A paramedic’s guide to learning to thrive under pressure

High-stakes situations are unavoidable in life. Paramedic Leigh Anderson has developed a framework to help people thrive under pressure.

In 15 years working as a paramedic, Leigh Anderson has had to navigate countless confronting situations.

While no two days are the same, managing multi-patient trauma incidents, cardiac resuscitations, or having to respond to life-threatening call outs alone can all be part of the routine experience.

“You have to make quick decisions,” Leigh says.

“There’s no time to stand around for debate.”

Why we need to perform under pressure

While most people are not dealing with emergencies on a day-to-day basis, Leigh, a podcast host and author of The Paramedic Mindset, believes the skills he uses to stay composed in unpredictable environments can help people from all walks of life learn to thrive when the heat is on.

“We all feel pressure if the outcome of what we’re doing matters to us and time is limited,” Leigh says.

“So it could be preparing for an exam or job interview or a big project at work.

“But the thing about pressure is it can overload our prefrontal cortex (or working memory) and it becomes so full of fear, doubt and failure that we’re not able to access all the information or knowledge we’ve trained for in the moment.”

The power of poise

To help people counteract this overload, Leigh has developed a systemic framework to stay cool under pressure, a skill he refers to as poise.

“Poise is about having self-composure and self-assurance under stress,” he says.

“It’s about staying true to yourself, being courageous and being able to hold fast in the face of adversity – and I think we all need poise in our life because we’re all going to face stress.”

Leigh says being able to remain poised through intense situations is not an innate trait, but something that can be developed through preparation and practice.

“I call it ‘mastery of skills’,” he says.

“It’s where you train a skill until it becomes almost unconscious competence and you can complete it with minimal to no thought – like when you learn to drive a car.”

How to keep a cool head in a hot situation

Leigh has a “toolkit” of techniques to help keep a clear head under pressure.

The first is to shift your perception of stressful situations.

“I talk about seeing stressful events as a challenge, rather than a threat,” he says.

“If you see it as a threat, you’re going to run and hide and not take action.

“Whereas if you see the same event as a challenge, you’ll feel like you have the resources to take it on.”

Listen to Leigh Anderson’s top tips for developing a paramedic mindset on The House of Wellness Radio show:

Six techniques to develop poise under pressure

1. Temporal distancing

This is positive self-talk in the third person.

“This puts a distance between you and what you’re trying to achieve,” Leigh says.

“It’s like giving advice to a friend.

2. Verbal persuasion

“Positive talk or feedback from other people can be really empowering,” says Leigh.

3. Cognitive pause

This involves literally stepping back from the situation and shutting your eyes for at least 30 seconds to give yourself time to think and assess, then coming back.

4. Cognitive offloading

Delegating tasks or using checklists to work through the situation.

5. Talking

Stepping through your processes out loud helps to free up your cognitive bandwidth as well as let others around you know what you’re doing, says Leigh.

6. Breathwork

Techniques such as box breathing slow your breathing down, which will slow your heart rate, and increase vagus nerve activity, which is associated with better decision-making.