To wonder how the hell drs, nurses and surgeons cope with dealing with death and emotional distressing situations as a regular occurance

[LardLizard]

Like the ones that work in areas of high stress like surgery or a and e etc

I don’t smoke,and don’t really drink
But I like a box set. Fluffy dressing gown, faffing about

I am a doctor on a NICU. There are some really emotionally taxing parts to the job. Withdrawing care on babies and handing them over to their parents to die, or working on a resuscitation for twenty minutes or so and having to stop, or having to ring parents in the middle of the night to come in because their baby is dying.

I cope in several ways. Firstly, if I feel myself getting emotional. I try and remember that this is not MY tragedy. Literally the worse thing that can happen is happening to those parents. They will never truly get over it. If I cry and fall apart it feels to me like I'm belittling their grief almost. Because, however much it affects me as a doctor, I will move on to the next patient.

Also this situation is so completely terrible, but as a doctor you can make it worse if you aren't careful. So I have to work very hard to do the absolute best I can to make this awful terrible situation as good as possible.

When it's all over, I have a cup of tea with colleagues (usually the nurse looking after the baby) and we feel a bit sad for a few minutes. Then you get back to work and move on to the next baby.

Then I go home and immerse myself in my children and my home life and try and leave the sadness at work.

You might forget the names of some of the babies, but you remember the experiences and they leave their mark.

I would hate for anyone to think I was emotionally detached. I think it's insulting. It's like saying I don't care and i really truly do. But it's separate from you to some extent. It's like watching a horrible earthquake on tv, and hearing stories of children and babies dying. You feel so sad it's happening, you think such things are terrible.....then you get on with your day.

Arghh not sure if I'm explaining well, but I just hate the idea that to survive in medicine you somehow have to switch your compassion off....when it's the opposite!

Not sure what left leaning has to do with it.

When i was nursing I was a teenager and early twenties abd coped fairly well. After my first 2 children I found it emotionally a very different job especially involving children. I was a better nurse to patients but it took more from me.

After dc5 and older I moved to district nursing and had a much more mature view of life and death.

Hospital work is much easier in a way as the support is there. In the district you can be alone with a patient when they die with just pehaps a caring neighbour or friend. Sometimes alone. Much tougher really.

In hospital I knew very very good surgeons and doctors who drank copiously and took drugs. Lots shagged around and expected is to cover for them with their wives.

One surgeon now a world renowned figure had a total breakdown no drunk and drugs just over involvement in his patients and caring too much.loveky man.

I think most people leave or go into teaching eventually.

Some people get to you more than others and it’s not always the predictable ones.

I work in a hospice and we get our reward from knowing that we've done a good job and they've had a good peaceful death. It's more distressing to see someone in distress and struggle to help them, than to look after someone who is calm and comfortable. Thats very different from A+E trauma though

Nemo

I think you explained yourself very well.

Left leaning has for me a whole lot to do with it.very much so
I see health and social inequalities,poverty,impact of benefit changes,poor housing,homelessness. There are limited resources to refer on to
It’s political without a doubt

i think you do learn to detach, as a paramedic we may be first on scene alone and you have to shut out everything else apart from treating the patient so you ignore screams and tears from relatives and bystanders.
Although I'm used to pronouncing life extinct and telling relatives that their loved ones have died I do still feel but you have to stay strong and remember its not your grief. I have always been a fairly pragmatic person and it is easier to deal with when its someone who is very elderly.
The ones I will never forget nor do I want to are the children and babies, the day I forget carrying a small limp body into resus whilst doing chest compressions is the day I give up my job.
It is difficult to go onto the next job and remain polite and professional when its a young person with a cold. You have just held a Mother in your arms who is facing the very worst day of her life and its hard not to let rip.

It depends on the situation. Expected deaths, even when very tragic situations, you can prepare for. And there’s a lot to be said for giving someone a good death, means the world to their families.

Unexpected is always harder, especially when it’s a situation that personally affects you. On my first day back from mat leave for example I ran a cardiac arrest for a woman my age with a week old baby. That’s always awful. You get through it, you stay strong for the family and you go home, hug your own family and have a good cry.

I’ve had wonderful cards and meetings with family members of people I looked after in these situations, however briefly and the knowledge that we helped make an awful situation slightly less awful really helps.

I used to be a carer for both elderly and younger terminal people. You just disconnect from it. Its really hard to explain because you love and care about the patients and some deaths hit you harder than others. But its life and you have to just get on with it.

I think to a degree you become used to whatever type of death your specialty regularly presents you with, it's the unusual that catches you off guard. I went to a double fatal road collision a few years ago, and whilst the fatalities and the serious injuries where challenging and upsetting, it was the dead dog that had been traveling in one of the cars that sticks with me, because that is something I'm not used to seeing, and wasn't expecting.

Great thread, thank you for the insight.

My dad is in his last days/weeks. The care he (and us!) is receiving from the hospice is amazing. I have often wondered how the staff feel after their shift, or if they ever get used to being around so much death and sadness.

As a firefighter I've been at some pretty horrific incidents. My colleagues get me through, we go back and talk after anything that's traumatic. At first I found it really hard to accept that these things happen but now I try and deal with them as best I can, the ones with children are the worst! I don't have any kids but an eerie silence always falls over everyone. It's so sad x

I’m not disconnected or switched off,that’s the point.im very connected in the moment
You cannot work in an environment were you see,hear,read things that are beyond most folk ken
You connect to that because it matters,because you want to connect
And the day I don’t feel connected I’ll walk,do something else
And you seamlessly slip into being mum when you return home,because I’m emotionally connected to that too.

I’m aware I’m fortunate, my kids are fortunate. There’s adequate food, they have a safe home,they are loved.

I think a big part is the fact that we start training at 18 - you spend a long time being initiated into the mindset of medicine (and presumably nursing, but I’m not a nurse so can’t compare).

You compartmentalise. It’s sad when patients die, but sad like watching sad things on the news, not sad like it’s happened to you. I think because we start young, you don’t have much understanding of grief when you start out so it doesn’t affect you. And by the time you do understand, it’s become normalised.

So it doesn’t bother me at all when patients die - I see it as a natural process. I see breaking bad news as something I should try to do as well as I possibly can, to help the family, but I do see myself as a messenger rather than feeling responsible for the death so it doesn’t upset me particularly. I used to get very stressed about doing it wrong and making things worse, but I’ve been doing it for long enough now that I know what I’m doing.

I would probably have more trouble with children or babies dying, but I don’t work in those areas. I did find that working in A&E turned me into a bitch, but that was all the dross and drug-seeking that came in - it made me view all patients as adversaries. I switched to a less frontline specialty, and immediately went back to being That Nice Dr Sashkin.

Reading with interest.

Nemo really well put.

I remember one of my paramedic colleagues describing going to a preterm delivery where the baby died, the paramedic had herself had a full term still birth some years ago, so had dreaded a job like that, she said it was "never as bad as when it is happening to you" and coped with it really well.

I was an A&E nurse for a long time, I am currently going through assessment for ASD and like pp I believe my ability to detach and compartmentalise got me through some horrible things. I'm also very logical so in the midst of a trauma or cardiac arrest I was able to stick to the algorithm and not think too much about it. That said, when it came to looking after the bereaved relatives, preparing a body or end of life care, that was something I took pride in doing well. And when you work in areas like that your colleagues become a second family to you because you've been through some awful times together, I think that's important.

I'm a student nurse. I do well up but I have a way not of detaching but of protecting myself emotionally.

The hardest I will never forget was being asked to be with a patient who was to be given a terminal diagnosis. She looked the Dr in the eye and thanked him. I bit my lip and bowed my head. Later on I helped her back to her room and made a cup of tea. We sat together chatting about her life and how she was glad she knew.

Another was a terminally ill lady who had been very well and suddenly deteriorated. I spent a lot of time with her and I still well up about a time when we were doing her personal care and it took 4 of us to do it slowly and carefully. She looked me in the eye, smiled. Pulled me in for a cuddle and gave me a kiss on the cheek... gawd I'm welling up just now remembering her.

The hardest for me is knowing a patients results before the Dr can give them to the patient and having to act like nothing is changed.

My husband is usually the deliverer of very sad news to those not expecting it. I asked him once how he did, how he wasn't in bits getting out of the car, rapping the door etc. He just told me that he thought of us, that it helped him to think how he would want to be told if any of us had died. He sort of felt that in his job it was the one thing that he could do for someone else - to make sure that the people that loved them the most and that were going to be told that they had died would be treated with compassion and that things would be explained clearly and with finality and that any answers to questions that he could answer would be given over and over again if necessary.

We have young enough kids that when he comes home - they're all "Daddy Daddy - look at this, let me show you, help me draw a rainforest" etc. He takes nothing for granted in life. I know that some sights and being first on scenes are much worse than others - on those days he takes a longer drive home and he does something else on his way home like see his mum, do shopping, buy something we don't need.

Everyones explaining it much better than me. I only cried at one death in work and it was sudden and unexpected and no one told me until my next shift. I went to the toilet and cried for 2 minutes before pulling myself together and dealing with the other patients. I cried on the way home the next day. Was stangely the only death that hit me hard.

NemoRocksMyWorld

I think you explain very well. And I think your thought processes are extremely balanced. You sound as if you allow your patients and families all the dignity they deserve, and retain your humanity and professionalism.

I find putting my uniform on is like putting on a 'professional mask'.

I sob at 24 hours in A&E and OBEM, but cope during the moment when at work to try my best to save my patients.

I'm a breast surgeon. So don't deal with the very immediate life and death issues like some of my colleagues anymore (I did during training), however I spend a lot of time telling ladies they have cancer, and sometimes that they're going to die.

I agree with others. You have to detach a small amount, but equally detaching completely would really affect your ability to do this with real care and compassion. For some people this is the worst day of their lives, yet you can make a real difference if you do it well. In a strange way I find that really rewarding, when my patients tell me that I made a shit time easier for them. I agree with lipsticks that the day I don't give a shit will be the day I stop.

Additionally I get the hugely satisfying moment of knowing I might have cured someone of cancer, and when I tell them results that are better than anticipated and they're delighted that's also really rewarding. I rarely have a clinic where I don't get a hug from one of my patients thanking me for what I've done.

It can be shit though. Recently I found out that I made an error that will mean a lady needs more extensive surgery than she might have done. That's hard to take. I dealt with it by being totally honest with her, and reporting myself for investigation, but then that needed to get put in a box and detached from or I wouldn't have been able to deal with the other ladies I needed to see and give my all to that morning. I don't know what will come (very unlikely career ending or limiting, my main upset is actually because of the because of the impact on her and dealing with that guilt) but whatever happens I'll deal with it and move on. I have to detach from this to some degree as in the meantime my other patients need me.

So, from the above you'll see I totally and utterly disagree with this comment made early on in the thread:

Surgeons tend not to get emotional with people at work whether they are colleagues or patients as they know they work in an area where their mistakes can cause death and even if they don't make a mistake someone can die anyway

There are some surgeons like this. They're a minority though in my experience and this certainly does not describe me.