Psychological First Aid

“I’m not sure why I keep thinking about it, it was over two weeks ago. It must be me. Maybe I’m not cut out for this job. I keep replaying that night. I was the resident on the emergency response team. I got called to a building I’d never been to before to a patient I didn’t know, and when I arrived, they’d already started chest compressions. I was told to get in line. As I looked around, I didn’t recognize any of the other staff. Suddenly it was my turn. I’d never done real compressions on a real human before and was trying to remember all the training. The next few minutes were a blur. When someone told me to adjust, I adjusted. Someone told me it was time for the next compressor, so I stepped back. In just a few minutes the fellow in the room called it. Only then did I notice that the patient’s family was standing in the corner, sobbing. Since it wasn’t my patient, I left and went back to my unit and finished my notes. It was surreal. It was nothing like anyone described. I’ll never forget what it felt like.” 

A version of this story was relayed to one of our RISE (Resilience In Stressful Events) peer responders during a confidential support session. This event was unique, but so many healthcare professionals have had a similar experience. Often these experiences help us to become better at our jobs. Sometimes they haunt us because we remember mistakes we made, things we did or didn’t do, or the ways we would do things differently next time. Sometimes they stay with us because they were physically, mentally, and emotionally hard.  

These events can exceed our ability to cope, leading to anxiety, depression, and a loss of confidence. Long-term, they can contribute to emotional exhaustion and burnout. In both cases, this can hinder us from functioning at the high level needed to give excellent patient care. 

There are times we can all benefit from the psychological first aid provided by organized programs like RISE, or from the empathetic listening of a colleague. Timely support can help us to regain our equilibrium and ease us back into our zone of personal resilience. While some in medicine view seeking help as a sign of weakness, it’s really a demonstration of strength. Here are a few things to keep in mind:  

1. When a distressing event happens to (or around) you, try to acknowledge and honor the impact it might have on you.

2. If you reach out to a colleague to help you process an event, maybe frame the conversation with “Could you listen to my story? I don’t need any solutions right now; I just need a safe place to process it.”

3. When a colleague starts to tell you a distressing story, minimize distractions and give them your undivided attention without judgment.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.