title: The psychological health and well-being of emergency medicine consultants in the UK.
abstract: OBJECTIVE
  To explore the experience of psychological distress and well-being in emergency medicine (EM) consultants.
  
  
  METHODS
  A qualitative, interpretative phenomenological analysis (IPA) study based on 1:1 semistructured interviews with EM consultants working full time in EDs across South West England. Eighteen EM consultants were interviewed across five EDs, the mean (SD) age of participants being 43.17 (5.8) years. The personal meanings that participants attached to their experiences were inductively analysed.
  
  
  RESULTS
  The analysis formed three superordinate themes: systemic pressures, physical and mental strain and managing the challenges. Pressures within the ED and healthcare system contributed to participants feeling undervalued and unsatisfied when working in an increasingly uncontrollable environment. Participants described working intensely to meet systemic demands, which inadvertently contributed to a diminishing sense of achievement and self-worth. Consultants perceived their experience of physical and emotional strain as unsustainable, as it negatively impacted; functioning at work, relationships, personal well-being and the EM profession. Participants described how sustainability as an EM consultant could be promoted by social support from consultant colleagues and the ED team, and the opportunity to develop new roles and support ED problem solving at an organisational level. These processes supported a stigma-reducing means of promoting psychological well-being.
  
  
  CONCLUSIONS
  EM consultants experience considerable physical and mental strain. This strain is dynamically related to consultants' experiences of diminishing self-worth and satisfaction, alongside current sociopolitical demands on EM services. Recognising the psychological experiences and needs of EM consultants and promoting a sustainable EM consultant role could benefit individual psychological well-being and the delivery of emergency care.
authors.affiliation: Clinical Psychology & Counselling Department, Nephrology and Transplant Directorate, Cardiff & Vale University Health Board, Cardiff, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Fitzgerald
authors.affiliation: Department of Psychology, College of Life & Environmental Sciences, University of Exeter, Exeter, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Yates
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.|Academic Department of Emergency Care, Emergency Department, Bristol Royal Infirmary, Bristol, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Benger
authors.affiliation: Emergency Department, Royal Devon & Exeter Foundation Trust, Exeter, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Harris
mesh_terms: D000328:Adult; D003253:Consultants / Q000523:psychology*; D004632:Emergency Medical Services / Q000639:trends; D004635:Emergency Medicine; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D000078329:Workforce; D016526:Workload
keywords: emergency care systems, emergency departments; emergency department; psychology, staff support; qualitative research; staff support