Post-traumatic stress disorder (PTSD) is a rising concern in the medical field.
It is believed that 18 percent of nurses,15-17 percent of ER physicians, and 12-21 percent of ER residents experience PTSD, while as many as 50 percent of physicians treating terminally ill patients experience burnout. All of these numbers are much higher than that of the general population with PTSD,which is around 8 percent.
To figure out why this issue is so prevalent among medical professionals and what can be done, we did some investigating.
Explaining the research
Like being in the military, where 10-31 percent of veterans suffer from PTSD, medical professionals experience copious amounts of gore, death, stress, fear, and sadness—in addition to cumbersome work hours and irregular sleeping and eating patterns first developed in medical school.
For many medical professionals, they must tell patients the worst news of their life or notify family members that their loved one has passed. They tend to wounds, they see pain, and they’re not always well-received by patients. These emotionally draining experiences can lead to feelings of self-loathing, failure, and incompetence. It can also cause anxiety, depression, alcoholism, substance abuse, and in extreme instances, suicide.
Sadly, 300-400 doctors in America commit suicide each year. That means one doctor will end their life each day—a rate much higher than that of the general population (12.3 per 100,000 versus 28-40 per 100,000).
While this distressing reality is becoming more prevalent in public conversation, it isn’t anything new. Since the late 1800s, suicide within the medical field has been a prevalent issue. There even exists a Wikipedia page titled “Doctors who committed suicide” with a long list of famous doctors who have ended their lives. Being a doctor has the highest suicide rate of any profession and the phenomena is not unique to America—it is found overseas as well.
The stigma of trauma
While there are many factors that contribute to PTSD and suicide in medical professionals (as stated above), it’s not an easily understood phenomenon, in part because of the stigma surrounding it.
Simply put: Many medical professionals don’t want to go on record regarding their mental health out of fear of losing their job. When I put out a social media call to interview medical professionals who have suffered from PTSD, I received zero responses. I even privately messaged a doctor friend asking if they knew of anyone who would talk to me, offering anonymity per my friend’s suggestion, and was never able to make any connections.
Day in and day out, medical professionals experience trauma, and they must internalize their emotions surrounding trauma—for their patients’ sake, their staff’s sake, and their career’s sake.
According to best-selling author and physician Dr. Lissa Rankin, many medical professionals feel that trauma comes with the territory of the job, so they accept any bad that might come with it. She wrote that this internalized trauma trickles down from doctor to nurse or doctor to patient because the doctor is not getting the help he or she needs due to stigma and fear of losing their job, lack of time or energy, or the ability to see through the dark clouds of their PTSD.
What can be done
It’s clear that this cycle must be broken. Medical professionals do not deserve to suffer alone, and in alleviating their suffering, it will in turn help their staff and patients.
Due to the rising conversation of PTSD and suicide in the medical field, researchers have studied how and why medical professionals stay resilient.
A 2012 study at the University of Colorado School of Medicine found that ICU nurses who had “poor social network, lack of identification with a role model, disruptive thoughts, regret and lost optimism” typically suffered from PTSD while nurses with “spirituality, a supportive social network, optimism” and a “resilient role model” fared much better.
While this study is informative and helpful in understanding ways medical professionals can increase happiness at work, it’s not always easy for them to find a social network or role model.
Like the general public, medical professionals who are suffering from PTSD should receive psychiatric care (such as psychotherapy, exposure therapy, cognitive therapy or medication) to help them acknowledge their emotions of fear, anger, sadness, and inadequacy, and to heal from their trauma. Fortunately, medical professionals who understand PTSD in healthcare like Dr. Rankin and Dr. Rachel Naomi Remen have created their own in-depth programs to help the medical community heal.
But the onus to find help shouldn’t fall squarely on the shoulders of medical professionals since it’s not always easy for them to recognize their own trauma. Detachment and diminished interest in activities are symptoms of PTSD, which means the individual might not have the ability to seek support. Medical centers should establish systems to recognize PTSD in their staff and offer a path to healing.
Edwin Leap, MD, in Emergency Medicine News suggests short sabbaticals might help, while Olena Chapovalov, RN, BScN, BSc, MPH, in Hospital News recommends employers engage in risk assessment as a “legal duty under the Occupational Health and Safety Act to assess the risks specific to this hazard and notify the worker of its existence.”
Peer-support programs are another effective implementation employers can make, Chapovalov argued. She wrote, “Although the evidence to show its efficacy is still limited, organizations and workers who have this active in-house resource report very positive feedback. Overall, there seems to be a benefit to having access to an individual within the organization who is skilled and knowledgeable in trauma counselling.”
Pamela Wible, a physician and TEDMED speaker who specializes in medical student and physician suicide prevention, believes changes need to be made as early as med school—when the trauma begins.
“The world is not what it was 20, 30, 40 years ago,” Wible wrote on her Ideal Medical Care blog. “We need to stop pushing people to continue in a system that’s obviously failing and imploding, right? We need new thinking. We need new ways of training physicians. We need to stop terrorizing them and violating their human rights.”
Whether trauma happens during med school or later on is up for debate. But what matters is that medical professional get the help they need, as early as possible, so they can find and maintain joy and meaning in their important work and life.
The more we talk about PTSD and suicide in the medical industry, the more the stigma will be lifted—and the more lives will be saved.
If you or anyone you know has contemplated suicide, there is hope. You are not alone. You are important. Please contact the U.S. National Suicide Prevention Lifeline 24/7 at 1-800-273-TALK.