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The psychological health and well-being of emergency medicine consultants in the UK
  1. Katherine Fitzgerald1,
  2. Philip Yates2,
  3. Jonathan Benger3,4,
  4. Adrian Harris5
  1. 1 Clinical Psychology & Counselling Department, Nephrology and Transplant Directorate, Cardiff & Vale University Health Board, Cardiff, UK
  2. 2 Department of Psychology, College of Life & Environmental Sciences, University of Exeter, Exeter, UK
  3. 3 Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
  4. 4 Academic Department of Emergency Care, Emergency Department, Bristol Royal Infirmary, Bristol, UK
  5. 5 Emergency Department, Royal Devon & Exeter Foundation Trust, Exeter, UK
  1. Correspondence to Dr Katherine Fitzgerald, Nephrology and Transplant Clinical Psychology Dept, Pentwyn Dialysis Unit, Unit C3, Avenue Industrial Estate, Croescardan Close, Cardiff, UK CF23 8HE; katherine.fitzgerald{at}


Objective To explore the experience of psychological distress and well-being in emergency medicine (EM) consultants.

Methods A qualitative, interpretative phenomenological analysis (IPA) study based on 1:1 semistructured interviews with EM consultants working full time in EDs across South West England. Eighteen EM consultants were interviewed across five EDs, the mean (SD) age of participants being 43.17 (5.8) years. The personal meanings that participants attached to their experiences were inductively analysed.

Results The analysis formed three superordinate themes: systemic pressures, physical and mental strain and managing the challenges. Pressures within the ED and healthcare system contributed to participants feeling undervalued and unsatisfied when working in an increasingly uncontrollable environment. Participants described working intensely to meet systemic demands, which inadvertently contributed to a diminishing sense of achievement and self-worth. Consultants perceived their experience of physical and emotional strain as unsustainable, as it negatively impacted; functioning at work, relationships, personal well-being and the EM profession. Participants described how sustainability as an EM consultant could be promoted by social support from consultant colleagues and the ED team, and the opportunity to develop new roles and support ED problem solving at an organisational level. These processes supported a stigma-reducing means of promoting psychological well-being.

Conclusions EM consultants experience considerable physical and mental strain. This strain is dynamically related to consultants' experiences of diminishing self-worth and satisfaction, alongside current sociopolitical demands on EM services. Recognising the psychological experiences and needs of EM consultants and promoting a sustainable EM consultant role could benefit individual psychological well-being and the delivery of emergency care.

  • emergency care systems, emergency departments
  • emergency department
  • psychology, staff support
  • qualitative research
  • staff support

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  • Contributors As lead author, KF led the planning, conduct, and reporting of the work described in the article. PY, JB and AH supported the planning and recruitment process from an academic and clinical perspective. PY supported KF in reviewing the analysis conducted by KF. PY, JB and AH reviewed and edited the manuscript. These were the only people involved in the study and article.

  • Competing interests None declared.

  • Ethics approval University of Exeter.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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