Advice needed. bad first day.

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appleguy

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Hey guys, im a new member but ive been around these forums for awhile just reading and looking for some answers to questions but i rarely ever post. Ive had something that I just cant shake and ive seen some good advice come from these boards and hopefully you guys can help me.

Im graduated from my EMT-I85 course, and i take the national registry the 12th of this month. My first clinical was about 2 months ago. I rode with a rural ambulance service and had a great day. The first 11 hours of the shift were great, I had an abundance of calls and they were all different and I didnt have any problem doing anything. I loved it actually. Then @ about 1800, we get a mvc involving a motorcycle. When we get there the guy is in and out of consciousness and really tore up. Partial amputations, severe lacerations and avulsions. He was gurgling and struggling to breathe. As a student, most of the firefighters and other medics on scene really took over, and I was there to fetch them anything they needed. We had air one meet us in a parking lot where he was flown out. What makes it worse was that his girlfriend was following him and saw the whole thing. Before we had him packaged his entire family had shown up (must have been close by.) I assure you, this was a rough scene. I left out a lot but im sure you guys can piece it together.

Heres the issue. I felt so overwhelmed and helpless standing there. I remembered my training, but I just couldnt calm myself down enough to clear my head. The images and sounds of that scene stick with me as clear as ever. everyday. I wasnt ready for that my first day ever being on an ambulance. Its really messed with me but im too embarrassed to tell anyone. Thats why ive resorted to anonymously asking for advice on these boards. I dont know what to do or how to get over it. Its holding me back and making it hard to study. I just cant shake it. This is what I want to do, I just didnt think it would effect me like it has. I dont know what advice im expecting to hear... i just needed to write it out. Its been 2 months and i cant shake it.

Thanks for your help.
 
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Don't be embarassed. I've openly cried in front of my colleagues on the way back from the hospital after bad calls and you can ask anyone on here, I'm a pretty tough fellow. Talk to your colleagues, talk to a priest/rabbi/minister or go find a therapist to vent to. You'd be amazed what just getting it all out will do for you.
 
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This might not be the career for you...

Even so, it couldn't hurt to talk to someone about it.
 
appleguy said:
Hey guys, im a new member but ive been around these forums for awhile just reading and looking for some answers to questions but i rarely ever post. Ive had something that I just cant shake and ive seen some good advice come from these boards and hopefully you guys can help me.

Im graduated from my EMT-I85 course, and i take the national registry the 12th of this month. My first clinical was about 2 months ago. I rode with a rural ambulance service and had a great day. The first 11 hours of the shift were great, I had an abundance of calls and they were all different and I didnt have any problem doing anything. I loved it actually. Then @ about 1800, we get a mvc involving a motorcycle. When we get there the guy is in and out of consciousness and really tore up. Partial amputations, severe lacerations and avulsions. He was gurgling and struggling to breathe. As a student, most of the firefighters and other medics on scene really took over, and I was there to fetch them anything they needed. We had air one meet us in a parking lot where he was flown out. What makes it worse was that his girlfriend was following him and saw the whole thing. Before we had him packaged his entire family had shown up (must have been close by.) I assure you, this was a rough scene. I left out a lot but im sure you guys can piece it together.

Heres the issue. I felt so overwhelmed and helpless standing there. I remembered my training, but I just couldnt calm myself down enough to clear my head. The images and sounds of that scene stick with me as clear as ever. everyday. I wasnt ready for that my first day ever being on an ambulance. Its really messed with me but im too embarrassed to tell anyone. Thats why ive resorted to anonymously asking for advice on these boards. I dont know what to do or how to get over it. Its holding me back and making it hard to study. I just cant shake it. This is what I want to do, I just didnt think it would effect me like it has. I dont know what advice im expecting to hear... i just needed to write it out. Its been 2 months and i cant shake it.

Thanks for your help.
Click to expand...

It is time to go see a professional.

Once the emotional and mental fallout from a call is interfering with your life, it really needs to be addressed by people with the expertise to do so properly.

Needing help to cope with something doesn't make you lesser or weak. You also have to remember that as a new person, especially just a student, you don't have a lot of the coping mechanisms some of the established folks do. (Like a peer support group)

You will definately have to deal with the specific aspect of the call that bothered you. I have a sneaky suspicion it is not the injuries of the victim.

As well, the help you receive from this experience may be of benefit well into your career for you and even likely a benefit to others when you can recognize that they are struggling and point them in the proper direction.
 
Appleguy congrats on being open and honest.
Sometimes just writing the issue down and getting it out there, does go a little way to help.
After I poured out my guts in a thread the other day, about the issues going on in my little world,
to get a better understanding of things and also a bit of support.
People have been very helpful and I've had pm's of great support as well.

This thing in the EMS of 'stand up and suck it in' or 'your shouldn't be in this career if you can't handle a bad call', is just plain silly talk.

This call shows that you have a heart and care about the patients.
It not easy seeing such trauma for your first time out and seeing family members in such distress, as well.
As others have said, you do need to talk to a professional in dealing with the issues you have, or this incident will eat you up inside.
Sometimes after a bad call, a debrief is arranged at the station, or you could have asked to speak to a peer support person.
Don't ever feel bad about coming forward!

Good luck with your long and enjoyable future in the EMS family!

Cheers Enjoynz
 
I agree with Veneficus and USAF... If this feeling is still hanging around months later, and the fact that you were only a student and it bothered you that much, its time to seek help. Almost every community has some type of person that can talk to you about stuff. Many have people that specialize in emergency and "rescue" type personnel.

Everyone has calls that, for some reason or another, they cant shake. Ive had plenty of them. Usually they go away after a few days. Sometimes they dont. Its one of the biggest reasons for EMS "burnout". It causes family (*read marital*) problems, health problems, addiction, depression and other problems associated with emergency work. But it becomes a BIG problem when, like said above, you let it interfere with your life... Do your friends, your family and YOURSELF a favor, go talk with someone...
 
Thanks for all the great responses. You guys are right, it seems the longer I keep it suppressed, the more it interferes with me. I'll be making some phone calls after work today to see if I can find the right person to talk to.

Veneficus - you hit on something. It's not the injuries that get me, it was the distress of the family and overwhelming pity for the guy. He was the same age as me (22) and from what I gathered at the scene he seemed like a really good person. I'm a caring and compassionate person by nature, I was just taken off guard with how much this has stuck with me.
 
Not every day will be like that. It's ok to have difficulty handling something like that. It's a situation most people in first world countries will never encounter in their entire lives.

Having trouble dealing with a difficult call is normal. It's not something to be ashamed of, and it doesn't mean that you're a bad EMT, or that you aren't cut out for EMS. It does mean you have to find some coping mechanisms, either through contacting a professional, as others have suggested, or finding friends and / or colleagues you can talk to.

For what it's worth one of the better people I had to talk with was a good friend who was had worked in health care and had seen some horrifying situations in former Yugoslavia in the early 1990s. For me, sometimes hearing about something worse puts things in perspective better.

On a tangent, I think sometimes it's almost worse to encounter a horrible situation and feel nothing. You wonder if you've given up a little bit of your humanity in order to make a paycheque.
 
systemet said:
For what it's worth one of the better people I had to talk with was a good friend who was had worked in health care and had seen some horrifying situations in former Yugoslavia in the early 1990s. For me, sometimes hearing about something worse puts things in perspective better.
Click to expand...

I have traveled far and been around a while.

I maintain the worst thing in medicine is not an illness or an injury, it is man's inhumanity to man.

The worst of my experiences I share with nobody.
 
appleguy said:
Thanks for all the great responses. You guys are right, it seems the longer I keep it suppressed, the more it interferes with me. I'll be making some phone calls after work today to see if I can find the right person to talk to.

Veneficus - you hit on something. It's not the injuries that get me, it was the distress of the family and overwhelming pity for the guy. He was the same age as me (22) and from what I gathered at the scene he seemed like a really good person. I'm a caring and compassionate person by nature, I was just taken off guard with how much this has stuck with me.
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It is the hardest spot to be in, looking at yourself laying there.

Even the Great Master George Lucas knew that. (lol) (Empire Strikes Back...swamps of Dagobah)

If it's really still bothering you this far out, you need to talk to a professional. I have had several instances like that, where I could completely see myself in the position of the patient or the family members, whose lives are permanently altered because of a random event. You will not forget this guy, or the looks on everyone's faces, but the sharpness of it all will fade with time.

I don't think at all that this means this career is not for you. That was a shocking first day, and even if all you had was routine calls, they would have stuck with you for a long time. Find someone to talk this out with...then re-evaluate.

People like you, who feel empathy, can go on to make the best medics. Heartless people moving slabs of meat, not so much.
 
I would agree that you need to talk to someone.

sometimes the hardest part about these calls is the family and friends around you. It can really break your heart.

This field isn't for everyone, and you're going to see stuff like this on a semi-regular basis. But just because it hits you hard, doesn't mean that you aren't supposed to be in this field. I get into a "zone," and don't focus on the people around me. The patient is just that, a patient. I can't see him/her as a neighbor, a parent, a child, a friend, all I see is another face. But there are those calls that I see the face. those are the ones that stick with you.

I'm sure that my post didn't help you any, and I'm sorry if you can't understand it. But I wish you the best of luck on your journey, and there are many people who are willing to talk to you about this. And if you talk to your chief/ the head of the company you were riding with, they should be able to hook you up with some CISD. For the most part, its company policy and required to have that service available for you.
 
Thanks for the topic...I haven't experienced anything that bad personally yet (we don't typically get a LOT of trauma, and the few deceased on-scene patients had family members that reacted calmly at first and didn't really raise the stress level), but I've wondered myself what level certain scenes could get to before they really got to me later. It's helpful to see some of these responses and ideas from folks prior to that experience.
 
The thing is to actually feel these feelings.

Don't run away from them, dont shove them down when they come up. As others have suggested, seek professional guidance. It is hard to deal with many of the things you will see in this line of work.

If you stuff feelings, they grow and explode. If you feel them, well, they can be quite powerful and they can change your life.


Everyone has to evaluate and transform that energy everyday.
 
I still remember my first code. Hell, I remember all my codes. I remember doing CPR on a man and trying to get information from his wife on scene who was crying and begging her husband to come back or "wake up." They shook me up. However, I talked about them, and I use them as my motivation to "do better" or "try harder" next time. Make your weaknesses your strengths.
 
Thanks for showing up!

I'm very much liking the kinds of support that have come your way so far; and especially liking you found a safety net here filled with good advice and no judgment.

Sad but true, some of what we witness never leaves us. Some stuff gets in and turns around inside until we start doing what you're doing; working it OUT!

...and the people here acknowledged a real basic part of the work; some stuff gets in! You happened to hit on something a bit universal because everybody pretty much understood.

A professional will help you to face and sort through things. A professional will help you to understand yourself better. A professional will also help you to "take the edge off" of the trauma. But a professional doesn't understand like your peers unless he/she has done the work.

But that's a door opener for you; perhaps meant to get you back to your job. The real work boils down to facing the next one and the next one because that's what the job brings you.

My point is, learn from not only the trauma but from the advice you get here, and by a pro and especially YOURSELF.

Why? Because inside you is a quiet little voice that will teach you how to use resources available to you to "keep" the edge off.

IMHO each of us, as part of our jobs, must learn to develop his/her own networks of support and outlets and fallbacks. Burnout mostly happens as a result of silence and inaction. That need not be your path.
 
I think what you are doing, talking about it, gathering advice from your resources, and your ability to know, something "just isn't what it should be", is a positive step forward.
It is okay to be emotional during a scene. We are only human. I have cried many times, on scene, with family, with peers, and alone. My best way of handling a tough situation is: giving my most loved ones (my children) a call, just to tell them I Love them. They know when I call, they will say, "Momma, had a bad call, huh?" They reassure me that I am who they want me to be. Go forward and know that WE in EMS, really do know what you are going through. You will find Peace, time heals.
 
Does the agency you were doing the clinical with, or the school you took your training through, have a CISM/CISD team? Seems like this would be exactly the kind of call they specialize in.
 
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Veneficus said:
Hopefully not.

I encourage you to read the literature on that. Specifically the ones that show it doesn't help or causes harm.

http://www.bryanbledsoe.com/data/pdf/journals/CISM (Bledsoe).pdf
Click to expand...

Thanks for that link. And all this time I just thought CISD was stupid...now I know why.

It would be tough if you hadn't developed a support system, to find one. I think new providers are often not confident enough to open a conversation like this one with the crew that was on the call, and we all need to be more receptive to that kind of conversation, anyway.
 
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