PICTURED ABOVE: Tracy, a nurse manager from Metro South Hospital and Health Service, shares her advice on how to cope during difficult times working in an emergency department.
The following words have been published with permission from Tracy.
Working in an environment like ED can seem like being on a boat in a never-ending storm. We have all had days where we have gone home empty, or we have given everything only to leave still feeling like nothing was accomplished on our shift. And yet, we come back to work, ready to start again. Our work lives have a chaotic glamour. We work in the unknowable, unthinkable situations that randomly present themselves to us. And we love it.
But there are often times that are more difficult than others. Times when we don't know if we will make it. I have personally experienced times like that. I have felt like I have no resilience left and also have no idea where to find more. If you are having one of those days, those weeks or just those times, here is some helpful information I have found.
- Loneliness and burnout
- Getting back on the motorbike
We all feel like this. Not all on the same day, and not all for the same reasons. But we all have dark times where we look around and see no hope. We feel alone, we feel helpless and we feel like this is what other people see when they look at us. A great book that I found talked about adversity and resilience, and the connections between the two. It’s called Supernormal by Meg Jay and it says how often very resilient people can feel like failures when they get to a point like this.
Worse still, we don’t talk about it. We don’t want other people to judge us, to see our weakness, or to think that this snapshot of us at this point in time is all we are. In our minds, we catastrophise and punish ourselves which only makes us feel worse. Something identified in the book and in the author’s talk was that having people to confide in can help us recover faster.
Even when we experience suffering through witnessing traumatic events and awful situations and injuries, there is something that can protect us: connecting with our team or friends and family. According to the Harvard Business Review, people who don’t have someone to talk to not only feel worse, but loneliness registers as physical pain in the brain. And pain makes everything worse. In teams where people have a friend or colleague with whom they can speak freely, burnout occurs less. If you feel down, stressed or just generally low, one of the best things you can do is talk to someone about it. I like talking to the people whom I work with because I feel as though they understand. They have seen the same things and they just know.
There is a certain type of person who comes to work in an emergency department. We are the people who run towards danger when everyone else is running away. We are the types of people who accept things quickly and come to solutions fast. Recently, our team had a rough time. Something that made a phenomenal difference to our team was the kindness of two other local EDs. They both sent us care packages for our teams and sweet messages. Even though we don’t know them all personally, this feeling of support, gratitude and kindness went a long way to helping us feel better.
When I was seven, I was learning to ride a motorbike and fell off. I was sure my arm was broken. My parents rushed over and put me back on the bike and said I had to ride to the car before they would even look at it. I was scared, but there was no other choice. So I did (my arm was not broken). Today I still have my motorbike license (admittedly a questionable decision for an ED clinician). When something bothers us, we may want to avoid that thing. But it only makes it worse.
A small problem gets bigger every day because it wasn’t stopped early. There is a Chinese proverb do the great thing, while it is still small. This is one of the most important things I have ever learnt. A vague feeling can be much more easily addressed when it hasn’t snowballed into a big problem. My parents addressed my potential fear of motorbikes by putting me back on the bike within seconds of falling off. Now, I barely think of it. But if they hadn’t have done that, who knows? This principle could apply to a difficult situation, going back into a role where you feel as though you failed, or just coming back to work after a big shift.
In summary, the main things that have helped me when dealing with difficult times are these:
- Remember other people feel this way (or have felt this way)
- Talking to people we trust will make us feel better (even if we don’t want to)
- Don’t avoid things that will eventually need to be faced (because by then they could have fangs).
The final thing I would love to add is an African proverb: smooth seas don’t make skilful sailors. It is only in tough times that we stretch and grow and see what we can really do. In safe and calm waters it is easy to feel confident, but you'll never fully know how flexible, strong and capable you really are.
(And if you are working in ED, you didn’t come for that!)
Clinical Excellence Queensland would like to thank Tracy for sharing her words with us, and particularly in light of ED Wellness Week, we extend our gratitude to all emergency department staff - clinical, non-clinical and support roles - for the work you do each and every day and night. For more tips and stories on ED wellness, visit WRAP-EM. This website was developed by enthusiastic ED staff looking to enhance individual and organisational wellbeing.