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How events in emergency medicine impact doctors’ psychological well-being
  1. Laura Howard1,2,
  2. Christopher Wibberley2,
  3. Liz Crowe3,4,
  4. Richard Body1,5
  1. 1 Emergency Department, Manchester University Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
  2. 2 Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
  3. 3 School of Medicine, The University of Queensland, Herston, Queensland, Australia
  4. 4 Paediatric Intensive Care Unit, Lady Cilento Children’s Hospital, South Brisbane, Queensland, Australia
  5. 5 Cardiovascular Sciences Research Group, The Innovation Centre, The University of Manchester, Manchester, UK
  1. Correspondence to Dr Laura Howard, Emergency Department, Manchester University Foundation NHS Trust, Manchester M13 9WL, UK; laurahoward{at}


Background Emergency medicine is a high-pressured specialty with exposure to disturbing events and risk. We conducted a qualitative study to identify which clinical events resulted in emotional disruption and the impact of these events on the well-being of physicians working in an ED.

Methods We used the principles of naturalistic inquiry to conduct narrative interviews with physicians working in the ED at Central Manchester University Hospitals NHS Foundation Trust, between September and October 2016. Participants were asked, ‘Could you tell me about a time when an event at work has continued to play on your mind after the shift in which it occurred was over?’ Data were analysed using framework analysis. The study had three a priori themes reported here. Other emergent themes were analysed separately.

Results We interviewed 17 participants. Within the first a priori theme (‘clinical events’) factors associated with emotional disruption included young or traumatic deaths, patients or situations that physicians could relate to, witnessing the impact of death on relatives, the burden of responsibility (including medical error) and conflict in the workplace. Under theme 2 (psychological and physical effects), participants reported substantial upset leading to substance misuse, sleep disruption and neglecting their own physical needs through preoccupation with caring. Within theme 3 (impact on relationships), many interviewees described becoming withdrawn from personal relationships following clinical events, while others described feeling isolated because friends and family were non-medical.

Conclusions Clinical events encountered in the ED can affect a physician’s psychological and physical well-being. For many participants these effects were negative and long lasting.

  • psychology
  • staff support
  • mental health

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  • Contributors LH designed the research study, collected the data, analysed the results and led on writing the manuscript. CW and RB were involved in input and advice on research design, analysed the results and critically reviewed the manuscript. LC was involved in input on research design and critically reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Health Research Authority (IRAS ID 209236) and Manchester Metropolitan University Ethics Committee.

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

  • Data sharing statement Unpublished data from this study (the emergent themes) will be presented in a second paper which will be submitted for consideration of publication.

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