Dispatching stress in the EOC #IAM999

ou're never making just one decision_(1)

In this month’s EMJ, Astrid Coxon and team have published a study looking at the experiences of staff working in local Emergency Operations Centres (EOCs). Broadly, staff who work there are in two groups. There are call takers who answer 999 calls from members of the public, process the information they receive, triage it, and pass it to the dispatch team, and in some cases stay on the phone line to talk to the caller or give emergency medical advice. The other group are the dispatchers. They take the information from the call takers, and liaise directly with the frontline crews to co-ordinate and prioritise the medical response to the huge volume of calls that come in every day.

The study looked at this second group, who are largely invisible to the public, and aimed to identify key stressors in the workplace, so that these could be managed and reduced where possible. They hope that this could have a positive impact on the well-being of the staff, reduce sickness absence, and decrease staff turnover. The main factors found involved resources and pay, interpersonal difficulties, and feeling overworked and undervalued – themes that I’m sure many in all areas of healthcare can relate to. You can read about some of the ways the participants in the study felt that stress could be reduced, as well as some of the authors’ suggestions, in the EMJ or on the website.

This article, as well as the recent #IAM999 campaign on Twitter and other forms of social media, reminds us how crucial it is to remember that before our patient turned up nicely packaged by the paramedics, and indeed before the paramedics even arrived on scene, there was someone on the other end of the phone, supporting and giving advice to a worried patient, concerned relatives, or a distressed bystander. They may have been listening to the last words someone would ever say, or helping a child try to resuscitate their mother or father.  There are so many people who work behind the scenes in pre-hospital and emergency medicine. Their support and work are a huge part of the process that has led to your patient arriving in the ED, but too often we forget that this bit actually exists. It’s reassuring that work has been done to try to assess stress in these people, and to look for ways they themselves, as well as the organisation they work for, can make changes to reduce this.

It can’t be an easy job, particularly when, like ED doctors and nurses, time is rarely taken to process what’s happened before moving onto the next poorly patient. However, it’s a rewarding job, and one that can make a huge difference to the lives of patients and their families.

As Sam, who participated in the study, said, “I can honestly say I go home at the end of every single day and I’ve made a difference to at least one person…”.

And for me at least, that’s what emergency medicine, from the first 999 call, to the patient leaving the department, is all about.




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