unquestionably there is PTSD in Emergency medicine. From having a minor panic attack walking into a shift seeing 8 ambulances in the trauma bay and knowing your night will be hell, to taking care of SIDS and the tears of the family, and on and on...learning to cope is a ongoing thing you have to do or you have to get out
Yeah, I always feel miserable when I come in and see a full ambulance bay, several police cars, and the first nurse I see says 'you should just leave.' Great idea, except I can't! That really ads to my stress level. I think we discount the PTSD component but this is a highly stressful job. A friend was a former Army airborne trooper and sniper, turned ED nurse. He says ED nurse is far and away the most stressful thing he has ever done. That's telling. Great to hear from you!
As a retired healthcare worker, I can attest the collection of trauma and terror we experience while helping the sick and injured has an impact that never leaves us. Sometimes I wish I didn’t know what I know from years, decades actually, of the difficulties people endure when they come to us for help.
I am a current RN in an Emergency Department. I was first an EMT in 1979, then again in 1987 to 1990. I was a paratrooper, a combat infantryman from 1983 to 1987. I became an RN in 1990, and I have been an Emergency Department RN for 32 years now, from 1992 to 2024. I am tired, depressed, and hurting, but I can't see myself leaving this Emergency Department anytime soon because there is a hiring freeze in my organization, and a nursing shortage. I only hope that when I retire, there will be enough healthcare professionals to take care of me and my family. Unfortantly, I despair because I don't think there will be.
I am retired after practicing Emergency Medicine for 30 years. It took 5-10 years for me to forget the stress & anxiety. PTSD? Burnout? Call it what you will. I will never watch a Medical show on TV. I survived. 😊
Thanks, Ed, for writing so eloquently about this. I agree with you. It’s a good way of describing the psychic injury of witnessing bad things happening to people day after day, year after year, and often being powerless to truly fix the situation. When those bad things are preventable, psychic injury is accompanied by moral injury, and that adds up too. I really appreciate your writing.
You don’t always realize how much pain you have consumed until after you have moved on, for whatever reason. I left the ED/UrgentCare after 10 years for my own well-being, went to hospice. Some would say that might be a more painful place to be. But death is expected here and we did our best to make it a comfortable passing. I am retired now. People ask me if I miss work. Without hesitation I say, no. I miss some of my coworkers and some of my patients, however.
"And to admit the emotional consequences seems a little soft, doesn't it?"
This hyper-stoicism, a value inculcated during "basic training" (aka residency) of all physicians, is one of 5 vectors of the "burnout" epidemic. Some physicians, when they decide they can't "just take it" anymore, feel such shame that they contemplate suicide. Some execute that desperate solution to their sense of failure to live up to their professional ego-ideal.
Ed…great piece. And thank you. We all need to learn it’s ok to not be ok. I wrote about not being ok in Annals of EM this summer and shared it here on substack (see link below). I had some really intrusive PTSD stuff a couple years back. It was unexpected and perspective-changing. I think it’s so important that we share our stories and hold space for each other to be real and vulnerable. Loved what you shared, Ed. Thanks again.
Ed, I hate to nitpick someone who is such a good and important writer on topics of great impact to our specialty, and careers, but… When you use a comparative, followed by a pronoun, the better usage is the subject form, as there is often an unspoken form of the verb “to be” as in, “You are better than I (am)”, rather than “You are better than me (am).” Also, an apostrophe after a word should indicate possession, not plurality, so “The PAs are usually well equipped, so I borrowed one of the PA’s percussion hammers.”
Thanks for the services you provide in articulation of the soul of medicine.
unquestionably there is PTSD in Emergency medicine. From having a minor panic attack walking into a shift seeing 8 ambulances in the trauma bay and knowing your night will be hell, to taking care of SIDS and the tears of the family, and on and on...learning to cope is a ongoing thing you have to do or you have to get out
Yeah, I always feel miserable when I come in and see a full ambulance bay, several police cars, and the first nurse I see says 'you should just leave.' Great idea, except I can't! That really ads to my stress level. I think we discount the PTSD component but this is a highly stressful job. A friend was a former Army airborne trooper and sniper, turned ED nurse. He says ED nurse is far and away the most stressful thing he has ever done. That's telling. Great to hear from you!
As a retired healthcare worker, I can attest the collection of trauma and terror we experience while helping the sick and injured has an impact that never leaves us. Sometimes I wish I didn’t know what I know from years, decades actually, of the difficulties people endure when they come to us for help.
Thanks for your writings!
Some things seen can't be unseen…
I am a current RN in an Emergency Department. I was first an EMT in 1979, then again in 1987 to 1990. I was a paratrooper, a combat infantryman from 1983 to 1987. I became an RN in 1990, and I have been an Emergency Department RN for 32 years now, from 1992 to 2024. I am tired, depressed, and hurting, but I can't see myself leaving this Emergency Department anytime soon because there is a hiring freeze in my organization, and a nursing shortage. I only hope that when I retire, there will be enough healthcare professionals to take care of me and my family. Unfortantly, I despair because I don't think there will be.
Oh man did I need to read this today! Writing through tears...
I am retired after practicing Emergency Medicine for 30 years. It took 5-10 years for me to forget the stress & anxiety. PTSD? Burnout? Call it what you will. I will never watch a Medical show on TV. I survived. 😊
Thanks, Ed, for writing so eloquently about this. I agree with you. It’s a good way of describing the psychic injury of witnessing bad things happening to people day after day, year after year, and often being powerless to truly fix the situation. When those bad things are preventable, psychic injury is accompanied by moral injury, and that adds up too. I really appreciate your writing.
You don’t always realize how much pain you have consumed until after you have moved on, for whatever reason. I left the ED/UrgentCare after 10 years for my own well-being, went to hospice. Some would say that might be a more painful place to be. But death is expected here and we did our best to make it a comfortable passing. I am retired now. People ask me if I miss work. Without hesitation I say, no. I miss some of my coworkers and some of my patients, however.
"And to admit the emotional consequences seems a little soft, doesn't it?"
This hyper-stoicism, a value inculcated during "basic training" (aka residency) of all physicians, is one of 5 vectors of the "burnout" epidemic. Some physicians, when they decide they can't "just take it" anymore, feel such shame that they contemplate suicide. Some execute that desperate solution to their sense of failure to live up to their professional ego-ideal.
https://bairdbrightman.substack.com/p/national-physician-suicide-awareness
Ed…great piece. And thank you. We all need to learn it’s ok to not be ok. I wrote about not being ok in Annals of EM this summer and shared it here on substack (see link below). I had some really intrusive PTSD stuff a couple years back. It was unexpected and perspective-changing. I think it’s so important that we share our stories and hold space for each other to be real and vulnerable. Loved what you shared, Ed. Thanks again.
https://open.substack.com/pub/tylerjorgensen/p/looking-downriver?r=1d3ejy&utm_medium=ios
Rings true.
We are not shielded observers.
Thanks for articulating…I may share this with others.
Ed, I hate to nitpick someone who is such a good and important writer on topics of great impact to our specialty, and careers, but… When you use a comparative, followed by a pronoun, the better usage is the subject form, as there is often an unspoken form of the verb “to be” as in, “You are better than I (am)”, rather than “You are better than me (am).” Also, an apostrophe after a word should indicate possession, not plurality, so “The PAs are usually well equipped, so I borrowed one of the PA’s percussion hammers.”
Thanks for the services you provide in articulation of the soul of medicine.
I say "Pick those nits" Michael! If we're going to write, we should write good (see what I did there?! :)
I ain’t got no complains about no regionalism, iffn that’s what yore fixing’ to do.