Emotion vs effectiveness as a medic.

[FMF_Doc]

I have a question and some thoughts-

Does emotion get in the way of providing care?


Now for my thoughts and personal experiences-

When I first got into emergency medicine 20 years ago, I actually cared and "felt" people's pain and sometimes paid the price for it after the incident (we didn't have crisis debriefing, etc in the beginning).

At some point I rose to the top 5% of my career field, was a successful and respected instructor, rock solid operator, but in order to get there I lost my sense of compassion- I was in it for the trauma and mayhem. By detaching from emotion I actually became a better practitioner, being able to make critical decisions without distractions.

And poof one day it happened- absolute burn out. I walked away from medicine altogether and switched career fields, but here lately I have been thinking of getting back into it.

.

[NinjaMedic]

"Does emotion get in the way of providing care?"

Yes

Can detachment and a lack of empathy get in the way of providing care?

Yes

The challenge that we will always face is trying to find balance and compartmentalizing the mind sets to be available to you when needed. I find it much harder to be empathetic sometimes than I do become detached and treating an injury. The issue is that less than 6% of our patient population that activates 911 actually has a problem that we can address. The other 94% make it very easy for me to justify apathy to myself, however my attitude and interaction towards them is dictated by me and I cant blame them when I allow myself to get frustrated and burned out.

[SeriousStudent]

.....

Does emotion get in the way of providing care?

............

Hi Doc,

I think it can. And I experienced pretty much exactly what you did, a long time ago.

It took some time for me to differentiate between "functional empathy" and "emotional attachment".

An example: You had to be able judge a child's pain level, while communicating and gathering information from parents, and then deliver care. It made you more effective to display a certain degree of concern, and understanding. That helped calm both parent and child. You were then more successful in eliciting patient history, mechanism of injury, assessing vitals, etc.

That made you a more effective caregiver. It was more efficient to display that persona.

If you wore your heart on your sleeve, so to speak, you were less effective. I learned to build a bit of a shell, as everyone in EMS longer than two weeks learns to do. The challenge for me came when something shattered that armor.

And I think that happens to just about all of us. There is a reason the turnover for field EMS personnel is so very high. You enter with admirable motives, and hopefully leave with your sanity, and your soul.

That was decades ago for me. I have thought about re-entering training, just for my personal skill set. I was in EMS so long ago, I got to watch "Emergency!" in the firehouse during prime time.

I think at some point, the sense of survival sends an override to the sense of compassion, and tells both of them to beat feet to a different career. I went into the Marines as an 0331 to escape from EMS. Brilliant, huh?

What are you thinking about doing? Studying for a challenge test? Or doing the classroom route and then clinical work?

[FMF_Doc]

I am thinking about starting over and taking EMT Basic and going through the program again to EMT-P and working on a volunteer truck somewhere, a good friend of mine who was a mentor of mine and a retired FMF Corpsman as well suggested I get back into it.

Basic I can do in my sleep, I was a program director and taught EMT-B and EMT-I for several years, and used a lot of those classroom hours as CE's to maintain my EMT-P.

I just want to feel the adrenalin rush again, knowing that you have only one chance to make the right decision and limited time to do so.

My biggest burnout factor was the ops tempo and our deployment rotations, you get really good at trauma care but the price when you are treating friends as opposed to total strangers is really heavy.

As you know operational medicine and civilian EMS/911 are different animals all together.

[citizensoldier16]

"Does emotion get in the way of providing care?"

Yes

Can detachment and a lack of empathy get in the way of providing care?

Yes

Well said. Each of us have to find that balance between caring and not caring. It's a bell curve I guess you could say.

[SeriousStudent]

....

My biggest burnout factor was the ops tempo and our deployment rotations, you get really good at trauma care but the price when you are treating friends as opposed to total strangers is really heavy.

As you know operational medicine and civilian EMS/911 are different animals all together.

Quite true.

I hope that does work out well for you. It honestly does sounds like fun, starting over and working as a volunteer.

I wish you the best in your efforts, and may your previous experience be an inspiration to your partners.

[Hell_Bent]

Replied. Made ZERO sense. Further attempts postponed pending sleep/introspection/psych eval.

Some great replies above, however...

[MIKE G]

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[benthughes]

To provide good patient care I believe that you need to be able empathize with a patient, conscious or not. Our company does scene calls and critical care transfers. There are countless times when you have to do a procedure that is very invasive/painful and you have to ignore the fact that and press on. It can be especially hard when dealing with kids.

I try to treat patients as I'd want to be treated. I don't hesitate with pain control or sedation where people often do. If I can do something to ease the stress of a situation or ease pain I will.

The times I have trouble are when dealing with drunk or high people. I have very little patience when dealing with the stupidity of others. I also have difficulty in dealing with people who have hurt other people and are requiring treatment. It was a regular occurance to transport people who have had a "medical condition" exacerbated by running from the cops.

[Saginaw79]

Just keep 'em under control!