They even work at night and weekends. They do not get panicky in times of crisis and are there to hold the hands of the dying and stride through messes and stay calm. They are the doctors, nurses and caregivers and they are the backbone of any healthcare. However, underneath their professionalism and strength is the truth: a mental burden so great, that, in most cases, it is not visible against the mask of duty.
As a healthcare industry, deadpan and stoicism are not only acceptable in the competitive and stressful game, they are mandatory. Whether it is medical school, emergency rooms, the medical profession teaches practitioners to suppress emotions, concentrate only on results, and be what we call a soldier to get through. Although such mentality in the short-term helps the performance, the effect of the same in the long run is devastating.
🔗 Find out more on the culture of emotional stoicism and how it impacts the way people behave and act and are mentally.
This article examines this psychological burden unseen by the health care providers. It draws attention to the fact that the self-sacrificial culture discourages vulnerability, and it requires the changes within the system to encourage emotional validation, support, and long-term well-being.
The Culture of Emotional Suppression in Medicine
- A Profession Built on silence
Healthcare workers are always dealing with tragedy: a child cannot survive the operation, a patient with cancer has taken his last breath, a parent is told that his or her child is dying. The feelings that come out during such moments are something that will scar. In hospitals however, grief is perceived as a distraction, something to do behind the scenes, nothing at all.
The absorption of pain by doctors and nurses has been exercised without attention, and the doctors and nurses often think that this emotional silence is part of their job.
- The Myth of the Invulnerable Caregiver
There is a tendency to glorify a depiction of a hard, emotionless doctor, the one who does not flinch, who does not break down, who does not hesitate, the one that the popular culture would consider a strong and a stoic doctor. Nevertheless, this myth has its after-effects. It has also set an example that hurt feelings are unmanly and a mentally unhealthy person is unprofessional.
As a consequence, many caregivers put off their own internal pain until it becomes a more destructive issue.
Emotional Stoicism: Strength or Survival Mechanism?
Emotional stoicism is not always bad, sometimes it enables a healthcare worker engaged in the following of life-saving decisions. However, eventually, it may become desensitization, particularly when supported by the institutional norms.
Key effect of emotional stoicism include:
- Control as activation of unreleased feelings in form of anxiety, depression or anger
- The fear to be judged and thus not getting assistance
- Loss of Depersonalization: loss of point of patient care
- Mental fatigue is normally mixed up with exhaustion
Unaddressed, emotional stoicism is just a form of coping that some day leads to said serious mental health issues.
The Hidden Mental Burdens
Care giving is a process, which has a psychological cost that does not come suddenly. It is the accumulation of day after day pain, support and the various moral dilemmas that the healthcare workers observe and carry on with.
- Burnout
Exhaustion, depersonalization and lack of sense of accomplishment have been used to describe burnout. This is prevalent more so in the high intensity settings and working environments like emergency wards, intensive care unit, and the operating wards.
Employees are tired, disengaged and have no ability to influence the situation. However, they do not stop, and usually without recognition and help.
- Compassion Fatigue
The emotional remnant of trauma and suffering experienced by the patients is called the compassion fatigue. With time, the caregivers may end up feeling emotionally numb not because they have ceased being caring, but because they have tried to be too much caring and have no emotional reserves to count on.
Symptoms include:
- Emotional detachment
- Cynicism
- The guilt feeling due to failure to help every one of them
- Intrusive or flashbacks thoughts
- Depression and Anxiety
Depression and anxiety are kept in the shadows by most healthcare workers. The research indicates that the rate of suicide is above the average, among doctors and nurses; they usually have undiagnosed mental health conditions. The toxic workplace culture and the stigma around seeking help press that a lot of individuals remain silent.
Real Stories from Behind the Mask
Chioma, Nurse in Lagos
“I lost the number of patients who I have witnessed dying. One could not shed tears in the workplace. I used to sit in the storage room and cry. It is a violation of a regulation to feel a human being.”
Dr. Marcus, ER Physician in the U.S.
“I desensitized after a decade of being in emergency medicine. One of them was admitted in cardiac arrest. It has taken me an hour when I worked on him. On his death, I felt nothing. Feeling of being defeated was not as much frightening as the feeling of fear.”
All of these stories indicate a dangerous normalisation of a lack of emotional connection in the health sector.
Barriers to Emotional Validation in Healthcare
🔒 Fear of Judgment
Healthcare workers are also afraid that the emotional distress is harmful to their public reputation, lead to a slow promotion or have any other forms of professional repercussions. Treatment of mental illnesses requires the disclosure of conditions even to therapists in certain nations who can be required to report the same to the licensing boards.
🚷 Lack of Safe Spaces
Other hospitals do not have any forums where they can process emotions or rely on peers. There is little debriefing and, in most cases, when it happens, it does not look at the emotional outcome, but rather the clinical outcome.
🛑 Insufficient Training on Emotional Resilience
Emotional intelligence is not taught with any significant emphasis; however, the technical competence aspect of medical education is a focus. Medical students are trained on ways of performing CPR, and not on how to handle the death of a patient.
The Need for Emotional Validation and Systemic Support
Emotional intelligence is not taught with any significant emphasis; however, the technical competence aspect of medical education is a focus. Medical students are trained on ways of performing CPR, and not on how to handle the death of a patient.
- Rewriting the Narrative: Vulnerability is Not Weakness
Cultural-based organizations and various training institutions need to defy the cultural story that vulnerability equates to incompetence. This can be achieved by:
Positive encouragement of the senior professionals to be role models in terms of emotional honesty
There is the inclusion of mental health training in the schooling of other medics and nurses
Facilitating the advocacy of such messages as the idea that it is okay not to be okay in the healthcare environment
- Building Institutional Support Systems
The support needs to be emotional, and it should be a part of infrastructure in the workplace and not one that comes at the time of the emergency.
Essential systems include:
- Regular mental healthcare screenings
- Private openings to counselors or psychologists
- Peer led helping groups
- Post traumatic debriefing arranged after the emotionally traumatizing events
This should not be stigmatized but normal.
- Educating for Emotional Intelligence
Students should learn the following already in the first year of medical or nursing school:
- Through the process of identifying the emotional suffering of other people and themselves
- On managing loss and grief
- What to say in order to express their feeling of sympathy with them without crushing themselves
- Techniques based on mindfulness, journaling and grounding…
Curriculum should teach emotional well being as basic – not elective.
- Creating Emotional Safe Zones
All hospitals or even clinics must be provided with at least one quiet room to reflect, shed tears, pray or even recollect their thoughts. Such places deliver one obvious message – it is permissible to feel.
Another practice leaders ought to follow is regular check-in on well-being but not on performance. Inquiring about how one is emotionally doing should be common.
Global Best Practices
Canada – “The Pause” Movement
Following a patient death, groups pause 30 seconds as a group, thus dedicating the incident to the life a patient had, and the weight of the feeling.
UK’s NHS – “Staff Support Hubs”
24/7 Incubation of mental health in NHS facilities in the UK is provided through virtual hubs. Employees are able to receive therapy and resilience training as well as emotional checks.
Kenya – “Peer Support Circles” in Community Health Programs
CHWs gather once a month to talk about mental health challenges, with the support of trained mental health professionals,
Such interventions have been proved to curtail burnout, enhance morale and bring open emotional communication.
Benefits of a Mentally Healthy Workforce
Others of care providers that hold emotions:
- More patients give satisfying responses
- Create fewer medical errors
- Have better team relationships
- Keep in their roles longer
- Serve with a lot of compassion and empathy
The emotional well-being of people is supported on the healthcare system and when this is supported, everyone wins including the care giver and the patient.
Conclusion: Behind the Mask Lies a Human Being
The mask that doctors, nurses and caregivers are putting is not only physical but symbolic. It conceals emotion, pain and even occasionally, the gradual disintegration of mental health. Professionalism does not require silence and emotional restraint, but being composed.
The irresponsible myth of the impregnable caregiver should be shattered. Human beings are the healthcare workers. Even they should have had a right to feel, to suffer, to talk – to recover.
By criticizing this culture of emotional stoicism, we open the gate to more humane and sustainable healthcare system. A system through which expressing the emotions is not a liability, but a token of the strength. A health care system enshrining the caretakers of ourselves.
