Emotion vs effectiveness as a medic.

[MiggyE]

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.

.

i can very much empathize with you. like you, i went into Emergency Med with all the high hopes and ideals of a young man. now, just 20 years down the line, i feel very much of a burn out, and am in the middle of trading the ER for some industrial position, as well as a teaching load. i am even seriously contemplating the job my father-in-law dangled in front of my face. and that would take my thoughts out of medicine for most of the week.

as to your question, yes, i believe emotions do get in the way. as a resident, i had the misfortune of being the guy to break it to a college friend that his only son, not yet 6, was dying of a brain tumor. you really want to do everything for the kid, although you KNOW that there's nothing you could really do. for the past several years, i have felt that i was doing my best work, even if it came to the fact that you try to remain detached from everything.......right now, just not thinking about leaving med, i still love it, just need something else to do the rest of the week.....

[Arclight]

This doesn't exactly answer your question, but it's a relevant story:

I've worked in EMS for ... oh, let's say just over 15 years now, but this story isn't about me. Through that whole time, one of my closest friends (NREMT-P) worked alongside me and far surpassed me in skill and dedication, working probably 60+ hours per week, every week in multiple departments.

Last month, while at a rural wedding, her little brother (26) fell on a broken drinking glass, cutting his hand very severely. He severed tendons and partially cut an artery. She provided definitive care, probably saved his hand, if not his life. She was telling me about it afterward and was really shaken up.

The noteworthy part, however, is this: She told me that she was almost glad it had caused such an emotional reaction in her. It had been so long since she had reacted emotionally to a call that she was afraid she was getting too cold and jaded to empathize with her patients anymore.

[Spike59]

I feel that in order to be objective about an emergency situation you have to detach yourself from the pt. and/or their family. You cannot help a person if you allow yourself to be sucked into all of the emotion, pain and panic of the moment. I have been accused of not being sensitive to my pts. before. I feel I have to close myself off from the pt. to better form an idea of what the pt.'s problem is...and how best to treat that pt. I have found that people that care too much about the pt. set themselves up for emotional burnout.

[ghettomedic]

MEDIC = My Education Doesn't Include Compassion

Just kidding, that's what I tell people when they ask, "So what's the difference between a paramedic and a nurse?"

Well, that and about $35K/year.

[bp7178]

This thread title really caught my attention. As a LEO, as was on a double fatal shooting a while back. The first victim I found was a young guy in his 20s. He was motionless on the sidewalk, face down and unresponsive. *

EMS rolls up and two medics come over. They started cutting off his clothes, and while holding his head, I see he has a bullet entry would just below his ear. Thick goopy (medical term) blood coming out. We all see it and I remember telling the medics that there are more victims, and they should move on to someone they could help.*

There has to be a level of detatchment. You have to be able to pull yourself out of it and stay disconnected, not for yourself, put for the people you can help. This can bite you.*

The hardest part, and what I think modern law enforcement is coming to, is mainting a state of readiness. Wading through all the bullshit, until you get to someone you can actually have a positive effect on. Ever meet a cop on an accident scene that had a bad attitude? No one signs up to write accident reports, but it's a necessary componet of the job. You have to smile and be professional and stay sharp, make that positive impact where you can.*

Recently, I broke up with my girlfriend, whom I lived with. This really took a toll on me. Me and another officer got a call for a shooting victim. Male subject was shot, drove a few blocks and called 911. We were about three blocks away, and arrived in seconds. We get to the car and the driver (victim and only occupant) is slumped over the center console with his head leaned back. Unresponsive. He had a entrance wound under his left armpit, exit at his right love handle. I propped his head up, my thought being airway. I started doing sternum rubs, which is a trick my old partner showed me when he worked at a hospital. The victim started coming around, but was in and out. This went on for about 4 min, which felt like 30. EMS shows up, and we roll him in and go.

When doing these kind of jobs it's very important to maintain a balance. Balance with yourself, personal relationships and the job. Burnout isn't all about the work we do, but other factors in our life. Jobs come and go. Take care of your loved ones and have that base to fall back on.*

One of the best speakers I ever heard was Bobby Smith. Smith was shot in the face during a traffic stop and lost his vision. Bobby said don't ever bring the cop home, he will destroy it. You need to be able to separate home from work. I think of my job as an acting gig. When I'm at work, I'm the police officer, acting to fill that roll. But that isn't me, it's a part I play.

[yellowfin]

I've been experiencing the same sort of phenomenon with the life, health, and disability insurance biz from time to time. While not exactly the same as medicine, individuals' health and certainly their well being and that of their families comes into play and the consequences can be almost as immediate. You see the tragedy and implications of people taking risks, not protecting their health, and not thinking ahead and what that does to families. You want to help as many people as possible, but they don't always think ahead and often push you away--the same attachment vs. detachment, compassion vs. business issue comes up. Everybody thinks they're invincible and know everything and will keep being lucky, it's always something that happens to someone else and never to them--but you just hate it for someone who really needed you but didn't see it that way at the time. While not the same as losing a life or limb, losing a house or kid's college funding, family business, or being burdened with debt for years or decades later is still a brutal consequence of accidents, injuries, and illnesses.

[Atchcraft]

This thread title really caught my attention. As a LEO, as was on a double fatal shooting a while back. The first victim I found was a young guy in his 20s. He was motionless on the sidewalk, face down and unresponsive.

EMS rolls up and two medics come over. They started cutting off his clothes, and while holding his head, I see he has a bullet entry would just below his ear. Thick goopy (medical term) blood coming out. We all see it and I remember telling the medics that there are more victims, and they should move on to someone they could help.

There has to be a level of detatchment. You have to be able to pull yourself out of it and stay disconnected, not for yourself, put for the people you can help. This can bite you.

The hardest part, and what I think modern law enforcement is coming to, is mainting a state of readiness. Wading through all the bullshit, until you get to someone you can actually have a positive effect on. Ever meet a cop on an accident scene that had a bad attitude? No one signs up to write accident reports, but it's a necessary componet of the job. You have to smile and be professional and stay sharp, make that positive impact where you can.

Recently, I broke up with my girlfriend, whom I lived with. This really took a toll on me. Me and another officer got a call for a shooting victim. Male subject was shot, drove a few blocks and called 911. We were about three blocks away, and arrived in seconds. We get to the car and the driver (victim and only occupant) is slumped over the center console with his head leaned back. Unresponsive. He had a entrance wound under his left armpit, exit at his right love handle. I propped his head up, my thought being airway. I started doing sternum rubs, which is a trick my old partner showed me when he worked at a hospital. The victim started coming around, but was in and out. This went on for about 4 min, which felt like 30. EMS shows up, and we roll him in and go. I'm running code to escort the ambulance. I remember getting overwhelmed with emotion on the way in. I actually said a prayer, asking to keep this man, who I've never met, alive.

It wasn't until much later that I realized that I wasn't asking for his benefit, but for mine. Between losing my girlfriend, my home and everything that goes with it, I couldn't take any more loss in my life.

When doing these kind of jobs it's very important to maintain a balance. Balance with yourself, personal relationships and the job. Burnout isn't all about the work we do, but other factors in our life. Jobs come and go. Take care of your loved ones and have that base to fall back on.

One of the best speakers I ever heard was Bobby Smith. Smith was shot in the face during a traffic stop and lost his vision. Bobby said don't ever bring the cop home, he will destroy it. You need to be able to separate home from work. I think of my job as an acting gig. When I'm at work, I'm the police officer, acting to fill that roll. But that isn't me, it's a part I play.

Very well put, bp. I went through something very similar, relationship wise, when I became a LEO. It's not always an easy thing to "disconect" before coming home. I'm lucky to have my current wife (and I don't mean that to sound like I plan on any others) was EMS and is now an LEO also, so she's been there. It helps to have someone around that actually understands what it is that you are going through, but also is great at keeping me from dragging it into the house. I liked Kevin Gilmartin's "Emotional Survival for Law Enforcement", pretty much hit the nail on the head for me. Now I have some great, completely unwork related hobbies!

I guess my point is, x3 for disconnect! You may have to make yourself do it, but it must be done.

Be safe.

[LUCKY MEDIC25]

I am currently in Iraq. I have learned over my year here that it is very important to detach yourself to be any good to someone needing your care. ESPECIALLY in the case of traumas. I feel that we would not be able to do what we need if we let our feelings get in the way... As most in the medical field know, you usually have to cause more pain to those at the hands of the angel of death, before we can save them.

I can relate to FMF Doc in that I LOVE trauma! Although, I don't feel we do it because we love seeing people hurt or love the craziness of it, I think we do it because we love knowing that a trauma is another chance for us to apply what we've trained so hard for! To give somebody a chance in life! To get them home to their families alive and well!

In conclusion, I would say that emotion does get in the way of us being able to effectively do our jobs. I leaned very quickly with the first soldier dieing in my hands, that you still feel compassion... I broke down after and think of this soldier every day. I will always feel compassion and care for my patients at the end of the day.

[WS6]

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.

.

Yes, extremes in emotion can. Getting "attached" DEFINITELY can. Empathy not sympathy.

*Opinion based on working 1 year in SICU and Stepdown units as an RN,BSN.

[Atchcraft]

Yes, extremes in emotion can. Getting "attached" DEFINITELY can. Empathy not sympathy.

*Opinion based on working 1 year in SICU and Stepdown units as an RN,BSN.

It's easy to deal with emotion on-scene. But, at the end of the day and after years of build up, it's another thing not to feel something at all or let it effect you emotionally... for me anyway.