The Impact of Compassion and Emotion in the Emergency Department

Emergency departments are often hectic and stressful places filled with patients who are uncertain and scared, and healthcare providers who are overworked and overstimulated. Some patients are in the midst of intense distress stemming from both pain and the psychological aspects of anxiety, fear, anger, or hopelessness that are associated with an emergency. The emotions involved in the interpersonal interactions between patients and healthcare providers in an emergency room play a significant role in clinical care and patient outcomes.

Studies suggest that patients’ perception of compassionate care during medical emergencies has a long-term impact on their physical and psychological recovery. However, medical providers themselves are only human, and emergency department (ED) physicians and nurses have repeated interactions with patients experiencing heightened emotions. Emotionally evocative patients can elicit anger, frustration, or irritation in a provider, but they can also elicit positive emotions such as happiness, satisfaction, or appreciation. Provider perception of individual patients can subconsciously influence decisions on patient care and even impact patient safety.

Research from social cognitive and affective science has demonstrated that emotions such as anger and happiness do reliably influence how people think. For example, it can influence whether someone processes information in a superficial or analytical manner. In a clinical setting, the distinction between superficial and in-depth analysis can significantly impact the level of care provided.

While the emotional aspect of interactions between patients and providers is essential to consider at all levels of the healthcare system, the ED is a prime setting for heightened emotions in critical medical situations. Recognizing this, one study aimed to identify reliable psychological skills that can enhance emergency care providers’ performance under stress. The study recommended a specific set of four performance-enhancing psychological skills: breathe, talk, see, and focus. 

Breathing techniques promote slow, deep, and controlled respiration, which can help reduce anxiety. Positive self-talk involves an internal monologue that includes instructional, motivational, mood-related, and self-affirming statements. Visualization, also known as mental practice, consists of visualizing the steps of a clinical skill or procedure, keeping in mind what an effective performance looks like. The last step, focus, involves implementing a “trigger word,” any word that the provider chooses to bring their full attention to the task at hand. The mnemonic proposed by the study for remembering these skills is “Beat the stress, fool,” with the intention that the mnemonic alone will elicit a smile, which can help reduce stress.

Research suggests that compassion matters far more than many suspect in the moment. ED providers are, first and foremost, human beings who frequently find themselves in challenging scenarios. Data suggests that angry encounters result in detrimental behaviors that likely reduce the quality of care, while positive encounters lead to better care and possibly fewer errors. While it is impossible to avoid emotionally evocative encounters in the ED, training that informs providers on the importance of monitoring their emotional response when making clinical decisions, as well as teaching psychological skills that can help providers stay grounded, could increase positive outcomes for patients in the ED. The administrations of hospitals can also make a difference by cultivating an environment where providers’ mental health is prioritized and compassion is systemically encouraged.

Thank you for reading,

Ashby Glover

Sources

Clifford M. Marks, Amanda Scudder, Brian W. Roberts, Adrian D. Haimovich, Stephen W. Trzeciak, and Nathan I. Shapiro. “Compassionate care in the emergency department: A narrative review and blueprint for future inquiry.” The American Journal of Emergency Medicine 91 (2025): 1-7. doi: 10.1016/j.ajem.2025.02.012

Linda M. Isbell, Julia Tager, Kendall Beals, and Guanyu Liu. “Emotionally evocative patients in the emergency department: a mixed methods investigation of providers’ reported emotions and implications for patient safety.” BMJ Quality & Safety 29, no. 10 (January 2020): 1-2. doi: 10.1136/bmjqs-2019-010110

Michael J. Lauria, Isabelle A. Gallo, Stephen Rush, Jason Brooks, Rory Spiegel, and Scott D. Weingart. “Psychological Skills to Improve Emergency Care Providers’ Performance Under Stress.” Annals of Emergency Medicine 70, no. 6 (December 2017): P884-890. doi: 10.1016/j.annemergmed.2017.03.018