Hospitals Need Dedicated Counselors

Snacks just aren't enough.

I’ve talked with a number of physicians, nurses and others in healthcare recently.

They frequently say that they have significant anxiety, particularly about their own family members.

Working with the sick, injured and dying has always been hard. The profound stress it causes became much more evident when COVID struck and those in EMS, in hospital ERs and in intensive care units saw death on a daily basis.

I have observed, over the years, that many people in these professions seem to enter these fields to try to mitigate their own anxieties about crisis.

A common theme seems to be this: “What will I do if something happens to someone I love?”

Personally, I have struggled with anxiety over the years and I am convinced that this desire to manage crisis, this desire to rescue, was one of several reasons that I went into emergency medicine. I know that I’m not alone. So many people I know rush into the pain, the trouble, as a way to confront and try to overcome their own fears.

As a consequence, many of my colleagues spend an enormous amount of emotional energy in worry. And why not? What we see, whether at the scene of the accident, in the trauma bay, in the intensive care unit, can be shocking and stressful.

And yet we so often try to make it seem like nothing. “Yeah, that was a rough day,” we say. Our husbands or wives, parents or children will ask “what did you see today?” We respond with “oh, nothing different.” And maybe it wasn’t, but it might still have been a thing that would shock the average person.

The world is full of people who take CPR classes; but we do CPR, hundreds of times in a career. The world is full of people who have seen death in movies and on television; but we stand by as the light goes out despite our best efforts. The average person, watching a tragic death in person, takes a day or two off work to recover.

We we return to the “shop”, our dark humor emerges and it’s back to work. Indeed, what other option is there? We create boxes in our hearts and minds to hide the memories, to put them away and try to never open them again; even though they often pop up when we least want them; sometimes when we have another, similar event.

And yet the memory of a floor covered in blood is indelible. The haunting recollection of a mistake, even an honest one, can cause a lifetime of guilt. The sound of a spouse or parent begging us to “do anything” plays on a loop in our minds, often for a lifetime.

Of course it isn’t just pain and death that get to us. It’s also the fact that we see other kinds of suffering. The lonely, the homeless, the psychotic, the addicted, the aged with no hope or options. We try to help them too. But the resources, the finances, the options just aren’t available. It’s a terrible kind of powerlessness for those dedicated to helping others.

It is for this reason that I believe every hospital should have a counselor on staff. Not for the patients (although that’s important as well) but for the employees. A professional should be dedicated to those immersed in pain and suffering. A person dedicated to the mental health of those who struggle with what they see and do, and with the fact that so often their efforts, our efforts, don’t succeed.

Fire and police departments often have chaplains.

Military units have chaplains.

Hospitals should have the same; chaplains or counselors or psychologists to help everyone bear the burden.

Ultimately, chocolate bars or pizza parties are nice, but they don’t help us to cope with the very important and very difficult work of healthcare.

But someone to talk to would be a worthwhile investment in the health, wellness and retention of the excellent professionals who treat the sick and dying every day.