need of immediate or urgent care before serving patients whose care needs may be delayed.

            My leadership skills that may improve my ability to lead and manage victims of a MCI include collaborative and communication skills. Collaborating with other in emergency situations leads to making of shared decision, shared goals of care, and improved healthcare outcomes (Ignatavicius, Workman, & Rebar, 2018). In addition, I have to be empathic rather than sympathetic so as to be objective in my action and approaches in managing mass casualty situations and to ensure patients are served based on urgency of their healthcare needs. In addition, I should improve my ability to manage limited resources in an emergency situation since Olchin and Krutz (2012) states that a mass casualty event can increase demand for medical resources and care.