Trauma team on call: Why are we all so stressed?

Acute stress is a known contributor to surgical outcomes. While trauma care is widely acknowledged to be stressful, understanding of specific sources of practitioner stress across learner levels is currently limited. Implementing tailored stress mitigation techniques is not possible without an increased understanding of the specific stress triggers. The objective of this study was to explore sources of acute stress for trauma care providers across various learner levels. Semi-structured interviews were undertaken following major trauma activations at a Level 1 urban trauma center. Interviews were conducted with medical students, surgical residents, and surgical attendings, exploring their perception of acute stress during the preceding event. Interviews were transcribed, coded and analyzed for emerging themes. 38 trauma team shifts were observed including major trauma activations. 58 interviews were conducted with 4 medical students, 7 junior residents, 4 senior residents, and 7 trauma surgery attendings. Three predominant themes related to sources of acute stress where identified: “performance”, “stress contagion” and “fear of the unknown”. While all three themes were identified across all learner levels, emphasis and context for a given theme varied based on an individual's position within the team hierarchy. Three recurring sources of stress identified amongst all learner levels within the trauma team: “performance”, “stress contagion” and “fear of the unknown”. These themes offer concrete targets for future development of stress mitigation efforts.