I sometimes see men and women who come to the emergency department and tell me about their PTSD, caused by service in Iraq or Afghanistan. I believe some of them; others I doubt, since their PTSD seems directly connected to a desire for Percocet, Lortab, MS-Contin or other prescriptions for back pain. Sadly, the VA system does not lend itself to inquiry by outside physicians, so in many instances I am treating them in an information vacuum.
However, as I contemplate their allegations of PTSD, I wonder how many physicians and nurses from emergency departments have the disorder. I’m no psychiatrist, but it just seems probable that the years of cummulative stress, the years of sleeplessness and snap decisions, the untold shifts filled with unpredictable chaos, pain, threats, death and anxiety would add up to significant emotional turmoil for providers who work in that environment.
It is appropriate that we are attentive to the needs of those who serve in combat zones. And yet, they may spend only spend one or two years there. Granted, that can be terrible enough.
But we must begin to pay attention to the emotional toll of work in America’s trauma centers and emergency departments. The pay may be better than combat pay, but the fear, the uncertainty, the gut-wrenching pain of watching loss and grief, the struggle to make life-altering decisions, are all as real as those of any battle ever fought.
We may be different kinds of veterans, draped in scrubs not camo, but our struggles, and our pain, also have consequences.
Amen Ed, I ran into a fellow entrenched colleague at BiLo and she related to elements of you article as we all do. The interesting thing was even though the specialty was a little different. The same acute pains were mutual. To twist Othello “Be ware of medicine my Lord, it is the green eyed monster that doth mock the meat it feeds on”
mem
13 years ago
Please do not forget the staff working in Psych ERs. I worked many years of ER and a total of about 5 years managing and working in County Psych ERs. I am newly retired after nearly 30 years of nursing (RN) and among my dear friends and colleagues count too many with substantial injuries and what is really PTSD from many, many years of very high risk, high intensity work. There are also too many who fall to substance abuse issues over time. The last time I looked, the American Assoc. of ER nurses estimated between 8% and about 24%… Read more »
SarkMD
13 years ago
Edwin, As you and your readers have noted, there are many places and situations in medicine that can cause stress and burnout amongst we who work there. One of obvious sources of stress is workplace violence. The US government reports that there were 69 homicides against healthcare workers between 1996 and 2000. Of course most of the violence is non-fatal, but serious nonetheless. Psychiatric intake has higher rates than the ER, which has higher rates than the OR or the floors. Nurses are victims more than docs, due to being on the front lines more than we are. We don’t… Read more »
Matt W.
13 years ago
Dr. Leap,
Great article. This made me wonder of those Doctors who are also enlisted in our military. Combining combat with the experiences of emergency medicine-talk about PTSD!
I have been browsing on-line more than three hours as of late, but I by no means found any attention-grabbing article like yours. It’s lovely price enough for me. Personally, if all webmasters and bloggers made just right content material as you probably did, the net might be a lot more helpful than ever before.
{"id":null,"mode":"form","open_style":"in_place","currency_code":"USD","currency_symbol":"$","currency_type":"decimal","blank_flag_url":"https:\/\/edwinleap.com\/wp-content\/plugins\/tip-jar-wp\/\/assets\/images\/flags\/blank.gif","flag_sprite_url":"https:\/\/edwinleap.com\/wp-content\/plugins\/tip-jar-wp\/\/assets\/images\/flags\/flags.png","default_amount":100,"top_media_type":"none","featured_image_url":false,"featured_embed":"","header_media":null,"file_download_attachment_data":null,"recurring_options_enabled":true,"recurring_options":{"never":{"selected":true,"after_output":"One time only"},"weekly":{"selected":false,"after_output":"Every week"},"monthly":{"selected":false,"after_output":"Every month"},"yearly":{"selected":false,"after_output":"Every year"}},"strings":{"current_user_email":"","current_user_name":"","link_text":"Leave a tip","complete_payment_button_error_text":"Check info and try again","payment_verb":"Pay","payment_request_label":"EdwinLeap.com","form_has_an_error":"Please check and fix the errors above","general_server_error":"Something isn't working right at the moment. Please try again.","form_title":"EdwinLeap.com","form_subtitle":"If you enjoy the content you read here, please consider dropping something in the tip jar!","currency_search_text":"Country or Currency here","other_payment_option":"Other payment option","manage_payments_button_text":"Manage your payments","thank_you_message":"Thank you so much! I appreciate the tip!","payment_confirmation_title":"EdwinLeap.com","receipt_title":"Your Receipt","print_receipt":"Print Receipt","email_receipt":"Email Receipt","email_receipt_sending":"Sending receipt...","email_receipt_success":"Email receipt successfully sent","email_receipt_failed":"Email receipt failed to send. Please try again.","receipt_payee":"Paid to","receipt_statement_descriptor":"This will show up on your statement as","receipt_date":"Date","receipt_transaction_id":"Transaction ID","receipt_transaction_amount":"Amount","refund_payer":"Refund from","login":"Log in to manage your payments","manage_payments":"Manage Payments","transactions_title":"Your Transactions","transaction_title":"Transaction Receipt","transaction_period":"Plan Period","arrangements_title":"Your Plans","arrangement_title":"Manage Plan","arrangement_details":"Plan Details","arrangement_id_title":"Plan ID","arrangement_payment_method_title":"Payment Method","arrangement_amount_title":"Plan Amount","arrangement_renewal_title":"Next renewal date","arrangement_action_cancel":"Cancel Plan","arrangement_action_cant_cancel":"Cancelling is currently not available.","arrangement_action_cancel_double":"Are you sure you'd like to cancel?","arrangement_cancelling":"Cancelling Plan...","arrangement_cancelled":"Plan Cancelled","arrangement_failed_to_cancel":"Failed to cancel plan","back_to_plans":"\u2190 Back to Plans","update_payment_method_verb":"Update","sca_auth_description":"Your have a pending renewal payment which requires authorization.","sca_auth_verb":"Authorize renewal payment","sca_authing_verb":"Authorizing payment","sca_authed_verb":"Payment successfully authorized!","sca_auth_failed":"Unable to authorize! Please try again.","login_button_text":"Log in","login_form_has_an_error":"Please check and fix the errors above","uppercase_search":"Search","lowercase_search":"search","uppercase_page":"Page","lowercase_page":"page","uppercase_items":"Items","lowercase_items":"items","uppercase_per":"Per","lowercase_per":"per","uppercase_of":"Of","lowercase_of":"of","back":"Back to plans","zip_code_placeholder":"Zip\/Postal Code","download_file_button_text":"Download File","input_field_instructions":{"tip_amount":{"placeholder_text":"How much would you like to tip?","initial":{"instruction_type":"normal","instruction_message":"How much would you like to tip? Choose any currency."},"empty":{"instruction_type":"error","instruction_message":"How much would you like to tip? Choose any currency."},"invalid_curency":{"instruction_type":"error","instruction_message":"Please choose a valid currency."}},"recurring":{"placeholder_text":"Recurring","initial":{"instruction_type":"normal","instruction_message":"How often would you like to give this?"},"success":{"instruction_type":"success","instruction_message":"How often would you like to give this?"},"empty":{"instruction_type":"error","instruction_message":"How often would you like to give this?"}},"name":{"placeholder_text":"Name on Credit Card","initial":{"instruction_type":"normal","instruction_message":"Enter the name on your card."},"success":{"instruction_type":"success","instruction_message":"Enter the name on your card."},"empty":{"instruction_type":"error","instruction_message":"Please enter the name on your card."}},"privacy_policy":{"terms_title":"Terms and conditions","terms_body":null,"terms_show_text":"View Terms","terms_hide_text":"Hide Terms","initial":{"instruction_type":"normal","instruction_message":"I agree to the terms."},"unchecked":{"instruction_type":"error","instruction_message":"Please agree to the terms."},"checked":{"instruction_type":"success","instruction_message":"I agree to the terms."}},"email":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email address"},"success":{"instruction_type":"success","instruction_message":"Enter your email address"},"blank":{"instruction_type":"error","instruction_message":"Enter your email address"},"not_an_email_address":{"instruction_type":"error","instruction_message":"Make sure you have entered a valid email address"}},"note_with_tip":{"placeholder_text":"Your note here...","initial":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"empty":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"not_empty_initial":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"saving":{"instruction_type":"normal","instruction_message":"Saving note..."},"success":{"instruction_type":"success","instruction_message":"Note successfully saved!"},"error":{"instruction_type":"error","instruction_message":"Unable to save note note at this time. Please try again."}},"email_for_login_code":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email to log in."},"success":{"instruction_type":"success","instruction_message":"Enter your email to log in."},"blank":{"instruction_type":"error","instruction_message":"Enter your email to log in."},"empty":{"instruction_type":"error","instruction_message":"Enter your email to log in."}},"login_code":{"initial":{"instruction_type":"normal","instruction_message":"Check your email and enter the login code."},"success":{"instruction_type":"success","instruction_message":"Check your email and enter the login code."},"blank":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."},"empty":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."}},"stripe_all_in_one":{"initial":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"empty":{"instruction_type":"error","instruction_message":"Enter your credit card details here."},"success":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"invalid_number":{"instruction_type":"error","instruction_message":"The card number is not a valid credit card number."},"invalid_expiry_month":{"instruction_type":"error","instruction_message":"The card's expiration month is invalid."},"invalid_expiry_year":{"instruction_type":"error","instruction_message":"The card's expiration year is invalid."},"invalid_cvc":{"instruction_type":"error","instruction_message":"The card's security code is invalid."},"incorrect_number":{"instruction_type":"error","instruction_message":"The card number is incorrect."},"incomplete_number":{"instruction_type":"error","instruction_message":"The card number is incomplete."},"incomplete_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incomplete."},"incomplete_expiry":{"instruction_type":"error","instruction_message":"The card's expiration date is incomplete."},"incomplete_zip":{"instruction_type":"error","instruction_message":"The card's zip code is incomplete."},"expired_card":{"instruction_type":"error","instruction_message":"The card has expired."},"incorrect_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incorrect."},"incorrect_zip":{"instruction_type":"error","instruction_message":"The card's zip code failed validation."},"invalid_expiry_year_past":{"instruction_type":"error","instruction_message":"The card's expiration year is in the past"},"card_declined":{"instruction_type":"error","instruction_message":"The card was declined."},"missing":{"instruction_type":"error","instruction_message":"There is no card on a customer that is being charged."},"processing_error":{"instruction_type":"error","instruction_message":"An error occurred while processing the card."},"invalid_request_error":{"instruction_type":"error","instruction_message":"Unable to process this payment, please try again or use alternative method."},"invalid_sofort_country":{"instruction_type":"error","instruction_message":"The billing country is not accepted by SOFORT. Please try another country."}}}},"fetched_oembed_html":false}
Amen Ed, I ran into a fellow entrenched colleague at BiLo and she related to elements of you article as we all do. The interesting thing was even though the specialty was a little different. The same acute pains were mutual. To twist Othello “Be ware of medicine my Lord, it is the green eyed monster that doth mock the meat it feeds on”
Please do not forget the staff working in Psych ERs. I worked many years of ER and a total of about 5 years managing and working in County Psych ERs. I am newly retired after nearly 30 years of nursing (RN) and among my dear friends and colleagues count too many with substantial injuries and what is really PTSD from many, many years of very high risk, high intensity work. There are also too many who fall to substance abuse issues over time. The last time I looked, the American Assoc. of ER nurses estimated between 8% and about 24%… Read more »
Edwin, As you and your readers have noted, there are many places and situations in medicine that can cause stress and burnout amongst we who work there. One of obvious sources of stress is workplace violence. The US government reports that there were 69 homicides against healthcare workers between 1996 and 2000. Of course most of the violence is non-fatal, but serious nonetheless. Psychiatric intake has higher rates than the ER, which has higher rates than the OR or the floors. Nurses are victims more than docs, due to being on the front lines more than we are. We don’t… Read more »
Dr. Leap,
Great article. This made me wonder of those Doctors who are also enlisted in our military. Combining combat with the experiences of emergency medicine-talk about PTSD!
Matt
I have been browsing on-line more than three hours as of late, but I by no means found any attention-grabbing article like yours. It’s lovely price enough for me. Personally, if all webmasters and bloggers made just right content material as you probably did, the net might be a lot more helpful than ever before.
Appreciation for your personal great composing. I’m glad We’ve taken a lengthy time for you to determine this.