Earthquake: The Long Road Back : Hospitals’ Front-Line Workers Near Burnout : Stress: Psychiatric counselors offer help to weary doctors and nurses who have been logging 14-hour days.

If Gen. H. Norman Schwarzkopf had been a psychiatrist, he might have been like Dr. Stephen E. Salenger.

Clad in Army fatigues and black combat boots, the husky, bearded Salenger prowls the halls of Northridge Hospital Medical Center, pausing here and there to talk with haggard-looking doctors and nurses, offering them words of solace and encouragement as if they were battle-weary soldiers headed back to the front line.

Which, in a sense, they are.

Since Monday’s shattering earthquake, Los Angeles hospitals have treated and released 6,547 injured people. Another 1,292 were admitted with serious injuries, and many of them are in critical condition.

That huge influx, combined with the frustrations of broken equipment and the tensions of 14-hour days, have left many hospital workers exhausted to the point of burnout.

At several hospitals, psychiatric counselors have swung into action, advising staffers on coping with the twin stresses of caring for hordes of injured people even as they struggle to clean up their own quake-tossed homes and reassure their aftershock-frazzled families.

At Kaiser Permanente in Panorama City, a counselor met with employees of the optometry department to discuss their feelings after their popular department head, Burton Krell, was killed in an auto accident while heading for the hospital shortly after the quake struck.

At Cedars-Sinai Medical Center in West Los Angeles, a psychiatrist sent one employee home after she expressed terror that she would be swallowed up in ground softened by repeated aftershocks.

Just minutes into a quake-stress meeting at the Northridge hospital, situated virtually atop the quake’s epicenter, a middle-aged nurse stood up and walked swiftly from the room. Returning later, she said she had thrown up--a reaction to days of trying to suppress her fears of the quake and its aftershocks.

“I’ve been acting braver than I really am,” she said. “Suddenly just now I felt this awful nausea. I thought I was doing quite well until that point.”

At the same meeting, a young emergency room technician expressed shame over not rushing to the hospital right after the quake; a top executive said he was angry at political “looky-loos”--including Gayle Wilson, the governor’s wife--for appearing at the overloaded hospital for photo opportunities.

Northridge hospital officials acknowledge that day after day of 12- and 14-hour shifts--combined with worries over quake-damaged homes and anxious spouses and children--are wearing down staffers.

“It’s a massive amount of psychic trauma, and around here it’s not letting up,” said Dr. Paul Karis, who supervises the emergency-room staff at Northridge, which has treated more than 600 quake victims since Monday. “The staff is just running out of steam.”

Karis told of approaching another Northridge doctor a couple of days after the quake to ask how he was holding up.

The other man erupted in tears.

“He’s the first person you see in the morning . . . and he says he has several patients with chest pains, one with a heart attack. His house is basically condemned, he hasn’t slept more than six hours in the past three days,” Karis said.

“His wife is coming apart, his kids won’t stop crying. His brick wall fell down, and the dogs ran away.”

Some hospitals also have set up day-care centers for employees whose regular day-care arrangements were canceled or who simply cannot bear to be separated from their children at the moment--or vice versa.

To help stressed-out staffers at Northridge, psychiatrist Salenger and three dozen other doctors, nurses and emergency workers were brought in under a little-known federal program, the National Disaster Medical System, which dispatches teams of medical workers to back up local ones overwhelmed during major disasters.

Salenger’s team, which also responded in Hawaii after Hurricane Iniki, wears distinctive blue jumpsuits or military fatigues; many members also wear combat boots. Most of them work at hospitals and fire departments in San Bernardino County.

Striding the corridors at Northridge in his camouflage combat outfit, Salenger, chief of staff at Patton State Hospital, a psychiatric facility in San Bernardino, sought to reassure anxiety-ridden staffers that their reactions were nothing to worry about.

“These are not psychological problems,” he said. “This is not mental illness. These are normal reactions to abnormal situations.”

Salenger described their problems as “critical incident stress,” saying the best treatment is simply to give workers a chance to vent their feelings and fears--while on the job.

Although temporary, if untreated, such stress can metamorphose into far more serious post-traumatic stress disorder, a mental disturbance suffered by some Vietnam War veterans, he said.

Dr. Geoffrey Newstadt, head of emergency psychiatry at Cedars-Sinai, said his unit has counseled a number of staffers “in crisis” as a result of the quake.

“I didn’t hear a lot of people on Monday and Tuesday say, ‘I’m scared,’ ” he said. “I’ve heard a lot of people say that today,” he said earlier this week.

Newstadt added that many staffers also tell of bizarre and frightening dreams, probably set off by the quake. Others complain of sleeplessness due to the aftershocks.

“There’s nothing quite so unnerving as the earth moving and buildings falling down,” he said.

But hospital officials note that the surge in patient numbers won’t last forever. And they add that the best medicine for their staffs may be simply talking out their problems--while sticking with their jobs.

“The more they tell their story, the more they can put it into perspective,” said Bonnie Lipton, head of social workers at Kaiser in Panorama City.

“And they can do this while working.”