Emergency room doctor: “Explosive situation but I’m staying in the public service”

The story of Gabriele Valli, employed in a large Roman hospital: “Ours is a high-stress job but it’s beautiful and I won’t change, but we need to protect white coats”

“It is undeniable that the emergency room situation in Italy is difficult”, burdened as they are by increasingly pressing problems. Above all of “organization, starting from insufficient local medicine that leads to too many improper requests”. Added to this is “the reduced number of doctors, the lack of tools to offer treatments to patients once the acute problem has been resolved, the need to manage not only assistance but also the discontent of citizens”. All of this “certainly brings with it very high stress for the operators. An explosive situation, in short. But, in any case, it is a beautiful work, the maximum expression, in my opinion, of the doctor’s profession. For this reason, despite everything, I’m staying. And I ask, at the same time, for more attention and protection for this sector “. It is the story, told to Adnkronos Salute, by Gabriele Valli, an emergency room doctor in a large Roman hospital that motivates, in such a complicated framework for the sector, the choice of those who are not attracted by the sirens of the highly paid ‘token holders’ or from escapes to the private.

“Emergency rooms – underlines Valli – represent the gateway to hospital care. We are used to dealing with health emergencies and unprecedented emergency situations. With Covid, which surprised us at a stage in which there were already difficulties, we had to manage incredible problems, moreover keeping under control two different emergency rooms: ordinary and Covid. It was very difficult. However, in general, facing and solving unexpected problems is part of this job. It is the charm of medicine urgency, but also the source of stress. I love this job that I would not change, I will not change. It is wonderful because it has a key role in the cure: it is the maximum expression of what I consider the profession to be, not the healer but the one who cures And treating doesn’t necessarily mean healing from the disease, but taking charge of the patient. The people who turn to us do so, above all, with extreme trust. It’s my experience”.

Having said this, however, “the stress that accompanies the profession can become exhausting, therefore this figure should be protected who, in this particular phase of the NHS, is overwhelmed by the public health crisis. We are on the front line, we are the first to suffer the “wave, as emerges more and more from the news. But without corrective measures, other sectors will also have similar problems, from family doctors whose shortage is increasing, to specialists”, continues Valli. “Stress, I repeat, is part of this profession. It happens that you have to manage a sudden influx. But if every day you find yourself managing 40 stretchers for hours and if the numbers never drop below the critical threshold, stress becomes explosive. This, even if it doesn’t happen in my structure, large and articulated – he specifies – emerges more and more often in the stories of colleagues in different areas of the country”.

It is not surprising, therefore, that the “number of doctors who choose to be an emergency specialist has decreased”. To complicate everything, in a “vicious circle”, we have “a local medicine that works little, which does not filter out improper accesses”, while on the social-health level “there is often a vacuum. We are the only open door in any 24-hour health emergency. Unfortunately, however, we lack the tools to channel those who are treated into subsequent care pathways, I am thinking, for example, of the homeless: who to entrust after treatment? In many cases we happen to have to hospitalize the lonely old man, who could be assisted at home, because there is no one who can take care of him in the slightest need. All this is left on the shoulders of the doctors, we are alone. Having more instruments would relieve stress”.

And it would be less burdensome even if there were “gratuities for the operators, not only in terms of money but also – he suggests – of time, of usability of holidays, but above all of stimulating professional perspectives. For example, personally, the possibility of managing the training motivated me a lot. But it would also be useful to use our experiences for research in the field of emergencies. Many tools come to us from studies done by those who do not work in the emergency room and do not fully understand the critical issues, such as the need to follow multiple patients at the same time”.

Indeed, having ‘mobility’ and stimuli in the activity “is fundamental with respect to the reduction of psychological pressure and fatigue. It is one thing to work shifts at 30, another at 60. It is unthinkable that a doctor remains to sleep awake six times a month after 30-35 years of activity, as if he had started the day before.It gets very exhausting, and a little scary – he admits – not seeing a real and concrete prospect of changing the own type of activity over time”, concludes Valli, underlining that “greater attention from political and institutional decision-makers would make it possible to make emergency doctors feel less alone”.