Can you remain steady in the midst of chaos—whether in the emergency room, on the unit, or in the clinic? There are times in medicine when chaos ensues. Maybe it’s a trauma rushing into the ER. Or a refractory asthmatic coming into the office who rapidly deteriorates, requiring immediate intervention. Maybe it’s a newborn who is floppy and cyanotic after birth.

Regardless of the clinical setting, there are times when the unexpected occurs and chaos results.

How do you navigate the chaos?

Have you trained yourself to remain calm and patient and listen to others as they convey the information you need as you prepare to respond? Or are you the physician ready to react, to jump into action, firing off questions and possibly even orders with frantic energy?

Depending on which one you are, you’re either the calming force the team looks to at the moment, or you’re adding to the stress and anxiety.

Practice medicine long enough, and you’ve probably been both.

When the energy is frenzied and scattered:

• Assumptions are made.
• Communication among team members breaks down.
• Role assignments are blurred, and it is unclear which team member is responsible for what task.
• Policies and procedures that function under normal conditions may be disregarded.
• Team members scramble as patient care is administered.
• Delays occur.

When you’re calm in the chaos of the clinical setting:

• You listen acutely to both verbal language and non-verbal cues.
• You anticipate patient care needs before they declare themselves.
• Communication is clear.
• Team members are proactive and operate in their assigned roles.
• Policies are adhered to.
• Patient care is streamlined.
• Patients and their families recognize the team’s responsiveness.

It’s easy to understand how chaos results during a patient emergency. Adrenaline runs high for everyone involved—the physicians, the nurses, the therapists, and other team members. The fight-or-flight mechanism goes into overdrive as each team member reverts to their default mode of operation.

It takes consistent practice to understand one’s default reaction and determine whether it is effective in chaos or needs to be realigned.

Being OK in the chaos involves these steps:

1. Recognize when you are triggered.
2. Understand your default reaction.
3. Decide on the most effective response to yield the desired outcome for the patient, the team you lead, and yourself.
4. Take the necessary action that aligns with the chosen response.
5. Use a pattern interrupt to restore your energy once the emergency has passed.

Operating from a calm place is not just for the team and the patient; it is also for the physician. When the starting point is calm, not chaos, it takes less time to move back into a place of peace. There is less stress on your mind, body, and soul. Your overall well-being thanks you for choosing calm in the chaos.

Stephanie Wellington is a physician, certified professional coach, and founder of Nurturing MDs, dedicated to guiding physicians from stress and overwhelm to ease and flow in the demanding medical field. She empowers clinicians to infuse new energy into their careers and reconnect with their identities beyond the stethoscope. She can also be reached on Facebook and LinkedIn.

She is a speaker, author, and recipient of the Excellence in Teaching Award. If stress and overwhelm are part of your practice, get started with the free guide: “15 Ways to Infuse New Energy.”