Subtitles section Play video Print subtitles Hello. I'm David Hoffman, filmmaker, and I'm about to show you a film I made to help people deal with extreme stress. Do you feel stress, too? I feel stress. Lots of times. Do people hate stress? Anxiety? I hate anxiety. It feels awful. Let me give you a few statistics. Most Americans, 70% say they have moderate to high stress. Much of the time. I assume it's even worse in other parts of the world. Some of you and not in America. Tell me about it. Are you feeling that level of stress? 44% say their stress levels have increased in the last five years. It's getting worse. Stress is getting worse. Where more stressed, I know that when I drive even in my town and certainly on the highway, you can feel it in the car. Is people getting like this? 77% feel physical symptoms, headaches, stomachaches, difficulty sleeping. That's horrible. We are a stress society and maybe a stressed world. 73% have psychological problems and they say the primary sources of stress Here they are job fears. I understand that real well money, fears, money, money, money, money, money. I'm sick of money yet. I need it. We all needed stress. Health fears. I have a lot of those. I'm a bit of a hypochondriac. I don't know if you are, but it ain't pleasant. It feels bad. Fear, fear, fear. That's the course of this stress. Well, this subject has interested me all of my life. And in my younger life, I felt really bad stress I looked around for where can I get somebody to allow me to make a movie to really look at the subject? And I got Detroit receiving hospital. A trauma center, a great hospital. Ah, place where there is a lot of stress. And where is the most direct in the hospital? You can guess the E R area, the emergency room. The emergency department filled with stress. Why? Because their energy goes up. Up, up, up, up, up, up. Somebody's about to die. Ambulance coming in, down, down, down, down! Waiting for the next call. Sitting around waiting for the next ambulance. Up, up, up, up, down, down, down, down! Brutal! So I made a film to help emergency room workers, nurses, doctors, others deal with the stress. But I really made it for everyone. And I hope that it helps you consider what these people do. How did they deal with this? And also have the courage to look at your own stress? I look at mine because I can't avoid it. Maybe you feel the same way. The anxieties in me right now as I'm shooting. Am I doing a good job? Am I sharing with you what I need to What would help you? Um I'm doing it right. In any case, take a look. Stress hope it helps. And at the end, if you can really make comment and tell me what are you dealing with these days? Okay. One? Yeah. I don't know. No problem. I don't know. Yeah, he doesn't have any family here. The magic didn't work this time. Way were too late to make a difference. It happens sometimes. Someone we don't even know. Perhaps I don't even want to know. Will touch us. Will make us think will break through a shell. 88 year old father. I think about this sometime. I see him coming through like this about my dad. When something does get through, a lot of us tend to push it down, black it out. Try and carry on without work way. Tell ourselves it doesn't get to us, but it does. Death can be a powerful stressor, but then there's no lack of stress. And what we do is that it's It's barely 6 30 on Friday night, and the emergency department modules are already filling up at a few codes through complicated cases. And the adrenaline can really start pumping. It may help make the night go faster, but can leave you exhausted by morning. This'll has to stay. So this is what's equivalent to being normal for him, right? Yeah, but on the party we actually had our way. Paste can be real, Agnes. So can the responsibility. All those decisions big and small decisions which affect our patients when he gets too much for too long, the result can be burnout. We all know the symptoms so we don't talk about it. Much. Feelings of helplessness, demoralization, avoidance, depression, exhaustion, difficulty sleeping headaches, loss of appetite. Does it mean were burnt out? Not necessarily. Burnout is a cumulative process, one we only need worry about if the symptoms become chronic and start to interfere with our work end her home life. It's a very intense atmosphere. You know anything goes wrong, you know, a suit. You're wrong at the right at a particular time when you're trying to sew something up, there's a tremendous pressure, and in between these pressures, you have to relax you. You can't be keyed up and tight all the time. And generally the tighter the situation, the harder things more You have to sort of fool around in between. The more you have to look on the light side because otherwise you'd crack. It's not the big things that suddenly put him over the edge. What's interesting is it often a tiny little straw? Some offhand little comment are just getting the wrong result of just being given the wrong extra. You're just picking up the wrong a piece of paper. Once a guy loses his sense of humor. Once a guy can't smile once a guy can't say good morning. Once a guy can't kid with somebody else, you gotta worry. A sense of humor probably is our best defense being able to smile or a joke. It can relieve the tension, even if it might not always seem appropriate to an outsider. After all, we deal with so much pain and suffering that often the only way we can talk about the things that touch us that upset us is by finding the humor in them. I love working here. There's a certain rhythm to our work, really. Especially here in the emergency department. Waken be overwhelmed at times, often for hours. Suddenly it's quiet like now Now is the time to take a break. Swap a story. Tell a joke, event any pent up frustration. Gotta wanted to get out. Goes to pull it. No, no, no. But these old important moments never seem to last long enough. Just when we're starting to relax, something always happens. Only 84 11 number way. Very female. Hit by a truck trump. For me, it's clear. I think it was a car versus truck larvae. Just a car with leaders minutes. The next line. We'll be there, buddy. Minute. She's a night. It was you was in advance unit. They're gonna get a line. He's downstairs. Change and you'll be on the dock. Did you count the countdown to a code like this? One can be pretty nerve racking even when we've been through it 100 times anticipation, preparation, the checking and double checking. No matter how well we briefed, we've learned to expect the unexpected. Just having a sound truck so loud. Yeah, incredibly wage. Yes, good girl. She's talking about moving way. Had to constantly social. Okay, okay, Yeah, multiple codes. Complicated ones like these. This is recess at its best. To an outsider, it could look like it's getting out of control, but it is it. This is what we've been trained for. All of us are prioritizing, making decisions, thinking fast, heard what's going on around us, our patients, each other. We're all part of a team were in it together. We're also pushing ourselves to have limits right out there on the edge. It's exciting. It's what draws a lot of us to this work. And yet it's exhausting, too. It's a routine that can eventually get to be too much, and it can wear us down and it can burn us out. This kind of an environment for some of us and at some stages of our life is a tunnel. It gives us purpose. It gives us a sense of doing something that is, uh, one of the most remarkable human endeavors you can D'oh! You're You're healing the wounded. You're there where the action is. You're part of something that is, uh it has a lure. And there's nothing wrong with a drama of coming to work in the urban mash unit of the trick. On the other hand, after a while, that aspect of working in a place no longer has its special flavor. It may not bring out of you rejuvenation, creativity, the good kind of arousal. And instead, because of many factors, often things going on in the rest of our lives. Not what's going on here. Well, we lose that elasticity way, Get more emotionally fragile on really? We get hard. Housekeeping. Recess, please. Housekeeping. Recess. This is the aftermath of a code with three cold spect about big ones. I mean, I haven't been out of this room 34 hours, so it's kind of tough, and we got some new Dax and that makes it a little carrier than usual, because they tend to be a little sloppy. And then if you don't get it put back up and you're not ready for the next one. So far, it's been another busy shift for Carol Taylor. I'm on a lot of gas. I'm due for a break. She's getting tired, maybe even a little irritable. That's when we need to find ways to ease off. We all have our ways of relaxing a cup of coffee, something to eat a few minutes off in the lounge. That can help. Sometimes you put your head down for a while. I close your eyes for 15 20 minutes at house tonight. There's always been something getting in the way. What? No, the second time. If Europe the second night, You don't want to sleep, so you you sort of start to adjust your clock. That 1st 1 is kind of. Some of these people live at night. I don't know how they it's bizarre. Getting enough sleep is often easier said than done. Too little for too long can really grind us down. So we have to be careful. We have to take care of ourselves. It's important to keep fit to get the right things, get a little sleep whenever we can. I've woken up in the middle of the night and bolted out of bed looking for a patient's chart. My room. Uh, seriously. I mean, I've scoured the room looking for I've called into the hospital. I want to call the hospital to the person who was on call here asking if I put in a central line. It's a patient If I started a catheter underneath this patient's serious procedure, So you wake up with these delusions. We've all had the occasional delusion when tired. On many nights, the anger and menace of the city streets can sweep into the hospital. We know that it's an emotionally charged environment way know that people don't want to be here. They're not coming in for a well baby check. They're coming in because they're injured or they're hurt. Or they are. They're sick and and oftentimes they're angry. And you see people that are very emotionally charged and it brings out emotions in the health care giver that probably they would wish that they didn't. They didn't have to bring out. I mean, we patched him up, shipped amount. We deal with him for months that saying the intensive care unit go out. You know, just come back next week, come back drunk and shot are you know, whatever it was that brought a man, it just brings him right back, so that part makes you better. It's easy to get cynical and angry. It's a natural reaction, but one which can diminish us as people and professionals, sometimes with patients. It's not easy to have empathy for their problem, and I think that when you lose that empathy, uh, that you don't give us good care. We all know how good we feel when we see how we've been able to help Ticketmaster. It's easy to connect with the patients and families we can relate to, but there's a downside when things don't work out. We end up sharing the grief in the pain. And he was a C six, quiet and really just a nervous wreck, and he couldn't breathe on his own, was diaphragm didn't work, and he had a wonderful family. But he himself was just so anxious and he tried everybody's patience. He was very demanding. He didn't cooperate with the care and I hear on days that I wasn't here. He was really just awful because he and I ended up having a really good report and it be days when I'd yell at him and then, you know, then he said, I'm sorry. We worked it together, but then when I wasn't there, everybody, I'm so glad you're back. You can have your primary bag, you know? So I guess the hardest thing for me when a sister called City died, like maybe a few days after he liked here, You know, after all that work we put into it and everything in first, I don't know, something happened. And it's like he said before he left, was gonna die. D'oh! When we've gotten this close to a patient, invested this much of ourselves in their recovery, their death can be very upsetting. Most of us will try to leave these emotions here at the hospital. Others find it helps to share them with their families. She's supposed to have this done. Usually has this done before ago. Carol Taylor collects pins and she wears the Mona scripts whenever she gets up and gets ready to go to work, you know, usually wash your uniforms and stuff for and all the pens have to come off. Each reminds her of someone or something. She doesn't want to forget it under the door.