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The emergency room at Akron Children’s Hospital is where nurse Laura Worlow spends most of her work day. She has worked as a first responder – as a paramedic, and now as an ER nurse – for 25 years.
Worlow has suffered from asthma for years, and the constant exposure to stress and trauma at work only exacerbated her condition.
"I was very good at shoving things away and saying oh I’m fine, not working through it… Until my asthma said, Nope, we’re doing with this… And literally put me in the hospital," Worlow said.
Most Americans are stressed about money and work, says the American Psychological Association. A 2015 study out of Stanford University examining the cost of workplace stress found that it causes some 120,000 deaths – and $190 billion in healthcare costs – each year.
Jeffrey Pfeffer, an author of the study and professor of organizational behavior at Stanford University, equates the impact of those deaths and costs to be as bad as exposure to cigarette smoke.
"We found that the health effects of these workplace exposures – many of which are stress related – are as great as secondhand smoke, a known carcinogen which is regulated," Pfeffer said.
For first responders like paramedics and nurses like Worlow, the level of stress is particularly high… and that impacts their mental health. According to the Journal of Emergency Medical Services, 37% of paramedics contemplate suicide, compared to only 3.7% of average Americans. Substance abuse is also a common issue for emergency responders, with up to 40% having alcohol and drug problems, according to a 2009 study.
Robert Kaplan is a forensic and clinical psychologist who has worked closely with emergency responders. He notes that being the first to respond to scenes rife with trauma, death, and abuse wears on the mind and body.
"An individual who is in this kind of work has to do more to manage stress in their life than the average individual," said Kaplan. "And if they don’t, then they’re much more subject to physical disease. They begin to have stomachaches, backaches, headaches, hypertension, cardiac disease, heart attacks… I mean, these are the types of illnesses that are more commonly seen in emergency responders and police officers than you would see in the general population."
Experts say a big part of overcoming stress is simply stopping to talk through the experiences. At Akron Children’s Hospital and across the country, a tool known as Schwartz Rounds is starting to help doctors pause during their hectic schedules and discuss the tough cases they bury in the back of their minds, says Dr. Mike Forbes, an ER doctor at Akron Children’s Hospital.
"I’ve watched attending physicians who are discussing cases from 7 years ago break down and start crying," Forbes said. "Because you actually never stop to grieve the loss… you just go on to the next case. So what the Schwartz rounds have allowed us to do is to actually pause and rewind, and say okay how did you actually feel about that."
Laura Worlow is now a leader of the critical response team at the hospital and coaches fellow nurses on how to respond to stress and trauma. She hopes her efforts help first responders learn how to consider their own health while working to save the lives of others.