How They Train ER Nurses For Extreme Stress & Burnout

In 1988 my team and I recorded what it was really like in the emergency room at Level I Trauma Center Detroit Receiving Hospital. The purpose was to create a video to help ER nurses to deal with the extreme stresses that they confront on a daily basis. This is a clip from that film. ER nursing is stressful as nurses are responsible for providing emergency care to patients with serious, life-threatening conditions. ER nurses must be able to think quickly and make critical decisions under pressure and they must be prepared to handle a wide range of medical emergencies from trauma injuries and heart attacks to strokes and respiratory distress. I decided to have my crew sit in the hospital during the day and night shifts and film what we saw. I felt that the first step in helping nurses and doctors and other hospital support personnel to reduce stress would be to admit the circumstances that they are under on a day-to-day basis - circumstances very often of extreme stress. Filming inside an emergency department with the freedom to go anywhere and see anything gave me a profound appreciation for what hospital work is like, for how much I as an American citizen appreciate the doctors and especially the nurses and especially the ER nurses who do this incredible work saving lives day, after day after day. This film was made in 1988. What has changed since? Advancements in technology and medical treatment have led to an increase in the acuity and complexity of patients being treated in emergency departments. This means that emergency room nurses today may be dealing with more critical and complex medical situations than they were in the past. ER nurses today deal with a high number of patients, which can lead to high stress levels. For example, in a single shift, a nurse might care for a child with a broken bone, an elderly patient with a heart attack, and a victim of a car accident. Patients in the ER are usually there due to serious, life-threatening conditions. A nurse might have to assist in resuscitation efforts, administer medications in a critical situation, or care for a patient in severe pain. This urgency and the high stakes involved can be very stressful. ER nurses never know what they will encounter during a shift. For instance, a normally quiet day could suddenly turn chaotic if a multiple-vehicle accident happens nearby, or if several patients with severe conditions arrive at once. Nurses often bear the emotional brunt of difficult situations, such as when they must deliver bad news to family members, or when a patient they have been caring for does not survive. They also deal with a range of patient behaviors, from confusion and fear to aggression and noncompliance, which can be emotionally draining. The job involves long hours on their feet, physically assisting patients, and sometimes dealing with physical aggression. For example, a nurse might need to help move a heavy patient or restrain a violent one. ER nurses have to make quick decisions under pressure. For instance, they might need to prioritize which patients to attend to first in a busy ER, decide which medications to administer, or quickly assess a patient’s condition and potential treatment. ERs operate 24/7, which means nurses often have to work nights, weekends, and holidays, which can disrupt sleep and family life. The combination of high stress, emotional demands, and long hours can lead to burnout, which is a state of physical and emotional exhaustion. Burnout can make it even harder to cope with the demands of the job and can lead to mental health issues like accident happens nearby, or if several patients with severe conditions arrive at once. Nurses often bear the emotional brunt of difficult situations, such as when they must deliver bad news to family members, or when a patient they have been caring for does not survive. They also deal with a range of patient behaviors, from confusion and fear to aggression and noncompliance, which can be emotionally draining. The job involves long hours on their feet, physically assisting patients, and sometimes dealing with physical aggression. For example, a nurse might need to help move a heavy patient or restrain a violent one. ER nurses often have to make quick decisions under pressure. For instance, they might need to prioritize which patients to attend to first in a busy ER, decide which medications to administer, or quickly assess a patient’s condition and potential treatment. After all that I saw in the making of this film, I came away with a deep and abiding respect for nurses. And when I or other members of my family have been in the ER, I feel blessed for the care that they have given us. Thank you nurses everywhere. David Hoffman filmmaker