Modern Healthcare – August 12, 2019

August 12, 2019 | Modern Healthcare 29

In the aftermath of more mass shootings, let’s

remember we must also care for the caregivers

By Dr. Vidor Friedman

U

npredictability is the norm for emergency departments across the country.

It is true, the managed chaos of a day in emergency medicine becomes

familiar over the course of years on the job. But far too many of my

colleagues know that a mass casualty response is unlike any other day in the ED.

Dr. Vidor

Friedman is

president of the

American College

of Emergency

Physicians.

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The impact these incidents have on
the medical community, particularly
emergency physicians, is often over-
looked.
Indelible images of neighbors at risk
and in pain stay with you long after the
shift ends. The enormous weight of loss:
A mother who loses her son. A friend
forever gone. The efforts of heroic first
responders and courageous acts of by-
standers—it all stays with you.
Emergency physicians train for this
and most institutions conduct exten-
sive training for these events. When
an ED fills with severely injured pa-
tients, adrenaline and expertise kick
in. Still, physicians may feel over-
whelmed, stressed and out of their
comfort zone. In these moments, it is
imperative to trust the training and
personal experience.
There will come a time when a phy-
sician confronts situations well out-
side the bounds of the usual practice
patterns and there is no one-size-fits-
all response to these tragedies. That
is when it is most important to trust
instincts, abilities, and most of all,
each other.
There is no textbook to dictate the
best way that each person processes
the toll exacted by the mental, physi-
cal and emotional energy required to
respond to these incidents. Physicians
learn that they must trust and accept
their decisions. Even the most expe-
rienced physicians need constructive
outlets for the stress and the roller
coaster of thoughts and emotions that

become part of the job. While it may get

easier, it never gets easy.

What happened in Dayton, El Paso,

Las Vegas, Newtown, Orlando and

countless other communities can hap-

pen any where. Physicians can learn

strategies for communicating tough

news to friends and families of victims,

but these conversations are hard, every

single time.

From dispatchers and responders to

the all-hands response while beds or

staff or medicines run short, every role

is important and effective emergency

response takes a village. Accordingly, it

is too much to ask for anyone to be left

to process these events alone.

We must care for the caregivers.

Post-incident support and counseling

for the entire team inside and outside

the hospital, including physicians, is

crucial for healthy recovery. It can be

incredibly helpful to seek the advice

of others who have experienced such

events. Physicians, staff and admin-

istrators must not underestimate or

downplay the lasting impact these hor-

rific, senseless tragedies have on the

entire staff and community.

The American College of Emergen-

cy Physicians strongly believes that

firearm injuries—accidental or other-

wise—should be addressed as a public

health epidemic. Let’s make sure that

we push for constructive solutions ev-

ery day, not just in the immediate af-

termath of a shooting. The frequency of

these tragedies is a uniquely American

problem.

The ACEP supports legislative, regu-

lator y and public healt h efforts t hat can

help end the epidemic of gun violence.

This includes expanding access to

mental health services, universal back-

ground checks and restricting the sale

or ownership of weapons, munitions

and large capacity magazines designed

for military or law enforcement use. A

significant increase in public and pri-

vate funding for research is needed to

expand firearm safety and injury pre-

vention research.

There is one common thread emerg-

ing from these events—they each seem

to leave more questions than answers

in their wake. Unfortunately, the sim-

ple questions seem to be the hardest

for Congress to answer. Perhaps we

can start there. Emergency physicians

will continue to ask policymakers: Is it

finally time to do something? l