Nick Smith excels at managing in a crisis.

It’s a key part of his job as Emergency Department/EMS manager at Kings Daughters Medical Center, and it’s a role he relishes.

“When I came out of high school, I didn’t really know what I wanted to do,” said the Lincoln County native and Brookhaven Academy graduate.

“I went to Co-Lin and three years later, I had my nursing degree,” he said with a laugh.

And, like so many others in emergency medicine, Smith said the first time he worked in an emergency department he knew he was called to this field.

“I really loved the ER,” he said. He transferred into radiology for a while, enjoying the family friendly work schedule. “But when the ER manager job came open, I knew I wanted to do it.”

Since then, his role has grown to include oversight of KDMC’s Emergency Medical Services as well. Today, Smith manages 35 full and part-time employees in the EMS service, which operates two 24hour trucks and one split-shift truck, as well as some 35 full and part-time nursing staff in the emergency department.

The  Emergency Medical team works emergency transport calls, dispatched through the sheriff’s department, as well as non-emergency transfers.

Patients range in age from one infants to senior citizens, Smith said, adding to the scope of experience needed in emergency medicine.

“When you come out of nursing school,  you are prepared from a classroom perspective” Smith said. “I mean, you know what you learned in school, and you have some experience from that, but you don’t know what it’s like until you’ve really had the experience of working in the emergency room …

“You have to be able to think fast and think outside the box. You have to be able to think critically and remain calm and stay focused, especially during stressful circumstances.”

Those normally stressful circumstances were heightened exponentially during the COVID-19 pandemic, when Smith described the work of EMS first responders as “ challenging.”

“They never knew what they were going to find when they got there,” he said.

That willingness to face the unknowns is often underappreciated.

“It’s a big sacrifice, what these people do, especially in EMS,” Smith said. “They are the true frontline folks, going into the community. Often, they don’t know what they’re rolling into or what will greet them on the other side of the door.”