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"As we all face anxiety about the fallout of this pandemic, anger about a health care system that was already stretched thin and under-resourced is likely to grow," she explained in a university news release.
Isbell's team interviewed 45 doctors and 41 nurses who offered mixed feelings about life in the ER. Persistent issues such as understaffing, overcrowding and limited resources for homeless and mentally ill patients elicited overwhelmingly negative feelings.
"These physicians care deeply about their patients. They're working in a health care system that makes it really hard for them to practice the way they envisioned," Isbell said. "They are asked to handle and solve problems that are incredibly trivial or incredibly serious, and some aren't even medical problems. There is awareness that emotions could influence what they do with the patients."
One ER specialist said: "Emotions subconsciously play a role in every single patient and how you work them up, and how you diagnose them, and what you do for them."
Doctors and nurses said that they may spend less time with angry, difficult or unreasonable patients.
One doctor said: "I do think it is likely that when you have significantly contentious relationships with patients that … you don't gain as much data [and to an] extent that could lead to diagnostic error."
Doctors and nurses said they use various coping strategies. These include suppressing or ignoring their emotions when on duty in the emergency department.
"But we know from the emotion literature that's not a good strategy," Isbell said. "It tends to rebound. You may take it out later on your kids or your spouse or dog. It's bad for your body physically and for your mental health."
It may also be bad for patients. The study suggests that more research is needed to learn whether ER providers' efforts to regulate their emotions help reduce the risk to patient safety.
The report was recently published online in the journal BMJ Quality and Safety.
-- Steven Reinberg
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