How do you cope

[EMT B]

this is my 3th week on the job, and I am having a rough week.

Tuesday there was a car accident that turned into a car fire. the 12 yo girl we extracted died in the rescue. mother burned to death.

2 nights ago I watched a woman jump off her roof onto the pavement in an attempt to kill herself.

Anybody else ever had rough weeks like this?

 

[MexDefender]

There are good weeks and than there are weeks like this, http://www.emtlife.com/showthread.php?t=31656 this is a way to de-stress and my best advice is talk to another coworker about how you are feeling.

My coworkers see the humor in everything so they cope with jokes and this helped me a lot as well.

 

[NYMedic828]

Honestly nothing to date has bother me...

I have sat on critical incident stress debriefing groups though to help people feel like they weren't the only one. Talking with people I imagine is the best.

 

[Achilles]

Cummulative stress happens from just holding everything in, so it is good to talk abou it. It's also good to have friends outside of ems, go relax, have a beer. You're are only human and you can't control everybody- only you!

 

[lightsandsirens5]

It happens. I'm in the middle of a crazy week right now myself. Suicides, LEO shootings, burns, full arrests, the whole nine yards. You aren't the only one these days/weeks/months hit now and again.

Honestly, I am not "bothered" in the least. However, I will tell you that the biggest thing you can do to mitigate what you are feeling is to talk. Be open and honest with how you feel. Talk to someone you trust, or maybe your agency even has a police about who you can go to. In any event, your supe should be willing to listen and help you out. Talk to your partner, other crews, etc. We all get these periods of time where its one nasty thing after the other and we start to question ourselves.

Another thing, as already suggested, is leave it all behind at work. Mentally "check out" of the work environment when you reach end of shift. Spend time with your family or friends. Leave work at work. Because after all, that is what it is. Work. It isn't your fault there was an MVA, you didn't cause the fire, you didn't cause the death. You and your crew were the best chance your patients didn't have prior to your arrival. When you have done everything you can do, fate gets to run the show, and sometimes it runs it differently than we want it to. Not your fault at all.

I know all that sounds cliche, but those are just some words that helped me through rough weeks. Especially back when I was a brand new newbie. You'll get used to it after a while.

 

[7887firemedic]

Personally I found it to be more disturbing years ago, seeing horrible things and having no feeling at all..........

 

[firetender]

Why are you there?

For a lot of us, in the beginning it's all about the call. Each call lives in a vacuum and we judge it and how we performed during it as if it were the whole world, when actually, it's only a very small and transient part of your life.

Every moment has a feeling associated with it and you're finding that you've been getting a lot of feelings in the same category reinforcing each other.

Let's call this one "helplessness".

And maybe here, with the cases you talked about, you have to come to a broader understanding. This usually comes about after years of trial and error but the bottom line is life in EMS thrusts you into situations where you really, REALLY can do nothing more than watch lives pass away or radically change right in front of your eyes and all too often, while they are happening you can feel these transitions with your hands.

This is just a brief outburst, one of many "runs" of certain types of calls that you'll be exposed to. In the overall race, the runs that are most likely to truly drive you nuts are the ones when you're doing nothing because there is nothing to do -- no calls.

As others have suggested -- and I have to say and am very happy to say it the culture IS really changing a bit to accommodate the human experience of EMS -- finding safe times, places and people to talk with is the way to work through the inevitable times when you're inundated with senseless deaths.

A big part of the game is being able to put it all in perspective.

Life in EMS is all about being witness to horrors of every imaginable shape and size. Your role is to do what you can while you can do it to LESSEN the suffering.

Of course, that's where I went with the whole dilemma. You may very well find your own philosophy that helps you do your best and prevents you from getting stuck in an endless cycle of self-judgment. The reality is the tools you use are going to be changing, so don't get down too much on how perfectly you use them. Death is NOT your enemy, it is an inevitability, so to a certain extent the role you actually play is sacred; it's all about being there as best you can in the time you have with each of your patients..

In the cases you cited, your hands were tied, but be certain that you learned something that may very well save a life or many lives in the future. The name of the game is to not get stuck in your helplessness, but to continually strive to add more tools to your bag of tricks.

You've taken a good start. As you hang out more here you'll find lots of allies who've gone through many if not all of the things you're experiencing. Keep talking and align with those who are willing to get in to the exploration with you rather than tell you how to feel.

 

[Veneficus]

this is my 3th week on the job, and I am having a rough week.

Tuesday there was a car accident that turned into a car fire. the 12 yo girl we extracted died in the rescue. mother burned to death.

2 nights ago I watched a woman jump off her roof onto the pavement in an attempt to kill herself.

Anybody else ever had rough weeks like this?

You call that a bad week?

I don't find it nearly as painful as a week of dialysis derby and nonacute-frequent flyers.

Really though, my gallows humor aside(my very best defense mechanism), I found that going out to eat with coworkers after a rough shift and talking about it, while noticing how many tables around you leave or ask to be moved, helps a lot too.(my second best defense mechanism)

You will hear different advice, you must find what works for you.

Don't bottle up. (I just totally ignored Firetender's advice on telling people how to feel, sorry about that buddy.)

Be careful about trying things that work for the "hardcore" providers if that is not your personality. Those mechanisms will be extremely destructive to you if that is not the life you lead.

Listen to firetender. Think about his words. He is probably the best source for this kind of thing.

 

[bigbaldguy]

Finding a peer group you can vent to is key. As firetender said you need a safe place to unload some of this stuff. Lucky you stumbled across EMTLIFE try to build a support group among your coworkers as well. Be careful you don't insulate yourself completely from the non EMS world. Like Vene said you might find non EMS folks will start avoiding you.

Don't be afraid to look into professional therapy if stuff really starts to bother you. Most major cities have therapists that specialize in medical providers. There are even therapists that specialize in EMS/police/fire. Therapy is usually covered by insurance with a reasonable copay. Basically you pay 35 bucks to go talk to someone for an hour about what's bothering you. Sounds silly but it really helps. A good therapist will help guide you through the coping process.

 

[titmouse]

It might be somewhat related to the OPs scenario. I am current EMT student and exactly a month ago I was riding my first ride along. Had a pt that was suspecting a heart attack and the otherher call was on the engine to provide help for cardiac arrest. After those 2 calls I was texting my dad telling time about the experience. The following morning my dad died of a heart attack and the first dead patient that I had encountered was my own father. 2 weeks later I was at the station doing another ride and we responded to a crime scene, nice we arrived we found a naked male about mid 50s , homeless and apparently died of a heart attack. That instance did not strike as much as seeing my dad, the only thing that I felt was wanting to help the homeless dude. It was too late. What has helped me with my dads death was talking about it with friends, my girlfriend, etc.

 

[EMSrush]

Honestly nothing to date has bother me...

Same here. Thought it was just me. I've always wondered if I'm "bulletproof", or if I just haven't come across the right call.

Most agencies will offer you CISD or some other type of counseling after a difficult call. That may be worth checking into.

 

[STXmedic]

Same here. Thought it was just me. I've always wondered if I'm "bulletproof", or if I just haven't come across the right call.

Nope, same here.

As far as coping with stress in general, running and cycling is my drug/destressor. And burying it deep down for nobody to ever see...

 

[EMSrush]

Sometimes I feel bad because I don't feel bad.

Perhaps it's my general philosophy pertaining to my job:

1. It is not my emergency. I didn't cause it, I didn't do it. It was that way before I arrived, and there's nothing I could have done to have prevented it from happening.

2. I understand that I have a set of guidelines to follow based on the presentation of the Pt, and access to more help is just a phone call away. I am confident in my training and abilities to perform any interventions and treatment within my scope of practice or to initiate additional resources as needed.

3. Definitive care is in the hospital.

4. Sometimes, a Pt is already dead before you get there. There's not much you can do about it.

5. Sometimes, a Pt is going to die during the course of your care. There's not much you can do about it.

6. The safety of myself and my partner always comes first, and is non-negotiable.

7. Definitive care is in the hospital.

 

[truetiger]

Sometimes I feel bad because I don't feel bad.

Perhaps it's my general philosophy pertaining to my job:

1. It is not my emergency. I didn't cause it, I didn't do it. It was that way before I arrived, and there's nothing I could have done to have prevented it from happening.

2. I understand that I have a set of guidelines to follow based on the presentation of the Pt, and access to more help is just a phone call away. I am confident in my training and abilities to perform any interventions and treatment within my scope of practice or to initiate additional resources as needed.

3. Definitive care is in the hospital.

4. Sometimes, a Pt is already dead before you get there. There's not much you can do about it.

5. Sometimes, a Pt is going to die during the course of your care. There's not much you can do about it.

6. The safety of myself and my partner always comes first, and is non-negotiable.

7. Definitive care is in the hospital.

That pretty much sums it up right there.

 

[firetender]

...and

we're all human beings first and technicians later. The interesting and harrowing thing about EMS is that we are exposed to such an incredible variety of calls that you can almost count on finding the one with your name on it; the call that strikes you directly in the heart that comes out of nowhere.

My only point is -- and ask anyone who's been around more than ten years -- most of us get there. Some sooner than others.

Real sorry to hear about your Dad, titmouse, that's about as big as they get.

 

[titmouse]

It's life and the thing that we can do is move on

 

[EMSnick]

I had a really rough time starting out on the road, and at times i still do! It's really tough on my girlfriend that she knows something is bothering me, but also knows that I can't/won't talk to her about it. What really helps me out a lot is talking to my partner. When you need to talk, go to the people that you work with.