Emotional Stress

We are often told to talk to our doctors when we face stress that feels too challenging

to handle, and this is good advice. Doctors have medical training so they understand the

causes and effects of stress and can point us to health resources and plans to manage

stress. They may also be quite adept at handling stress, but this isn’t always the case, and

the stress that many doctors face is far beyond basic run-of-the-mill stress.

One study found that the proportion of doctors experiencing "above threshold" levels

of stress is 28 percent compared to the general population, 18 percent of whom

experience this level of stress on the job. Another study by AMA and The Mayo Clinic

found that doctors work an average of 10 hours more per week than the average

population, experience emotional exhaustion at higher rates (43 percent versus 24

percent of the general population) and experience burnout at significantly higher burnout

rates (49 percent versus 28 percent) and lower life satisfaction rates as well (36 percent of

physicians reported being satisfied with their work-life balance, compared to 61

percent of the general U.S. working population). Another Medscape survey reported that

physicians in 26 or 27 specialties rated their burnout levels as a "4" or higher on a 1-7

scale and that nearly 60 percent of emergency room physicians felt burned out in 2017 up

from 50 percent in 2013. This problem can be difficult for doctors to cope with, but it can

also affect patients. Long hours of work, high stake and risky operations, perfectionism

are just examples of the things that causes for a doctor to be burnout and emotionally

drained.

The emotional consequences of patient deaths on physicians have been studied in a

variety of medical settings. Reactions to patient death include distress, guilt, and grief.
Comparatively, there are few studies on the effects of patient death on physicians and

residents in the Emergency Department (ED). The ED setting is considered unique for

having more sudden deaths that likely include the young and previously healthy and

expectations for the clinician to return to a dynamic work environment. Medical

professionals dedicate their lives to the treatment of patients in an attempt to cure, all the

while knowing that any cure is temporary. Despite being a prevalent experience, a

relatively small number of studies have shed light on death’s emotional effects on

physicians. Perhaps unsurprisingly, greater exposure to death was found to be strongly

associated with greater work-related stress. In one study, 61% of physicians interviewed

reported that their most memorable patient death remains emotionally distressing. Cases

that elicit strong emotional reactions include: patients with whom the physician feels an

interpersonal connection, those who are not cured by standard treatment, younger

patients, and deaths that lack dignity (e.g., futile resuscitation). After a recent patient

death, physicians report feelings of numbness, feeling upset when thinking about the

patient, guilt, and stress as cited by BMC Med Educ, 2017.

Dr. Josephine GWS Wong. Doctors and Stress, Medical Bulletin. June 2008.

www.fmshk.org/database/articles/03mb1_3.pdf

Mohammed Gad. Ain Shams University, Cairo, Egypt. January 23, 2018.

https://www.studentdoctor.net/2018/01/23/witnessing-first-patient-death/
 Dr. Ranjan Srivastava. Support the guardian.

https://www.theguardian.com/commentisfree/2015/mar/20/patients-die-doctor-grief

Alfie Packman. Support the Guardian. April 19, 2017.

https://www.theguardian.com/education/2017/apr/19/prepare-seeing-patient-die-

student-nurses-death

Sansone RA, Sansone LA, Innov Clinic Neuroscience. April, 09 2012 - 2017.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504556/?

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