Anybody who works in a profession caring for those in need knows what I’m talking about: it’s impossible not to be affected by the pain, suffering, and mortality of other humans when you are there to help them. We are deliverers of the hard truth – if the patient is conscious and not obtunded, you might be surprised to know that they often seem to be relieved that we are honest.
Palliative care for patients who won’t accept their mortality is especially difficult in the ER. At the risk of stating the obvious, we are not a hospice. We can can treat emergent pain (to the best of our ability), but we are set up for emergencies with the goal of resuscitation, not to provide end-of-life care. Having said that, we still do our best to meet their needs with empathy and respect.
But at the end of the day, every shift has some amount of existential sadness to process for the docs, nurses, and techs. How we process it is a statement of who we are.
It’s a precarious balancing act to find the space between empathy and over identification with the sick and dying. If you don’t get it right it you’ll end up carrying a toxic psychic load. We all know where that leads and it’s not anywhere good.