The crisis-oriented nature of emergency medicine makes implementing traditional stress management techniques particularly challenging. Between constant interruptions, lack of privacy, and the pressure to maintain patient flow, most wellness practices prove unsustainable in the ED environment. In this context, Emotional Freedom Technique (EFT), or “tapping,” stands out as a uniquely practical solution. This evidence-based practice integrates cognitive behavioral therapy, exposure therapy, and traditional Chinese medicine’s acupressure principles in a way that can be utilized even during the busiest shifts.
Benefits for Emergency Physicians
In the busy ED environment, EFT provides immediate stress reduction in 2-3 minutes between patients and requires no special equipment. The Journal of Nervous and Mental Disease cites EFT’s effectiveness for anxiety reduction, depression, overall severity of symptoms, and symptom breadth. Further, WebMD notes a survey of 20 studies that compared EFT’s efficacy for the reduction of depression symptoms to conventional treatments, making it particularly valuable for healthcare workers experiencing occupational stress.
How to Perform EFT
EFT follows a simple four-step process that can be completed in minutes. While it may feel awkward initially, the sequence quickly becomes second nature with practice. Cleveland Clinic outlines the following steps:
1. Identify and Tune In
- Put a hand on your chest and close your eyes
- Focus inward on the specific emotion or issue bothering you (e.g., stress from a difficult patient encounter)
2. Rate the Intensity
- Score the intensity from 0 (“totally fine”) to 10 (“absolute worst”)
3. Create Setup Statement
- Acknowledge the issue while affirming self-acceptance
- Example: “Even though I feel overwhelmed by this trauma case, I fully and deeply accept myself”
4. Perform Tapping Sequence
Using two fingers, gently tap each point 7-9 times while repeating variations of your setup statement:
- Side of hand (below pinky finger)
- Eyebrow (inner edge near nose bridge)
- Side of eye (on bone)
- Under eye (on bone)
- Under nose
- Under lip (above chin)
- Collarbone
- Under arm (about 4 inches below armpit)
- Crown of head
Complete 5-7 rounds, then reassess your intensity level. If needed, repeat the sequence until you feel a reduction in intensity.
Implementation in the ED
Emergency physicians can practice EFT before starting shifts, between difficult cases, during breaks, or after challenging encounters. It can be helpful to set phone reminders, use during known down times, and incorporate into pre-shift routines for consistent practice.
Start Small: Begin with 1-2 minute sessions focused on immediate stressors during natural breaks in workflow. This gradual approach builds consistency in practice.
Target ED Stressors: Apply EFT to specific challenges like high patient volume anxiety, difficult patient interactions, critical case stress, and end-of-shift fatigue.
Build Routine: Identify trigger points in your shift and develop standard responses to common stressors. Create personal tapping sequences for recurring challenges to make EFT an automatic stress response.
Recap
The beauty of EFT lies in its simplicity and immediacy. In a specialty where time is precious and stress is constant, having a quick, evidence-based tool for emotional regulation can significantly impact daily practice and long-term wellness. While EFT isn’t a substitute for the medical treatment of anxiety, depression, and other serious emotional issues, it can help many people manage workplace and personal stress.
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