Exam Day Advice
Situational Exercises – Unravelling the Mystery of Mental Shutdown
So many of us Lifeguards have well developed skills, fitness levels, and can spout emergency guideline theory like a well seasoned pro, and yet once in a simulated situation (sit), it just doesn’t go as smooth as expected. Why do otherwise competent guards forget the basics such as an all important pool clear, or EMS activation? Why do they work with their backs to the pool? Why do majors and minors become confusing? Commonly, Lifeguards, who are known for their social interaction with their peers, clam up during a situational exercise knowing full well that communication is the key to success in any real emergency. Why is this?
The following points should help all lifeguards get through their situational exercises, and more importantly gain the intended benefit – practicing for the real thing.
Practised Stress - Perspective Realignment
One of the purposes of the final exam is to prepare the candidate for an actual emergency. If the candidate is able to overcome the stress of an exam, they are more likely to prevail during a real emergency. It's a valuable and necessary experience.
Once in situation, ask yourself “What would I really do if this were actually happening?”
Often Lifeguards try to figure out what the examiner or coach wants to see, and this is actually a hindrance. There are generally many correct approaches to every situation; go for the first one that works for you and your team. Remember too, the examiner is only holding you to the established standard (Must Sees).
Guideline theory only highlights commonalities from past events and offers key steps that should occur. Real events have a high degree of chaos, and the Lifeguards often do not have complete control. Real events do not play out like a script or choreography; Lifeguards need to be able to adapt as best as possible including having the event play out in a different order than presented on paper. Guideline theory should only be used as a framework for the Lifeguard to follow.
It also comes down to understanding “majors” and “minors’. Everyone reads more into this than necessary. Minor = one guard can handle the situation. Major = 2 or more guards required. That’s it! Nothing more. Most candidates attach an urgency to the definition. No! No! No! Again: Minor = one guard can handle the situation. Major = 2 or more guards required. In theory, angina could be handled by one guard; it’s a minor. Yikes! Isn’t angina serious? Yes, it could be an M.I. But how many guards do we need? One – if they can handle it. Does the patient respond to meds? Are they relatively stable? And so on.
What this means is how the team responds to various situations. If you have, for example, two guards on deck, one on break, and a guard calls for assistance, does the third guard take over the guarding or assist? If this guard takes over the guarding, it’s a minor. If the third guard assists, it’s a major. If the pool no longer has sufficient coverage – clear the pool. It is that simple.
Remember as well, that guards don't necessarily show up in tandem or one at a time. Two may respond at the start and then are joined by more guards; perhaps the entire team responses together. This means the team needs to define each role quickly.
When responding to a situation ask yourself, "Is this a major or a minor?" Then handle it as such.
Remember that situations are judgment skills exercises. You are in fact problem-solving. This means that it is perfectly acceptable to adapt and take advantage of the circumstances as they unfold.
A good example: Two Lifeguards have just removed an unconscious patient from the water. A third Lifeguard appears with their gloves on and a CPR shield at the ready. Who takes over the patient’s head (vitals)? Obviously the guard that is ready to make any necessary contact with the patient - the one with the gloves and mask.
Other examples may be removing a spinal injured patient from the water first and then calling EMS because you only have two guards or the patient is large and all three guards are required immediately. You may opt to have 2 guards remove the spinal while a 3rd guard controls the deck. So really… there are many good approaches. THINK!
Real Versus Simulation
Real situations have real signals; the blood and pain are real, the injury or illness actually occurred. Situational exercises, no matter how elaborately set up, lack information. So...
ASK RELEVANT QUESTIONS DURING THE SITUATION!
- “I’m approaching the scene, donning gloves, what do I see?”
- “Is there danger present, is there evidence of trauma suggesting serious injury?”
- “I’m looking at the patient, what do I see?”
- “I’m checking for responsiveness, are they responsive?”
- “I’m checking for breathing, are they breathing? I have a mask if necessary.”
- “I’m giving two breaths, do they go in?”
- “I’m checking for signs of circulation, are there signs?”
- “I’m doing a rapid body inspection for deadly bleeds and emergency medical indicators. What do I find?”
- “I’ve positioned the patient according to their condition and placed a blanket on them. I’m monitoring vitals; are vitals still present?”
State What You Are Thinking and What You Are Doing
- “I see no obvious danger, I am approaching the scene.”
- “This patient is talking. Therefore, they are conscious with an open airway, breathing, and have circulation.”
- “I have checked this patient from head to toe and found no injuries or medical tags.”
Talk to your team mates, and listen to your team mates. This includes speaking up if a team mate is doing something wrong or needs help. Frame criticisms in the form of a request. "The chest strap is next!" The more you communicate with each other, the better the situation will flow. The best analogy is:
- The team is working on a group project.
- Everyone contributes to the project through discussion and doing their part.
- The rescue leader or team leader makes the final decisions.
Delegate and look or ask for things to do. Successful rescues are a team effort. If your trying to do everything yourself, you’re going to be over-tasked and prone to error. If you’re just standing there waiting for direction, you’re useless; look for the obvious priority task that requires attention and then do it! State everything you’re doing to the team or team leader.
Actually perform the skills, where practical, as opposed to just stating them.
Keep an eye on each other during your scanning. If a team mate looks tied up for more that 10 seconds - check it out.
Be aware of what is going on around you at all times. Lifeguards often develop a tunnel-vision like mentality during a situation, focusing only on what is in front of them and tuning out everything else. While it is important to focus on the patient, the lifeguard must also filter out important information that is occurring during the emergency. This includes cueing to the two-way radios, reports or requests from team mates, public address announcements, crowd control problems, unsafe conditions, tasks that require attention, poor performance from another Lifeguard, etc.
Keep it SIMPLE! ABCs are always the priority. Don’t read more into the situation than you need to. Often Lifeguards assume the situation is going to be far more complicated that it really is.
Example: a kid has been at the pool all day and his eyes are red and sore. Is it a massive chlorine leak or has the kid been at the pool all day, his eyes have had it, and he should bring goggles next time?
An old medical adage states: "Don’t look for zebras in your back yard". Simple does not mean shallow; pay attention to obvious details.
If you make a mistake, fix it just as you would in an actual emergency. Don't beat yourself up and shut down; there is probably a solution - make it work. Avoid maximizing your errors; they are generally not as big as you think. Avoid minimizing your good performance; give yourself and your team mates credit where it is due.
Final tip: the situations during an NLS exam may not be real, but the exam is very real; make it your reality.Top of Page