How do you train for seeing really messed up stuff on the job?

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soulsultan

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Hello all.
I'm quite new here. I've had the burning desire to become a medic, and them possibly going into Fire rescue.

I am aware that 80% to 90% of the job is medical and can range from a lonely person just needing attention to blood and body parts on the highway.

I'm not really used to any kind of gory or earth shattering experiences, I am also not the type who wants to flake out should a difficult situation arise.

My questions are these?

Do you become numb to seeing hard things on the job? Also, how do you prepare yourself for such things?
 
I think most people do become numb to it. But not everyone. And I really don't think you can do anything to prepare yourself for the worst. Everyone takes it different. The good thing is (in my area, at least) there is a debriefing committee that will come in and talk to the crew, if needed.
 
OP, its worth re-evaluating your assumptions about EMS. Do some reading on this forum, it's a start.
It's really not a matter of training, its experience. We dont purposefully want to numb ourselves, but we want to be able to process the facts that are important, and dispose with what is not important, at least for the patient on scene. We want to treat the patient in the moment, and deal with whatever else later. Quality EMS services should have an Employee Assistance Program in place, if crews need to talk things through after the fact.

At this point, you should focus on getting the education you need to provide your patients the best care possible. Think not about your potential hypothetical reactions, but what you can best do for your patient, at that time.

Hope this helps,

Dan
 
soulsultan said:
Hello all.
I'm quite new here. I've had the burning desire to become a medic, and them possibly going into Fire rescue.

I am aware that 80% to 90% of the job is medical and can range from a lonely person just needing attention to blood and body parts on the highway.

I'm not really used to any kind of gory or earth shattering experiences, I am also not the type who wants to flake out should a difficult situation arise.

My questions are these?

Do you become numb to seeing hard things on the job? Also, how do you prepare yourself for such things?
Click to expand...

A "burining desire" is something you may be afraid to try but have no doubts you will one day. If fear stopped us from doing everything, Obama wouldn't be our current president ^_^
 
If you have a lot of trouble seeing past gore to the real problem, or if you don't know if you can, try looking up some pictures. Try to look at them clinically, and estimate the cause as well as how you'd triage and treat. It's no substitute for real training, but can help you get used to seeing nasty scenes from the right mindset. It can also help you get over the usual set of bad reactions.
 
I am gonna pull something out of my love of ER, and paraphrase Dr. Carter, who said, "The bad news is that you never get use to it and the good news is that you never get use to it." Anyone who says that they are use to everything that they have seen and is prepared for everything they possibly will see is some one that is too callused for my tastes or delusional. IMHO, the only way to know how you will deal with emergent situations (or just different and stressful situations) it facing them in real life; trail by fire so to speak. No matter how much education and training you have, no one is 100% prepared for the real deal and you will always encounter new stuff that tests your resolve... experience in real life will either prove that you have the ability (and will develop it further) or will prove that you need a nice job as a house painter (which probably pays more anyway). You are either cut out to handle it in the present, or you are not... and nothing can really prepare you for everything that can be and will be seen and experienced; even the seemingly mundane things. Dealing with it after (sometimes years after) is the hard part…
 
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You are taught in training to distance yourself emotionally from the patient. In my opinion this is a complex art that no one on the face of this planet will and can ever master. Distancing yourself too much can make you miss important facts about the patient, they will not come out and tell you everything, EVER! At the same time, getting too close to a patient can tear a person apart.

As for the blood and gore, I go to my training. I imagined my first code would be a nightmare. When I got on scene my training kicked in and time flew quickly as I did compressions. I didnt have time to think with everything that was going on around me. Thats how I deal with the bad ones.
 
I wouldn't say that I've become numb so much as I've developed the ability to compartmentalize. For example, I have a badly hurt patient, whom I know is going to have permanent disability. I may feel bad for the pt/their family, and may think that it is a shame that whatever happened happened. I also know that at the end of the day I couldn't have stopped what happened, I did my part by getting them to the hospital without harm and hopefully* helped, and from here on it's in the hands of the doctors, nurses, rehab people etc.

To simplify "Sh*t happens, I clean it up. I don't worry about stopping it from happening because I know it's futile and will make me nuts".


* I say hopefully because some cases you just can't do much but get them to the hospital.
 
Two primary things:

When you're doing the job, all that is going through your head is actually doing the job, not how gross something is, or how sad something is, or how no one should see stuff like that. There is no thinking "Oh my God, he's bleeding all over me", it's "I need to get this blood stopped, I need to get a definitive airway, and I need to plan 5 steps ahead incase something does happen"



When NOT doing the job, that's when something called "Gallows Humor" comes in, and that's when you see us make the "inappropriate" jokes, or laugh at peoples misfortunes, or take death lightly. It's a coping mechanism.
 
Rural's second paragraph is it.

Know what you are supposed to do and do it.

Trouble comes in three flavors; if you identify with the patient; if you are feeling sorry and trying to take it easy on the pt; and if you are afraid of pain, suffering and gore for some reason. In an emergency you can get past them by remembering the pt is depending upon you, but that will only work so often before you get burned out.

You are not the patient. Gore will not hurt you. Taking it too easy on a patient does not get things done and they suffer more.

Initially, you will need to treat problems not people, and that way you are serving the person. Later when you are calmer and more secure you will find time and opportunity to lend a human touch.

But remember scene safety first. No foolin'.
 
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