Coping with Stress in Emergency Medicine

First responders, ER physicians and critical care personnel are charged with

rendering urgent aid to patients in need, oftentimes at the risk of putting their

own wellbeing in danger. Furthermore, emergency medicine practitioners face the

daunting task of making split-second, life-or-death decisions. All of these

circumstances contribute to a high degree of stress.

Stress is basically the body’s reaction to changes that require some type of

response. In small doses, stress can motivate and increase a person’s alertness. Too

much stress, on the other hand, can lead to a host of other mental, emotional and

physical issues, including headaches, fatigue, irritability and more.

This is why managing stress is such an important thing for emergency medicine

personnel to master. With the proper coping mechanisms, individuals who work in

high-intensity urgent care positions can keep their stress levels in check and care

for their patients more effectively.

The good news is, there are plenty of ways to deal with stress – before, during and

following an emergency situation. Let’s take a look at a few of those ways below.

Preventing Stress Before an Emergency

Being prepared in advance to deal with the impending stress that comes with an

emergency medical situation can put first responders and critical care practitioners

in a better position for success. Taking coursework such as an online CPR or Basic

Life Support (BLS) course, for example, can strengthen the skills and instill the

confidence necessary to deliver life-saving care in the event of a medical

emergency.

In the case of a first responder, such as a fire fighter or EMT, who is typically

the first person to arrive on the scene of an emergency, gathering as much

information about the incident as possible in the moments leading up to arrival on

the scene can help to alleviate some of the stress. For instance, these details can

help determine the first responder’s role in the emergency as well as what to expect

so critical support can be delivered swiftly and confidently upon arrival.

Finally, emergencies can often cause delays and interfere with other work duties.

Keeping the supervisor abreast of the situation can help to set expectations and

relieve some of the stress the first responder may be experiencing.

Coping with Stress During an Emergency

Medical emergencies can be chaotic scenes. While stress is inevitable, certain

actions can be taken to reduce the levels all around. For instance, when EMTs,

nurses and doctors work together as teams, not only can they speed up and improve

response, but they can also shoulder the burden together, thereby limiting the risk

of secondary traumatic stress and potential burnout during the emergency.

Secondary traumatic stress is the emotional toll caused by another person’s trauma.

It can lead to a number of physical and emotional symptoms, similar to those caused

by stress. Burnout can occur as a result of extreme exhaustion and the feeling of

being overwhelmed by the circumstances happening around you. This can make it

difficult for practitioners to focus, which can place both the patient as well as

the physician in danger. Being able to recognize the signs of these conditions early

can prevent them from escalating.

An emergency medical professional experiencing the signs of secondary traumatic

stress or burnout should step away from the scene and take a break as soon as it’s

feasible. Separating oneself from the chaos of a critical care situation can help

with regaining focus before returning to the scene.

Using a buddy system can also help with stress management during an emergency

situation. For example, if two EMTs work closely together, they can each monitor the

other’s wellbeing and help to recognize and manage the signs of serious stress

throughout the emergency.

Dealing with Stress After an Emergency

Emergency medical personnel do everything within their power to achieve the best

possible outcome for patients in their care. When things don’t go as well as they’d

hoped, “what ifs” and “if onlys” can start to creep in after the fact. Second-

guessing after an emergency can contribute to higher stress levels outside of work.

Here are a few suggestions for how to manage stress following urgent care

situations:

• Keep a journal of your thoughts and feelings.
• Practice relaxation exercises, like deep breathing or meditation.
• Eat a healthy diet.
• Get enough sleep (experts recommend at least 7 hours).
• Exercise regularly. Endorphins help to lower stress.
• Limit caffeine consumption.
• Avoid alcohol.

If you are really struggling with stress management and the tips above aren’t

helping you cope with stress, it may be a good idea to speak with your doctor. He or

she may recommend consulting a mental health professional who can provide additional

support and guidance.

Another, more formal tool for dealing with post-emergency stress is a practice known

as critical incident stress debriefing (CISD). This enables those impacted by an

emergency to share their experiences with a specialized counselor or disaster

recovery expert. CISDs typically take place within a few days of an emergency and

are usually sponsored by a government agency.

During a CISD meeting, participants are encouraged to share details about the

emergency through their own experience, as well as the thoughts, feelings, questions

and concerns they may have as a result of the situation. The specialist(s) running

the group will then offer insight, feedback, tools and other resources to help

participants cope with their symptoms.

Of course, there’s also friends and family who can offer support for those dealing

with post-emergency stress. If a critical caregiver is feeling overwhelmed, talking

through those feelings and emotions with a trusted confidante can do wonders. In

fact, a first responder who shares his or her feelings with a loved one is often

better equipped to deal with and move past stress than those who hold everything

inside.

The fact is, working in emergency medicine isn’t easy. Stress is a very real and

potentially serious side effect that could impact the wellbeing of the practitioner

as well as the outcome for the patient. Knowing how to deal with these feelings of

stress – before, during and following an emergency – can be beneficial for everyone

involved.