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‘Toughen Up, It’s Part of the Job’ – Coping with the Emotional Trauma of Emergency Service and Healthcare Work

Stressed medical professional struggling with mental health

This week we present a guest blog post from a British physician, Dr. Benjamin Janaway, who writes about medicine and politics for the international press.  Normally, our focus at www.rtor.org is on those who look to under-resourced and overstretched healthcare systems for help with mental health and emotional struggles, including trauma.  Dr. Janaway’s guest post turns the focus on the healthcare professionals who work within those systems, and can also be affected by the trauma, stress, and impossible to meet expectations they are faced with.  His article is a reminder that those who help are sometimes also in need of help. – Jay Boll, Editor in Chief

Some jobs are just harder than others, but some come with a cost too great to bear. As suicide rates reach record levels, the horrors of emergency service work are coming to light. Who could think that saving lives means losing your own? But in reality the harrowing experiences of staff can drive people past the point of no return. And unfortunately, it seems employers aren’t doing enough.

So, should we just toughen up? Or is there more to the story?

‘Toughen Up or Die’

It is a truth well known that there is an ethos of stoicism in healthcare. And those who cannot cope can be quickly dismissed. But the epithet of ‘Toughen Up’ is entrenched in the service, and it is doing damage. Whilst staff are asked to endure emotional trauma, it seems the support just isn’t there. And the solution, ‘try harder’, is just making things worse.

Increased workload, stress, burnout, compassion fatigue and an increased reliance on alcohol are just indicators of a wider problem. Heroes are not gods, they are exhaustible and have their limits. And our novel research backs that up.

‘Unhelpful and Bad’

Of one-hundred medical staff surveyed by the author 98% of respondents admitted to being exposed to a ‘toughen up’ environment at work. One respondent said;

‘I feel almost constantly overwhelmed. Trying to toughen up is just trying to survive.’

And 71% claimed this happened constantly, with 68% worrying that any sign of ‘weakness’ was met with derision or bullying. Another respondent told us:

‘As an ethos it’s harmful because if issues arise they tend to then be addressed in an arrogant manner without care or understanding.’

Worse still, an astounding 85% claimed that their own health had suffered.  One respondent told us, stressing anonymity:

‘I’m leaving healthcare early next year because of the strain it puts on my mental health.’

And he was not alone, as 75% questioned had considered leaving work, and 97% felt that organizations should offer more support.

However, 56% agreed that the need to ‘toughen up’ was ‘their duty’. And many stressed that although things were hard, this was just something they have to endure.

Another Way Forward

Perhaps the most interesting realization is the true extent that the ‘Toughen Up’ ethos has entered into work psychology. Although respondents were very much aware of dangers to their health, they still put these concerns as second place. And it seems that staff, medical at least, are happy to sacrifice their own health for the greater cause. But as noble as it is, martyrdom is not sustainable.

It is high time that the ‘Toughen up’ culture grew up. As science has shown us, humans are susceptible to trauma, and repeated bouts can have lasting damage. Even one severe event can cause problems for years to come. To truly build resilience, one must have a support network, people to talk to and an atmosphere of acceptance. And this is where we are letting our heroes down, letting their own wounds bleed whilst plastering others.

So, what is the answer? It’s quite simple really, remember that humans have limits, and work together to make sure they are never reached. And when they are, which they will be at times, come together.

If you or someone you know experiences mental health problems, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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Author Bio: Dr. Ben Janaway is a British Doctor and journalist with degrees in Medicine and Neuropathology. He currently writes on health and political topics for a range of publications including The Independent, Cosmopolitan Magazine, Patient.info and The Canary. @drjanaway


  1. http://www.news.com.au/finance/work/every-six-weeks-an-emergency-services-worker-in-australia-commits-suicide/news-story/728bedaac0840e4a6214c0e525324d44
  2. https://www.standard.co.uk/news/london/familys-tribute-to-young-mother-and-son-11-who-died-in-horror-car-crash-9591135.html
  3. http://www.aafp.org/fpm/2015/0900/p42.html
  4. https://www.smithslawyers.com.au/blog/health/compassion-fatigue-caregivers/
  5. https://www.physiciansweekly.com/alcohol-abuse-among-physicians/


The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc.

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