ER Docs Don`t Make List of Most Stressful Jobs

Jan. 26--Years ago, physician Jim McDonnel remembers, an 18-year-old girl entered a Bakersfield emergency room with an asthma attack.

A couple of hours later, as he sat down next to the girl's mother in the waiting room, the woman put a hand on his knee and said, "Doc, you don't think she'll have to spend the night in the hospital, do you?"

"Her worst thought was that her daughter was going to have to spend the night in the hospital," said McDonnel, who has been an ER doctor at Arroyo Grande Community Hospital for the past 20 years. "And I had to tell her that her daughter had died."

Understandably, whenever McDonnel sees a worker looking overwhelmed outside a hospital setting, he can't help but grin a little.

"When I see people in various situations thinking that their job is a lot of stress," he said, "I realize that everything is relative."

Oddly enough, ER doctor was not included in the annual list of most stressful jobs, put out this month by the website CareerCast.com.

"There's a whole bunch of jobs that should be on this list," said Pismo Beach psychologist Jason Cohen, who often deals with work-related stress in his practice.

Clearly, some careers are more stressful than others. Yet, professionals in the most tense of situations often find ways to cope thanks to support from others, a balanced home life and an affinity for their work.

"Just because something's stressful, that's not necessarily a negative thing," said Mary Verdin, a public relations executive -- No. 5 on the list of most stressful jobs -- who created Verdin marketing agency in San Luis Obispo a decade ago. "Sometimes that's exciting and gets you focused."

Facing trauma, death

In ranking the most stressful careers, CareerCast looked at 11 stress factors, including things such as growth potential, deadlines, exposure to the public and whether lives are at risk.

In his job, McDonnel regularly sees patients with chest pains, blunt traumas and other serious injuries.

"The stressful thing is when they bring John Doe from the (Oceano) Dunes, and he's 23 years old, and he's perfect, except for he's dead or near dead, and you do what you can to resuscitate him to keep him alive or make him alive," McDonnel said. "And if you don't succeed, 21/2 hours later, there's going to be pandemonium in the emergency department because that's when families arrive."

Police officers and firefighters (No. 10 and No. 3 on the list, respectively) can find themselves in life-saving roles. But usually a 911 dispatcher is the first to respond to a life-or-death situation.

Inside the Emergency Operations Center at the San Luis Obispo County Sheriff's Office, a poster describes some of the duties a 911 operator has. It begins, "Today I ... made life and death decisions," then continues to list other scenarios, including "prevented a suicide," "directed a helicopter to a serious emergency" and "instructed someone on CPR."

A 911 operator has to be ready for any of those calls, said Holly Porter, a dispatcher there for the past seven years, even though the callers are caught off guard by unforeseen events.

"The people that call into us, they're at the scariest time in their lives or they're angry or they're hurt," she said. "They're not at their best. But it's our job to be our best every time the phone rings."

Like Porter, McDonnel doesn't get to take a break when things are hectic. In the past 20 years, he said, he can only think of one shift when he didn't see a single patient. Usually, he sees at least five per shift. And he never knows what oddity he might confront -- be it a woman with a bald eagle's talons dug into her arm or a man with a circular saw blade embedded in his face.

"I've had countless people say, 'I don't know how you do what you do,' " he said. "Because they've seen me or one of my colleagues rushing around from bed to bed with everybody screaming and crying and in pain."

Stress in the mundane

But one's health doesn't have to be on the line for a job to be stressful. For Verdin, the most stressful days are those when something unexpected happens -- like when a client needs damage control in a hurry.

"I'm a planner, so I want things planned out ahead of time," she said. "If you get a call like that from someone, you have to find room right now to help them with something because tomorrow might be worse."

Obviously, enlisted military members (No. 1 on the list) would have inordinate amounts of stress during combat situations. But even soldiers who are stateside experience stress.

When Joel McClain of Grover Beach joined the Army National Guard, he found himself getting screamed at by superiors 2,500 miles from home.

"I was recently married right before I went to basic (training), so that was stressful on my relationship," he said. "And my daughter was born halfway through basic. I saw her when she was a month old, and then I didn't see her until she was 9 months old."

While talk of stressful careers usually involves romanticized jobs such as commercial pilot (No. 4) or photojournalist (No. 7), even the more mundane jobs can have stress, said Cohen, the psychologist.

"Oftentimes, a lot of what causes stress at the workplace is the inability of the worker to have some sort of autonomy or control or a sense of decision-making in the company," he said.

If there's a disconnect between effort and reward, a lack of job security or upward mobility, an unpleasant job environment -- all those things and more can contribute to work-related stress, he said.

Employers are often to blame, he said, for not properly screening prospective employees and not monitoring stress levels.

A poor job market can make them even worse.

"In this economy, they're squeezing more out of less and expecting to get the same results," he said. "You can't."

Finding support

But people do find ways to cope.

Even if Verdin has to deal with something unexpected in a hurry, the first thing she'll do is create a plan to re-establish order.

"There's a sense of comfort in that for me," she said. "And for clients, too."

McDonnel said the first thing he does in a stressful moment is check his own pulse.

"As the ER physician, you can have a calming effect or you can have an anxiety-provoking effect on the rest of the staff," he said.

A supportive environment helps. That can be casual -- at Verdin, workers bond over wine on Friday afternoons -- or more in-the-moment.

For Porter, the support often occurs during an intense call.

"If something intense is going on, we'll mimic back what the person is saying a little bit louder so everybody else in the room knows," she said. "I'll say, 'OK -- so he's not breathing,' and then everyone's paying attention to what I'm doing. My partner might flip my cards for me to get me right to CPR (instructions) so I don't have to try to thumb through and get it."

With time and experience, even the most stressful scenarios are easier to handle. Or, as McDonnel said -- "you get used to the blood and guts."

"Now it's like second nature," said Porter, who was an events and wedding coordinator before becoming a 911 dispatcher. "When that phone rings, you grab it without even thinking what might be on the other end."

In some cases, workers simply need to decompress outside the job with hobbies or relaxing activities.

When McClain was desperately homesick in Alabama, he and his buddies would take a cab to Panama City, Fla., and hang out at the beach.

"That was our escape," he said.

Porter likes to take walks and garden. McDonnel flies kites on the beach. And Verdin visits Disneyland with her family.

Family can help, too

"There are days when I get home, and I have to ask my husband and the teenagers, 'Please don't tell me any of your problems right now,' " Porter said.

While stress is not always viewed as a good thing, it can be a motivator.

"When deadlines start piling up or they start coming too fast, that's when the stress steps in," Verdin said. "But then that stress helps you get that shot of adrenaline to get it all done."

That stress level might induce a few gray hairs. But some of the most stressful scenarios can lead to the biggest rewards.

While McDonnel and Porter often deal with emergencies that don't turn out well, they get a charge from the more positive results.

"That is the good part of the job -- you can make a difference," McDonnel said. "Isn't it nice to be a significant part of a system that lets somebody live where they might have died?"

At the Sheriff's Office, a 911 dispatcher might help save a life by instructing a caller on CPR, they might assist deputies in finding a lost child or they might coach someone to deliver a baby.

"We have so many happy endings, the stress of the job is OK," Porter said. "Something amazing always happens."

Top 10 Most Stressful Jobs

1. Enlisted military personnel

2. Military general

3. Firefighter

4. Commercial airline pilot

5. Public relations executive

6. Senior corporate executive

7. Photojournalist

8. Newspaper reporter

9. Taxi driver

10. Police officer

Source: CareerCast.com

Copyright 2013 - The Tribune (San Luis Obispo, Calif.)