Major incident: a front line, on-scene personal account by a nurse observer

As a newly appointed junior staff nurse in a city Accident & Emergency (A & E) department, the author took part in an orientation programme which included joining a paramedic crew for a 12-hour shift as a nurse observer. During this shift the crew and observer were involved in a major incident, when a coach carrying a party of pensioners overturned into a water-filled culvert, with a loss of 13 lives. This paper offers a personal reflection on the holistic application of multidisciplinary teamwork, so often rehearsed but, thankfully, rarely required. Over 1 year later these reflections may serve as a respectful reminder of the decreased, and through that, an appreciation of the arduous tasks faced by emergency workers both front-line and within the A & E department. Also discussed is the need for access and the opportunity for counselling if required, thereby possibly averting the development of Post Traumatic Stress Disorder, or at least recognising its early stages and beginning to work with it.