Ambulance UK August 2022

FEATURE
Take a breath
References
Arnsten, A. F. (2009). Stress signalling pathways that impair prefrontal
cortex structure and function. Nature reviews. Neuroscience, 10(6),
410–422. https:// doi.org/10.1038/nrn2648.
Bradshaw, P. (2019) Good communication reduces risk of a complaint
or claim. BMJ 2019;367:l6160.
Briñol, P., Petty, R., and Wagner, B. (2009). Body posture effects on
self-evaluation: A self-validation approach. European Journal of Social
Psychology. 39. 1053 - 1064. 10.1002/ejsp.607. British Medical
Association, (2021) Medical staffi ng in England report. Available at
(Accessed 4th January 2022).
Emergency medicine is amongst the most stressful, challenging, and
demanding specialities within healthcare. It’s faced paced, dynamic with
life and death responsibilities bestowed upon clinicians who are often
working long, unsocial, and mentally taxing shifts. Handovers, especially
pre-alerts, within this department often involve individuals wanting lots of
information from you in a short space of time and expect you to deliver it
clearly, accurately, and concisely.
However, when placed under conditions of stress, the brain’s primal fi ght
or fl ight center (amygdala) activates and suppresses the brain’s thinking
center (neocortex) meaning that it is very diffi cult to think logically when
you’re stressed (Arnsten, 2009). This explains ‘exam phenomenon’
where individuals can easily recall knowledge outside of an assessment
setting, but once placed under stress (exam conditions) they can
become unable to think, act and perform.
In order to combat this, experts recommend engaging in box breathing.
Box breathing, or deep breathing exercises, have been proven to
stimulate your parasympathetic nervous system and calm your
amygdala (Ma et al, 2017). By doing so, it allows your neocortex to
reestablish dominance and provide you with the ability to think clearly
(Ma et al, 2017). So, when you arrive at hospital, start deep breathing
so that by the time you are ready to deliver your handover you are calm,
confi dent, and focused.
Hereen, A., Ceschi, G., Valentiner, D.P., Dethier, V., and Philippot,
P. (2013) Assessing public speaking fear with the short form of the
Personal Report of Confi dence as a Speaker scale: confi rmatory factor
analyses among a Frenchspeaking community sample. Neuropsychiatr
Dis Treat. 2013;9:609-618.
Loseby, J. (2013) Clinical handover of the trauma and medical patent: a
structured approach. Journal of Paramedic Practice.
Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei,
G. X., and Li, Y. F. (2017). The Effect of Diaphragmatic Breathing on
Attention, Negative Affect and Stress in Healthy Adults. Frontiers in
psychology, 8, 874. https://doi. org/10.3389/fpsyg.2017.00874.
Manias, E., Geddes, F., Watson, B., Jones, D., and Della, P. (2015)
Communication failures during clinical handovers lead to a poor patient
outcome: Lessons from a case report. SAGE Open Med Case Rep.
3:2050313X15584859.
Marie Curie. (2016) A long and winding road. Improving communication
with patients in the NHS. Available at (Accessed 3rd January 2022).
Nair, S., Sagar, M., Sollers, J., 3rd, Consedine, N., and Broadbent, E.
(2015) Do slumped and upright postures affect stress responses? A
randomized trial. Health Psychol. 2015 Jun;34(6):632-41. doi: 10.1037/
hea0000146. Epub 2014 Sep 15. PMID: 25222091. National Health
Service. (2018) Overview - Generalised anxiety disorder in adults.
Available at (Accessed 4th January 2022).
AMBULANCE UK - AUGUST
National Health Service. (2021) Agenda for change - pay rates. Available
at (Accessed 3rd January 2022).
National Health Service. (2020) Social anxiety (social phobia). Available
at (Accessed 4th January 2022).
Offi ce for National Statistics. (2020). Personal and economic wellbeing in
Great Britain. Available at (Accessed 4th January 2022).
Taylor, M. (2020). Why is there a shortage of doctors in the UK? The
Bulletin of the Royal College of Surgeons of England. 102. 78-81.
10.1308/rcsbull.2020.78.
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For further recruitment vacancies visit: www.ambulanceukonline.com