# Please, may I have some advice?



## Chickpea (Jun 27, 2008)

(I'm sorry if I'm posting this in the wrong place.)

I'm not an EMS anything, but my boyfriend has recently become an EMT, and I admire him very much for it. 
He loves his job (and I love that he has something that makes him feel so fulfilled.) But sometimes he has difficulty dealing with it when people he's trying to save don't make it. He blames himself for it. And me saying, "it's not your fault" doesn't seem to help. He says that I don't understand, and he's kind of right about that; I've never been in that position and I don't know what it's like. I really wish I could make him feel better, but I'm just not sure what I should say... so, um, if anyone here can offer me any advice on how I could help him to get through it, or even just to make things a little easier on him, I would be very, very grateful.

Thank you.


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## reaper (Jun 27, 2008)

He needs to learn that we don't SAVE lives. Sometimes no matter what you do, the pt dies. That is just a part of life. If he did everything he could and they still died, then they were going to die anyways.

If he does not learn this now, he will burn himself out and never enjoy the profession.

Some people think I'm cold, because I never get affected by a pt's death. I have always known from the start that you can't keep everyone alive. I am very passionate with my pt's, but I don't get wrapped up in their problems.

If I do everything right and I go home alive, then I am a happy camper!!!


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## MedicAngel (Jun 27, 2008)

Hon, Reaper is right, he needs to learn to deal with the stress and every day calls we get or he is going to become jaded and it will effect his over all performance and attitude in the long run.

Whether he is volunteer or paid, there should be a board of voted in members who serve as a team to sit down with him after a bad incident and debrief him and those on the call. I would strongly encourage him to read his by-laws or talk to an officer to see what their protocall is and follow up on it. 

One thing I have always done, and I have only been a volunteer EMT for about 4 years is keep a journal that only I know where it is in my house. When I have a particularly bad call I sit down and write out in detail what it was, what happened, and how it effected me and or how it could of gone differently. It is solely for me, no one else will ever see it and it helps me personally with things. 

Good luck and he is lucky to have a gf who is willing to ask questions. Let us know how it goes.


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## Airwaygoddess (Jun 27, 2008)

*Life.......*

Hi Chickpea, one of the hardest things to do in a relationship with an EMS person is trying to understand where their feelings are coming from.  What you are saying is right but for him, it seems like he has the the weight of the world on his shoulders.  It does not help with him being the new guy and trying to measure up to the older and seasoned staff.  
  First and foremost, dealing with human life at it's most fragile and unstable time  can be a true test of one's self. Our coping mechanisms come from how we were raised, our life experiences,and our faith, this haves a lot with how we deal with situations.  What is important here is that he needs to understand that people will always get sick and hurt, and yes people do die.  What is important is that your boyfriend must learn to not take it home to his heart.  It would be a good idea for him to talk to someone for counseling and learning new coping mechanisms.  In this job we are always learning, for ourselves and our patients.
                             I hope this helps............  Anna


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## mikeylikesit (Jun 27, 2008)

Just explain to him that even though he may not have saved the patient who was going to pass on anyways, that him being their made a huge difference in that persons life before they died. That he helped make them more comfortable for the inevitable. we can't save everyone and unfortunately when your new and a vet you still go through the "what if's" thinking that there may have been more that you could have done in order to save the patient. Acceptance can not be taught, only self learned from experience. If he is religious just tell him this. "If god wanted that person up in heaven...then he was going to them there no matter what you did".


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## The Lion (Jun 27, 2008)

I'm her boyfriend.

I appreciate her trying to do this for me, but I'd really rather.. deal with it alone. Thank you for your replies. I appreciate them as well. I'm not new to death. I worked as a police officer in Russia. I'm just not quite used to this aspect of it, so to speak. 

This will come in time.

I've been to the CISDs, they don't particularly help me.

Again, I don't wish to be a jerk, I really do appreciate you guys and gals trying to help. Thank you.


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## The Lion (Jun 27, 2008)

Um.. I thought I'd post twice. I'll admit that I got a bit angry when I saw her post here, and so my above post was a bit clipped and curt. I don't mean to be rude, so I'll explain myself a bit. I sort of feel a bit humiliated that something like that bothers me when it doesn't bother anyone else that I work with - and, some of you, apparently. 

In general, I'm a shy person. I don't like to talk about things much, which is really why the CISD's don't help me the way they may help other people. I'd really rather just say that I'm fine, and have them leave me alone. I do love my job, really, and I'm not here expecting to save everyone. I'd love that, but I'm realistic, and I realize that I won't be able to. It's just the way certain people die that bothers me, and again, I'm sure that I'll get used to it. 

I am pleased and a bit comforted to know that I did what I could, but.. I suppose, not as much as it comforts other people? I always assume I could have done more. 

I'm not upset about being the "new kid". The people I work with are very pleasant and I enjoy working with them. I learn a lot from them. Some of them have obviously noticed that I'm not entirely ok sometimes - the ones that work with me the most often, obviously - and they've tried to talk to me about it, but I don't really... talk. It's just my nature, I've always been this way. They've accepted me, and no one treats me like "the new kid".

As to what Anna suggested about the journal, I'm not sure how that would help me. Again, with my non-talkative personality, and the fact that if something bothers me, I don't like to remember the emotional quality of it, so to speak, I wouldn't like having to write it down. That would sort of ingrain everything in my memory.

I'm not comfortable with talking with councilors and such. I'm just not. I'm not trying to be difficult or anything, and I'm sorry.

I am religious, and I do try to think that at least this person is hopefully in Heaven, and no longer suffering, but it's not quite that easy.

Um.. I think that's all of it.

Ah, reaper. I don't think you're cold. You have a right approach, I think. Hopefully, in time, I will be like that.


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## traumateam1 (Jun 28, 2008)

I think not talking about what you have seen can cause a lot of damage and will burn you out quickly. Just because you have seen death in Russia as a police officer doesn't quite prepare you for this.. this is different. Trying for 30 minutes to save someone is quite different then seeing it as a police officer and not having the same "connection" as a medic will have.

There are a lot of shy people out there but not opening up and talking about that SIDS baby that you tried to save, or the family van that got pancaked between a semi and the side of a building will cause a lot of non needed emotional build up. I'm sure there will be people that will read my post and not agree with me.. but I have found that talking about it, or writing it out, or just getting it off your chest in some way is a lot better than NOT. Saying you are ok, and it's no big deal may work for a while.. but eventually it will build up and up and just like a volcano will "blow up" (burning out).

I'm pretty positive that most medics, whether its an EMT-B, EMT-I, EMT-P anything below or above that needs to talk about those emotionally disturbing calls. After all we are all humans and we do have emotions, while most of us have acquired the skill to temporarily "turn off" emotions at certain calls, I am sure that after.. reality will set in.

*As for the girlfriend* just know what the signs and symptoms of a medic that is burning out looks like. I'm not saying that it will, but be sure you are aware of it. Click here for a good site Be supportive and if he ever needs to just vent, let him. Sometimes going home to my girlfriend and just opening up really helps. You may not completely understand or know what he's going through but just let him vent.


And here comes the critisism....


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## Hastings (Jun 28, 2008)

You know, I wonder sometimes if there's something wrong with me, because I am completely unaffected by even the nastiest of calls. I always expected to be one of those people who goes into depression after losing someone. But ever since the beginning, I've never been affected. I wonder what my trick is. I wonder if I should care about these people more than I do.


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## mycrofft (Jun 28, 2008)

*Львев, hang tough. You too, Chickpea*

I see lots of good advice and feelings for you here, it may not seem right for you, but we're here and many of us have been through some rough stuff.

If you get persistent or self-damaging problems going, get professional help. Find a counselor whom you can work with (they are not all alike). Lion, you had to suck it up as a law officer, you are in a different field now. Chickpea, his problems are not your problems, but you folks can work on them together even if only through patience and support.

Me, I finally blogged about my most stressful encounter. Even after over twenty years, I was surprised at the relief. In fact, I found that it may have subconsciously been why I was blogging, becasue after that I was off the blog for a month.

Peace, bro and sis.


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## So. IL Medic (Jun 28, 2008)

Hastings said:


> You know, I wonder sometimes if there's something wrong with me, because I am completely unaffected by even the nastiest of calls. I always expected to be one of those people who goes into depression after losing someone. But ever since the beginning, I've never been affected. I wonder what my trick is. I wonder if I should care about these people more than I do.



Hastings, do you care enough to give your best to the people we serve?


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## Ridryder911 (Jun 28, 2008)

There is a difference between empathy & sympathy. One should have empathy towards the patient and family, if not GET OUT! We don't need apathetic providers. Being sympathetic is just as worse. Where one cannot remove themselves from a call or patient. The next patient needs and deserves your full attention. One should learn their expectations as well. Unfortunately, many did not learn that the majority of our patients do become worse, and yes most die. We attempt to to prevent if possible, but a majority of them the condition is to severe, or have awaited too long. 

If you are truly having a problem, and you realize it, get professional help. Please do NOT go for CISD! It has been proven repetivly to be potentially harmful for rescuers and as you have discussed the method is not for everyone. Why we still continue to promote such measures, I have no idea? If it was a medication we were giving we would be held negligible. Again, get a licensed professional.. Ironically most find out they can open up to one on one more than a group. Sometimes, being quiet is good ..sometimes it is not. Yes, it is worth it.. it may save you from more difficult times ahead, your career and your mental health. 

Also, you are lucky you have someone that cares for you so much. Apparently, they are concerned for your well being both physically, mentally and professionally. Many in this business are not so lucky.

Good luck! 
R/r 911


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## Hastings (Jun 28, 2008)

So. IL Medic said:


> Hastings, do you care enough to give your best to the people we serve?



Of course. I care about each patient while they're my patient as a human being, and give them the best care I can. The thing is that once we drop them off or they die, they're just a passing "oh well." It's just always caught me by surprise.


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## Ridryder911 (Jun 28, 2008)

Hastings said:


> Of course. I care about each patient while they're my patient as a human being, and give them the best care I can. The thing is that once we drop them off or they die, they're just a passing "oh well." It's just always caught me by surprise.



I think that becomes part of our emotional protectiveness. Especially, when one does this repetitiously and with experience. I too do not think about a cardiac arrest afterwards, or even a bad trauma patient, unless it has some unusual circumstances linked to it. I may work 2-3 cardiac arrest or bad calls in a day, I need a clear head after each call. In a ER setting I may have taken care of 35 patients myself in 12 hours, so I do well to even remember your case. 

One has to be very cautious though not to become jaded and apathetic, which is very easy to do. 

R/r 911


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## MSDeltaFlt (Jun 28, 2008)

Chickpea said:


> (I'm sorry if I'm posting this in the wrong place.)
> 
> I'm not an EMS anything, but my boyfriend has recently become an EMT, and I admire him very much for it.
> He loves his job (and I love that he has something that makes him feel so fulfilled.) But sometimes he has difficulty dealing with it when people he's trying to save don't make it. He blames himself for it. And me saying, "it's not your fault" doesn't seem to help. He says that I don't understand, and he's kind of right about that; I've never been in that position and I don't know what it's like. I really wish I could make him feel better, but I'm just not sure what I should say... so, um, if anyone here can offer me any advice on how I could help him to get through it, or even just to make things a little easier on him, I would be very, very grateful.
> ...



I've been trying to respond for a while now.  Chickpea, some of what I'm about to say may rub you the wrong way.  Some may rub your boyfriend the wrong way.  In a way, I'm the voice of experience, since I was involved in a traumatic event that was life threatening and life altering.

I find myself taking a lot things too personally.  I find myself blaming myself for things I have absolutely no control over.  My partners telling me "it's not your fault" means very little.  If I'm not careful, it will change my personality, and not for the better.

What I need to do is to realize it's not my fault, that it's OK.  I need to snap out of it and just do my job.  Tough love works very well.  At the risk of sounding a little crass, you might need to show a bit of tough love and get him to snap out of it.

Good luck


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## mycrofft (Jun 28, 2008)

*I wonder if the admins have considered having a one time live chat or thread*

featuring a real life mental health professional with experience in EMS  etc.?
I was lucky to have two good partners (one with five years' experience, the other a former Ranger with experience in Vietnam) and a few other good coworkers when things got sticky.


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## fma08 (Jun 28, 2008)

just gotta find an outlet of some sort, and a healthy one at that, me, after a hard day or a bad call... etc. i go home lock my door, put on my headphones and play guitar, and when i'm playing i usually am thinking about the day/call/whatever, and  when i am "done" playing, that usually means that i'm over whatever was making me feel bad... kinda strange but it works for me. it's my outlet, so you just gotta find something like that and you'll be alright. but like i said, make sure it's healthy, don't go home and drink a liter of (insert random alcohol here).


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## karaya (Jun 29, 2008)

Lion, your girlfriend has turned to your industry peers for advice concerning your emotional issues with death. Her concerns for your well being says a lot about her character and you should consider yourself fortunate to have someone such as her at your side.

Your own co-workers have even noticed your emotional stress and have tried to discuss your situation but according to your post, you don't like to talk. You stated that CISD programs don't work and you don't feel comfortable with counselors. Even your girlfriend's post for guidance here has angered you.

To me, you sound a tad bit selfish. Everyone in your life has been exposed to your emotional issues with death, which is apparently something you've made well known to loved ones and fellow co-workers as well as us here. And everyone that has come into contact with your issue, including some of the folks here, has offered suggestions and advice of which you have clearly declined.

I don't mean to berate. I'm stating a fact that you need to seriously consider. This is an issue that is impacting everyone around you and if obtaining any kind of help, professional or otherwise, is something that is just not in your horizon (from what I have read here it is not), then you need to consider another line of work.


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## Hastings (Jun 29, 2008)

Everyone I work with at this service is a chain smoker, alcoholic, etc, etc. Actually, most EMS workers are. But given the context of this thread, I think it a much wiser choice to take out your occupational frustrations on your apparently loving girl. And no, not with violence. You know what I mean. You knooooooow...

She seems to be more than willing to do what it takes to ensure your good mental health. And this is a stress-relief habit that benefits everyone!


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## karaya (Jun 29, 2008)

Hastings said:


> Everyone I work with at this service is a chain smoker, alcoholic, etc, etc. Actually, most EMS workers are. But given the context of this thread, I think it a much wiser choice to take out your occupational frustrations on your apparently loving girl. And no, not with violence. You know what I mean. You knooooooow...
> 
> She seems to be more than willing to do what it takes to ensure your good mental health. And this is a stress-relief habit that benefits everyone!


 
Most EMS workers chain smoking drunks?  And a little nookie cookie will cure Lion's on the job emotional situation?  You can't be serious.


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## Hastings (Jun 29, 2008)

karaya said:


> Most EMS workers chain smoking drunks?  And a little nookie cookie will cure Lion's on the job emotional situation?  You can't be serious.



100% serious. 

Works fine for me.


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## ffemt8978 (Jun 29, 2008)

mycrofft said:


> *I wonder if the admins have considered having a one time live chat or thread *featuring a real life mental health professional with experience in EMS  etc.?
> I was lucky to have two good partners (one with five years' experience, the other a former Ranger with experience in Vietnam) and a few other good coworkers when things got sticky.



Nope, and it will never happen.  Stuff like that should be done in person and not over an internet forum.


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## Tincanfireman (Jun 29, 2008)

Hastings said:


> Everyone I work with at this service is a chain smoker, alcoholic, etc, etc. Actually, most EMS workers are.


 
I think you're painting with a pretty wide brush there, my brother. We've beaten the stress relief threads pretty much to dust here in the past, but I can assure you that you assertion is far from reality for many of us.


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## Hastings (Jun 29, 2008)

Tincanfireman said:


> I think you're painting with a pretty wide brush there, my brother. We've beaten the stress relief threads pretty much to dust here in the past, but I can assure you that you assertion is far from reality for many of us.



I can't speak on your area, as I don't know the EMS employees there. However, I am speaking from my experience, and the EMS employees I come in contact with on a daily basis, whether they be paramedics, EMTs, or RNs. Again, this is to do with EMS employees in my area, and nothing more.


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## karaya (Jun 29, 2008)

Hastings said:


> I can't speak on your area, as I don't know the EMS employees there. However, I am speaking from my experience, and the EMS employees I come in contact with on a daily basis, whether they be paramedics, EMTs, or RNs. Again, this is to do with EMS employees in my area, and nothing more.


 
What kind of problems to you guys have up there to spawn widespread chain smoking EMS drunkards?


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## mikeylikesit (Jun 29, 2008)

if you want to turn yourself into a emotionless person all you have to do is when you start to think of the patient or the situation that unless you have a time machine you will never ever be able to do anything about it again. life moves on and everyone dies. yes its sad but if i got upset around death all the time then i would make a pretty useless medic. not to say that emotions are bad, but you can't let them get in the way of patient care for your next patient. otherwise you could spark a chain reaction of unintentional neglect by forgetting to provide certain care for critical care patients just because your mind is "somewhere else". If we are meant to save them...then we always will no matter what.


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## Hastings (Jun 29, 2008)

karaya said:


> What kind of problems to you guys have up there to spawn widespread chain smoking EMS drunkards?



Stress, I guess. I don't even know whether it's the job or the personality, since most of these people went into paramedic school this way. Smoking at every opportunity (and now every 15 minutes at work), getting mad drunk every night, etc. I imagine it's just the joining of personality and job/life stress.


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## The Lion (Jun 29, 2008)

I smoke, although I try not to too much, and I drink once in a while, and then, only on weekends. That doesn't really help me with stress much, and I've been talking about it with my girlfriend. I trust her enough to speak about it with her, and ranting about it a bit does help. 

I'm pretty sure it's just me getting used to the stresses of a new job, and a new way of dealing with things. 

I keep a level head on the job, and if I do get upset, it's always when I get home. I don't always get upset, and really, I can deal with it. 

I wanted to thank you guys for your advice, and I apologize that I hadn't responded earlier. I've been really busy.

I'll just do that best that I can to help my patient, and it will be enough for me.


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## Jon (Jun 29, 2008)

The Lion said:


> I smoke, although I try not to too much, and I drink once in a while, and then, only on weekends. That doesn't really help me with stress much, and I've been talking about it with my girlfriend. I trust her enough to speak about it with her, and ranting about it a bit does help.
> 
> I'm pretty sure it's just me getting used to the stresses of a new job, and a new way of dealing with things.
> 
> ...


There is a lot of stress in EMS, and a lot of interpersonal relationship issues.

There are some who believe that CISM is bunk... I agree to an extent. HOWEVER... You need to talk to SOMEONE about how you are feeling... internalizing the stress lets it build, which is BAD.

Find yourself a mentor at the station you trust and can talk with, and talk with him/her... or vent to us. you'll probably feel better.


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## karaya (Jun 29, 2008)

Jon said:


> There is a lot of stress in EMS, and a lot of interpersonal relationship issues.
> 
> There are some who believe that CISM is bunk... I agree to an extent. HOWEVER... You need to talk to SOMEONE about how you are feeling... internalizing the stress lets it build, which is BAD.
> 
> Find yourself a mentor at the station you trust and can talk with, and talk with him/her... or vent to us. you'll probably feel better.


 
Day late and a dollar short on all that advice, Jon.  Similar suggestions were made earlier in this thread as well as his own co-workers offering a shoulder.  Lion feels he can do it all on his own and with that I say --GOOD LUCK!


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## mikeylikesit (Jun 30, 2008)

and if all else fail a good old shot gun and a ton of breakable stuff ought to do the trick. i find that a good cathartic release every now and again has it's benefits.


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## The Lion (Jun 30, 2008)

Jon said:


> There is a lot of stress in EMS, and a lot of interpersonal relationship issues.
> 
> There are some who believe that CISM is bunk... I agree to an extent. HOWEVER... You need to talk to SOMEONE about how you are feeling... internalizing the stress lets it build, which is BAD.
> 
> Find yourself a mentor at the station you trust and can talk with, and talk with him/her... or vent to us. you'll probably feel better.


I could rant to you guys, sure. I would just feel foolish doing so. I'm unused to asking people for help. Not that I am too proud - although, sometimes I can be proud, hence my nickname - it's just that I've never particularly had anyone to offer it to me, before recently. 

(Pardon my English, I wasn't born in an English-speaking country).

A lot of it, as I explained before, is that I feel ashamed that I should need help. I don't mean to offend anyone, of course. I know you all have my best interests at heart. Since some people here seem to think that I am rejecting what you are telling me, I want to make it clear that I am not.

But, can you tell me how I should talk about it, then? What would I need to say? I'm really unsure. Mostly, I just babble away, and a lot of it involves much cursing.


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## The Lion (Jun 30, 2008)

mikeylikesit said:


> and if all else fail a good old shot gun and a ton of breakable stuff ought to do the trick. i find that a good cathartic release every now and again has it's benefits.



Around here, that would get me arrested.


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## Sapphyre (Jun 30, 2008)

The Lion said:


> Since some people here seem to think that I am rejecting what you are telling me, I want to make it clear that I am not.
> 
> But, can you tell me how I should talk about it, then? What would I need to say? I'm really unsure. Mostly, I just babble away, and a lot of it involves much cursing.



Find someone who doesn't mind if you babble, rant, rave and curse at them, and do just that.  You really don't have to have a set format.  If you seek professional help, they may let you babble, or they may focus in, or they may guide you, or a mixture.

The aforementioned target practice is one of my favorites, difference is, so far I'm satisfied with handguns and paper at the local range.
It's a probably a little too womanly for you, but I also knit.


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## Jon (Jun 30, 2008)

Shooting stuff (AKA "Lead Therapy) works as a stress reliever for me, too.

As for talking with someone... you need to find someone you can trust and who can put up with you venting to them. I've got an old partner I used to work with that I will call every now and then when I need to talk... he'll call me when he's having a bad day. I've also been blessed with parents who are willing to listen to me when I need to vent (because I got into this at 16).

While the person doesn't need to be in EMS, it makes it easier... you can use technical terms and jargon and not have to explain. Find someone around the station who you perhaps look at as a "mentor".... talk with them after a bad call.

In the end, remember that we aren't G-d. We can't save everyone... some people are destined to die. We do the best we can to help the most people possible. Often, the best way to overcome some of these feelings is to acknowledge that you did EXACTLY what you were trained to do and you gave the patient the best chance... but their survival wasn't in the cards.


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## BossyCow (Jun 30, 2008)

I can relate to what Hastings said about stuff not getting to him. I was that way for years. I figured I was immune or just lacking that emotional connection. I actually got pretty smug (no really.. I did... I know that doesn't sound like me.. but I did...) about my ability to handle the gnarliest call and walk away from it unscathed. 

Then we did a SAR on a 4 yo that was located submerged in a pond. After 8 hours of searching to be exposed to the grief of a family who just lost a child was the most difficult experience I have ever endured. Intellectually I understood all the how's, why's and wherefores about stress management. I had a good support network in place and this call still knocked me to my knees. 

I guess my perspective on this topic is, how badly are you affected when you lose a patient? Is it merely an emotional outburst, few days of processing the event then on with life? Or, is it weeks and weeks of sleeplessness, recurring replays of the event, inability to deal with your day to day responsibilities? We are all going to process bad calls differently. Some take more time with the process than others, some need to do it alone, others need that big group hug. 

Try to get clear on whether you are affected by a call, or hurt by it. With time, those who care about you will learn your personal style for dealing with the emotional cost of the work you do. But, if every bad call, creates a problem, then I would seriously suggest either a career change or a visit with a therapist to help teach you better coping skills.


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## So. IL Medic (Jul 1, 2008)

Hastings said:


> Of course. I care about each patient while they're my patient as a human being, and give them the best care I can. The thing is that once we drop them off or they die, they're just a passing "oh well." It's just always caught me by surprise.



Sounds like you're doing fine then. Getting emotionally stressed over every pt leads to quick burn out IMHO.


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## emtashleyb (Jul 6, 2008)

if hes having a problem he needs to talk with someone with cism, I wish I did now 3 years later I have ptsd from not dealing with my emotions on "not saving" someone. People die when its their time and there is nothing we can do sometimes despite our best efforts. He needs to realize it and not let it consume him.


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## mikeylikesit (Jul 6, 2008)

the lion said:


> i've been to the cisds, they don't particularly help me.
> 
> Again, i don't wish to be a jerk, i really do appreciate you guys and gals trying to help. Thank you.


 emtashleyb i don't think it will help


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## emtashleyb (Jul 6, 2008)

mikeylikesit said:


> emtashleyb i don't think it will help



I didnt fully read before i replied I have a horriable habit of doing that. Or just reading what my mind thinks its seeing and not really what Im seeing. Sorry im a ding-dong


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