When a patient’s heart stops inside a hospital, the resuscitation that follows is one of the most time-critical events in medicine. What happens to the doctors, nurses and orderlies who perform it, emotionally, has received far less attention than the survival of the patient.
The study, published in Frontiers in Medicine, was conducted by researchers at Aarhus University and affiliated hospitals in the Central Denmark Region. It comes at a moment when the problem has gained international institutional weight: the International Liaison Committee on Resuscitation (ILCOR) has identified ensuring the well-being of healthcare professionals as one of ten prioritized steps toward improving outcomes after in-hospital cardiac arrest. Yet, as the authors note, evidence on how to actually secure that well-being remains scarce, and existing interventions lack robust empirical support.
The scale of the underlying problem is considerable. In Denmark, more than 2,000 in-hospital cardiac arrests occur every year, with roughly 28 percent of patients surviving 30 days. Because arrests happen across many departments rather than only in intensive care, most healthcare professionals can expect to encounter one at some point in their careers. Previous research has shown that these events can be emotionally demanding and can affect psychological well-being, and that the emotional toll may contribute to burnout, stress and work-related anxiety. Earlier work has also found post-traumatic stress symptoms in 9.6 percent of emergency care staff after attending an in-hospital cardiac arrest, with junior staff particularly vulnerable.
To explore the question in depth, the team designed an exploratory qualitative study using individual semi-structured interviews. Participants were purposively recruited from two hospitals in the Central Denmark Region, a university hospital functioning as a cardiac arrest center and a smaller regional hospital, to capture variation in size and context. From each site, two doctors, two nurses and two orderlies were recruited, deliberately including orderlies, hospital workers who perform tasks such as patient transport and chest compressions on arrest teams, because they are often overlooked in discussions of burnout and mental well-being. Every participant had been actively involved in an in-hospital cardiac arrest within a window ranging from two weeks to 18 months before the interview, a timeframe chosen to balance opportunity for reflection against the possibility that coping experiences change over years.
Between March 27 and April 24, 2024, the researchers conducted 12 interviews, all of the invited participants agreeing to take part. The interviews, conducted face-to-face in Danish and lasting roughly 45 to 60 minutes, were audio recorded, transcribed with AI assistance and then checked against the recordings. The participants, seven of them women, had a median clinical experience of 7.25 years. Transcripts were analyzed using reflexive thematic analysis following the six-phase approach of Braun and Clarke, with coding performed in NVivo 14. Initial coding generated 82 codes across the 12 transcripts, which were clustered into themes and refined collaboratively by the research team, whose reflexivity discussions explicitly considered how their own backgrounds in resuscitation research and basic life support instruction might shape interpretation.
The analysis revealed six main themes and 14 subthemes, organized into two overarching categories: factors contributing to the emotional impact of cardiac arrest, and coping strategies associated with it. On the impact side, three themes emerged. Patient-related impact captured the deep distress of treating young patients and children; ten participants said pediatric cases or young patients affected them most, and a few reported deliberately avoiding departments where pediatric arrests were more likely. One doctor described the scream of a mother realizing her child had died as something you never forget, placing it on the level of losing one’s own loved ones. Dealing with the relatives of deceased patients was a related subtheme, with one doctor recalling having to call a wife while her children cried in the background, an event he said still affected him.
Contextual impact covered the distress caused when an arrest deviated from the norm: equipment malfunctions, such as defibrillator pads that were not connected when the first shock was due; team disruptions, including frustration when the arrest team arrived without knowing who the patient was; and unpredictable locations, such as a collapsed patient in a cramped bathroom. Nurses in particular highlighted frustration with unclear do-not-attempt-resuscitation decisions, with colleagues finding it deeply frustrating that no decision had been made. Personal impact, the third theme, included the lasting weight of a first cardiac arrest, which one orderly said he could never let go of, and the burden of a personal connection to the patient, as when a team had known and liked the patient well.
On the coping side, the researchers distinguished three styles according to how participants described their responses. Passive coping involved internal cognitive and emotional processes without deliberate action. Its subthemes were justification, rationalizing both the outcome and the circumstances of the arrest, for example by reviewing whether things had been under control; distancing, in which eleven professionals emotionally detached from the event, with one orderly describing the shift as becoming the person performing chest compressions rather than himself; and exposure, in which repeated encounters with arrests made subsequent events feel easier to handle, although participants did not describe this as a deliberate strategy.
Active coping, by contrast, involved deliberate actions. Post-event reflection ranged from informal conversations with peers to department-led debriefings: eight participants found it helpful to discuss their emotional experiences with colleagues, five valued walking through the arrest scenario step by step, and two reported no benefit from discussing emotions in debriefings. Notably, no department had a standardized debriefing protocol, and orderlies reported that occasional multiprofessional cold debriefings felt less useful, with one describing an inability to focus on sensitive matters in front of more highly educated colleagues. The second active subtheme, addressing educational needs, involved pursuing scenario training and refining resuscitation skills, which participants described as building confidence even when practiced on a mannequin. All 12 participants found it easier to process the emotional impact when sharing experiences with co-workers who had been through similar events, and reflection was most often initiated independently with a colleague of the same profession who had taken part in the same arrest.
The third style, reflective coping, captured participants’ awareness of how interpersonal and organizational conditions shaped their ability to cope. Subthemes included the work environment, where competent, supportive colleagues and psychological safety were described as crucial, with one orderly noting that simply knowing the first names of the anesthesiology team made a world of difference; and emotional awareness, the recognition of one’s own and others’ emotional responses, including the conviction that no one should be forced to talk before they are ready. A striking finding concerned junior doctors, who described the morning conference, a routine forum for case review, as an unsafe environment in which to discuss arrests they had led during night shifts. The authors argue this highlights the difference between support being offered and support being usable: a debriefing may exist on paper yet remain inaccessible to those who do not experience the setting as psychologically safe. Based on these reflections, the researchers propose measures including hot defusing sessions focused on emotional distress, profession-specific peer support options, facilitators trained in psychological safety, emotionally challenging scenarios integrated into arrest training, and recognition that experience does not eliminate the need for support. As an exploratory qualitative study of 12 participants at two Danish hospitals, the findings are shaped by participants’ accounts and the researchers’ interpretation, and the study was not powered to compare professional groups; but the authors say the results underscore the need for organizational support systems, and further research, to protect the well-being of the people who respond when a heart stops.
Subject of Research: How in-hospital cardiac arrests emotionally affect healthcare professionals and the coping strategies they use
Article Title: Identifying the needs and optimal support for healthcare professionals after in-hospital cardiac arrest: a qualitative study
Article References: Roest, S. L. K., Krogh, K., Løfgren, B., & Lauridsen, K. G. (2026). Identifying the needs and optimal support for healthcare professionals after in-hospital cardiac arrest: a qualitative study. Frontiers in Medicine, 13, Article 1940522. https://doi.org/10.3389/fmed.2026.1940522
Image Credits: AI Generated
DOI: 10.3389/fmed.2026.1940522
Keywords: in-hospital cardiac arrest, healthcare professionals, coping strategies, qualitative study, resuscitation, emotional impact, debriefing, psychological safety, burnout, nurses, orderlies, Denmark
News Source: Ophelia Keating. (October 28, 2026). After the Code: How Hospital Staff Cope With In-Hospital Cardiac Arrests. Scienmag.
