你有压力，我有压力

I was asked to give a psy opinion on the fact that a Canadian study found that stress levels were the highest in A&E doctors.

I tried to search for the above mentioned article but to no avail. Don't get me wrong, I have no intention of doing a journal critique. I just wanted to scare my MO out of her A&E traineeship so that she will join us in psy.

Back to the issue at hand.

If my limited interactions with A&E physicians were anything to go by, the plasma cortisol levels in our dear A&E colleagues must be sky high. I base this not on the degree of hirsutism but on several observations I have made:

1) the facebook status of a friend working in A&E reeks of fear before his shift starts.

2) the female A&E MO who attended to me when I sprained my ankle did not smile back!

3) a certain A&E has a protocol for medical HOs/MOs to accompany patients for CT scan even if the A&E was empty and the A&E MO then had to accompany the medical MO who was accompanying the patient to the CT scan as the A&E MO had nothing to do and felt paiseh that her classmate was accompanying her patient.

My own gripes aside :P, there are several reasons why the A&E is likely to cause more stress in their doctors than other speciality:

1) Shift work.
Shift work affects sleep and is a precipitating and perpetuating factor for insomnia. This can lead to a vicious cycle of poor sleep, anxiety, even poorer sleep and even more anxiety. A&E doctors also tend to have unstable meal times as well.

2) Uncertainty.
The work of most other speciality are more circumscribed while the A&E doctors can never predict what will come through their doors. Indeed, patients with psy complaints are often the most feared ones. Although A&E training probably equips their physicians in dealing with medical emergencies, they are not trained to deal with emotional disturbances and psy emergencies that may turn up at their door steps.

3) Identifying.
In the course of trauma work, clinicians often identify themselves with the victims. There is no doubt that some A&E doctors may identify themselves with RTA, burns, suicide patients. If not properly dealt with, the doctors may suffer emotional consequences.

4) Load.
As with all other specialities in Singapore, our load is ridiculous.

5) Care and Welfare.
Little or no formal programmes are in place to address the stress faced by A&E physicians and these are often substituted by camaraderie amongst colleagues and incessant rantings on blogs.

Of course, this does not answer the question of whether the A&E speciality is indeed the most stressful of them all.

If a teacher came to me telling me that her job was the most stressful one in the world, I would agree. If a prata seller came to me telling me that flipping prata was the most stressful job in the world, I would agree.

After all, stress is unquantifiable and up to an individual's own perception. If one chooses to perceive his or her work as being the most stress inducing, he or she is probably right.