In my professional opinion, this is all an act: Burnout in Healthcare
I.
I was a wide eyed, freshly certified EMT looking to create good in the world through my very first job in Emergency Medical Services. My plan was to “ride along” with a local ambulance company in the somewhat underserved side of town.
In the beginning, I was toned to help out a fellow ambulance crew. Once we got our first call we drove out to a creaky house that looked like it was on its last hinge. The patient was a woman lying awake on her side with a chief complaint of abdominal pain. Her concerned husband stood to the side with one baby girl in his hands and another toddler by his shin. The main EMT leading the call instructed us to help lift her down the porch’s front steps smoothly.
Suddenly, the woman fell unconscious.
My adrenaline quickened because something was obviously wrong. She wasn’t responding to any verbal stimulation or tapping. The lead EMT immediately called for an urgent paramedic. As I was standing off to the side, I watched the seamless transfer of the patient from the chair to stretcher and from stretcher into the ambulance.
The main EMT noticed me and slid the ambulance window shut. The first thing that he said to me was, “In my professional opinion, this is all an act. This is all b*llsh*t.” The shocking excitement of caring for the patient rotted into shock over his statement.
“What do you mean?” I sputtered.
“They just do that when they’re trying to get to the hospital quicker.” He waved his hand nonchalantly.
As it turned out, the patient had gone into shock due to her ectopic pregnancy. In laymen terms, the patient was pregnant with her egg in the wrong location that had caused life-threatening bleeding. Even upon hearing the devastating news, the lead EMT, who had made a mistake in extricating the patient said, “I hope that the doctors tie her up down there. She has way too many kids.”
II.
The irony of healthcare is the “care” part. One half of physicians and a third of nurses experience symptoms of burnout, some of which include increased cynicism and less empathy [1]. In the wake of the COVID-19 pandemic, the burnout that had existed anyway became exacerbated by the growing mortality rate or lack of PPE.
Lorraine, a secondary character in “Air Unplugged,” is a character who embodies burnout. She’s an older nurse and while she has more experience under her belt, she has also felt the heavy burden from the demands of the job for 20 years. In preparing to write Air Unplugged, I interviewed passionate nurses who really delved into the topic of burnout in healthcare. Nursing has always been tough, that isn’t a secret, but according to the nurses it used to be easier because of the humanity in hospital management. Nurses felt heard and their demands were met back then. Nurses were treated like individuals, not as a means towards a Christmas bonus.
But now modern nursing has become corporatized with extra insurance documentation and punitive environments. One nurse I interviewed talked about intimidation in her workplace when she wanted to speak up about a recurring issue. Even as a well established nurse, she was risking getting fired and taking the blame for the issue behind closed doors. These types of workplace issues put even more stress on a demanding job even for those at the top of the hierarchy. And for young nurses like the main protagonist in Air Unplugged, Ary, complaining in your first year wasn’t an option. When working such a high stress job with such a vivid hierarchy, it is no wonder that burnout and exhaustion is so commonplace in medicine.
Air Unplugged takes this idea of burnout and heavy corporatism mixed in with healthcare and lets the volcano explode. While Lorraine serves as a good mentor for Ary, she’s not perfect. As pressures comes from upper management to take a dangerous trip, no one stands up to management. For Lorraine, she’d be risking being fired. And for fresh-eyed Ary, her opinion isn’t even seriously considered.
III.
Needless to say, I didn’t take the job with the first EMS company for obvious reasons. But the same cynicism and burnout followed me to the other company where I worked with medics 30 years in the field. They too were jaded, working 50+ hours of a physically grueling job in order to make the most of their low wages. They still maintained their professionalism in the face of a patient — but you’d think these people were misanthropes if you heard them speak.
If you are interested in more, Air Unplugged is out for pre-order for the next month. https://www.indiegogo.com/projects/air-unplugged-by-olga-akopiants--2/x/25124941#/
