EMS medics are incapable of healing each other.

[firetender]

I've seen a theme seen running through a number of posts that speak of such things as burnout, PTSD, the trauma of witnessing trauma, and dealing with the incessant BS of politics.

The theme is (and I'm taking a broad stroke here) that when a medic hits a wall, the only people qualified to help them are trained professionals in some aspect of counseling or advising.

I have a couple observations around that leading to questions, and I'm interested in your opinions:

#1) Does honest expression of ones feelings and experiences (at appropriate times and places and with the appropriate people, like after, but not too long after an inciting call) mean you can't do the job you're supposed to?

#2) Were medics to have access to a regular, face-to-face forum where they could speak openly (and with a built in system of mutual support through peer counseling) about the stresses they're dealing with, would there be less hitting the wall?

#3) Is the assumption that we must turn to licensed, trained professionals for such counseling a way of saying that we're not (whatever, you fill in the blank) enough to take care of our own?

 

[jrm818]

ok i'll bite.

1) depends on you're experiences and reactions to them. In some cases the answer may be "yes." More often it's probably no.

2) Isn't this precisely what CISD is? In which case the answer is "no," there would be no less "wall hitting." In fact the walls may well find themselves more abused.

3) yes. just like most residents of nursing homes can't "take care of their own".

Also your contention in "3" that the notion that trained professional support is necissary is an "assumption" is flawed - as has been said countless times this is not some random assertion by some shrink, but rather a scientific finding from numerous studies that has been generally accepted by experts and non-experts alike. an assumption is made up and based on nothing. number three is based on scientific evidence.

I dont really understand what your opposition to professional mental health types. these are not automaton- they are simply people, like you, who have clinical training and experience in a field which is different than yours. Just as I would not want a shrink playing with my pneumothorax, I don't particulalry want an EMT playing with the ole' attic.

as for the argument that they need to walk in your shoes to help - I would ask you how many times you punctured broke your own leg before you were capapble of helping a pt. with that particular affliction.

 

[BossyCow]

This isn't a black and white issue. "EMS medics are incapable of healing each other"..... if I have a minor injury, I might ask a fellow EMT to bandage me up, or assist me with my nebulizer. But if I'm having an M.I. you bet I want to see a cardiologist.

Of course there are going to be some calls, some situations that a nice heart to heart with a co-worker or friend is going to be all you need. CISD says that before you can get to the cardiologist, you have to sit with a bunch of your buddies and hear that they have had chest pain too and it turned out to be heartburn. Then a nice little pat speech about avoiding fats and getting exercise.

This may be fine for someone who is a little weirded out by a call. This is not going to be enough for someone who is suffering from some serious effects. The training given to the CISD members is handy as part of the "Well Being of the EMT" Chapter, and definitely has some value, but in the case of a significant psychological event following a traumatic call, it's like putting a bandaid on an arterial bleed.

 

[Summit]

This isn't a black and white issue. "EMS medics are incapable of healing each other"..... if I have a minor injury, I might ask a fellow EMT to bandage me up, or assist me with my nebulizer. But if I'm having an M.I. you bet I want to see a cardiologist.

Well said!

 

[Ridryder911]

Since when can any EMS provider "heal" anyone? Healing is a long term adjective.

1) Does honest expression of ones feelings and experiences (at appropriate times and places and with the appropriate people, like after, but not too long after an inciting call) mean you can't do the job you're supposed to?

No, but that is a vague question. On just how much expression, and yet what type of experience. A death in a MVA versus a traumatic infant death? There is medium that one is expected to continue and perform their job, and as well as events that can cause problems. Not all medics want to hear other medics problems, many feel that they have enough of their own, as well may not see problems with that particular incident.

#2) Were medics to have access to a regular, face-to-face forum where they could speak openly (and with a built in system of mutual support through peer counseling) about the stresses they're dealing with, would there be less hitting the wall?

See below* There is a forum that has a trained licenesed counselor, Chaplain, that is a medic. Fieldmedics.com, that is discreet. Opening up on a forum, could be potentially dangerous, involving fellow peers erronoeous information and potential HIPPA violations.

#3) Is the assumption that we must turn to licensed, trained professionals for such counseling a way of saying that we're not (whatever, you fill in the blank) enough to take care of our own?

Just how much education and information was given to most EMT's in that 120 hour course? Do most EMT's really know what clinical depression is and the signs of multi disciplinary disorders are, or did they recieve all that education from that one chapter of a whole 12 pages? I already look at the "poor" medical advice that is already being given out on EMS forums, and this is even on "physical" conditions that one should already have knowledge on! Venting or discussing problems, is just one of steps in the process of healing, but what then afterwards?

What if that medic already has some form of mental illness? I know many that have bi-polar, clinical depression, schizophrenia and other forms, are you trained to recognize those pre-existing problems that might not have been diagnosed yet? Peer discussion is not always the best treatment in all cases! You see there are many different mental health problems, that may already exist prior to the incident. Like diseases, each should be properly evaulated by a qualified health provider.

Sure, medics discuss things with each other and they should. I have and still have partners that "open up" to me all the time. Sometimes, it is the usual family crisis, or the "bad" calls that things did not click well, or even a "bad incident". This is what friends and partners do... listen. Do I watch for other potential problems? You bet! Do I sometimes recommend professional help? Damn right! For example, I would never attempt to treat them if they had hypoglycemia by giving D50 and then say.."there ya go!".. your healed!

In this business the events and problems generally.."snow ball" and develop. It is not always that "one incident" that causes most problems in a medic. There may be other factors at home, school, private life, etc. that are adding up and then that "one bad call" is the final straw.

Just like regular routine physical examinations, I believe EMS personal should have mental ones as well. Sorry, the stuff and some of the crap we deal with does or should effect the normal psyche. Seeing people dying in front of you, or intubating through brain matter and seeing abused children, should affect one. If it does not, then again we have a problem. Being able to monitor and developing appropriate coping skills, is the key to lasting.

Remember, not all EMS personal want to bring their personal life, or problems to the table for discussion. Again, when I see anger, excitability and general change in attitude, many times it has nothing to do with the work environment itself, rather an underlying issue. There is still a lot of the B.S. issue of "sucking it up" and deal with it ourselves. Peer pressure does occur within this business. As well as the "we can cure anything" or personally deal with it attitude.

If one really knows anything about mental health, that it is a very complexed disease and usually has to be treated by long term multidisciplinary measures. It is not like most injuries we see and one cannot "fix" it immediately or in a short interval. It may require medication(s) and proper counseling, definitely nothing within the scope of any EMS provider.

Firetender, I have read your programs. I do believe such avenues would be a good adjunct in preventing "burnout". These type of programs would be great as "internal checks" and healing processes before such events occured (before the snowballing effect) or possibly as part of a treatment regime recommended per a mental health professional.

R/r 911