Thinking about a return to EMS. Wanted to get some input.

GooMan

Forum Ride Along
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Hi all!

So I worked as an EMT in a small town in the Northwest about 6 years ago.

It didn't go so well. I've reflected on why.

First, I had an alcohol problem that began early in my adolescence that I hadn't taken care of. I wouldn't say the stress of the job "drove" me to drink, but it certainly was a good excuse. In all actuality I was drinking regardless, whether I was washing dishes or working on an ambulance. I ultimately quit the job after being confronted by police during one of my drinking benders. They ultimately took me home instead of arresting me for public intoxication. They did tell my boss though, as they knew who I was, so I quit before I could get fired. Over the next few years my drinking got worse. It took 3 inpatient stays to finally get sober but I did it.

Second, I was completely unprepared for the job. I hadn't taken my training as seriously as I would have liked, and found myself overwhelmed by what the job really was. Practicing for emergencies and actually being in emergencies are two different things. The problem was allowing feelings of anxiety to cloud my mind on calls. Some calls I was able to "focus in" and get the job done. Other calls, not so much. The guy training me told me I was below average, and in his opinion I wasn't going to make it. It was a fair assessment, though I think he failed to see what I was doing right. I was a great communicator, for one. I was really good at talking to patients and their families, and my assessment skills were decent. Also, when I was on point, I was on point. One car accident call, broken glass, backboard, blood, and I totally ROCKED it. For whatever reason, I just zeroed in, did my job, and knocked it out of the park. My strengths are my analytical and communication skills. I can do assessments and communicate with patients and coworkers well. My weaknesses are the anxiety of calls sometimes causing me to "freeze up" and made it difficult to apply my training. It didn't happen all the time, but it did happen. One call I was so fired up I had trouble getting the gurney out of the ambulance. My coworker said "we gotta go," pushed me aside, and did it.

Which brings me to today. I have a few years of sobriety under my belt and I am very strong in my recovery. I manage stress very well, with a great self-care routine, that includes adequate sleep, relaxation, bible study, spirituality, church, recovery groups, hobbies, time with friends and family, socialization, and of course, Facebook memes. My life has radically changed for the better as I have transformed myself. I have developed strong morals and ethics as well.

So my return to EMS depends on two things: managing the stress of the job so as not to drink. That's number one. If I drink, it's game over. Second is managing my anxiety on scene so that I can think straight and get the job done. As I have had a tremendous amount of experience in high stress situations since then (I work in the inpatient mental health field, which is wild in its own right, as I'm sure you know from your psych calls), I am confident in my ability to do this. I seem to have slowly but surely gained an ability to center myself, block out the anxiety, and act. I do this by utilizing mindfulness and hyperfocus. I block out anxiety and focus on each task, one at a time, and do each task as competently as possible.

A true test of this was my Grandma's stroke. About a month ago I found my Grandma laying on the floor. My training seemed to flood back to me. I used the fireman lift (I think that's what it was called) to help her into a chair and began assessing. It took me about 5 seconds to determine "stroke." I remained calm and focused, got EMS on the way, did everything that they asked of me, and got her to the hospital immediately. I rocked it. Not to toot my own horn, but I may have saved her life. That's what my family says, anyway. Afterward, my grandma said I'd be great in the medical field, so here I am, questioning whether a return to EMS is feasible.

Anyway, let me know what you think.
 

planetmike

Forum Lieutenant
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I'm glad you've gotten over the alcohol. Keep it up.

Easy questions: Are you still certified, or do you need to retake the course? What are your long-term career goals? Do you want to move up to Paramedic? Or transition to nursing, or somewhere else in the medical field? Does your family support you returning to EMS?

Hard question: Are you in the same community you were in six years ago? Were bridges burned from your record back then? Both with the squad, and with others in the community (e.g. law enforcement)? Were there any actions filed against you with your state licensing bureau (ie are you eligible to return to EMS in your state)?

Harder question: Are you in a support group of some sort? Alcoholics Anonymous, Al anon, etc... What do they think of you going back to EMS? To a point, they may not totally understand the pressures of the field, so they may not be able to totally "get" why you'd want to go back to EMS.

Good luck. I hope you're able to work through everything.
 

mgr22

Forum Asst. Chief
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GooMan, I think we covered the alcoholism part in your first post. Let's talk about the anxiety part. I disagree that a "true test" of handling anxiety in the field is a family member's illness -- your grandmother, in this case. When I think back to anxiety I felt at the beginning of my EMS career, it had to do with partners/bosses/bystanders looking over my shoulder, dealing with strangers, and the unknown -- i.e., which parts of my training I might have to apply.

I did respond to a couple of family health emergencies early on. I felt much more confident than usual, probably because I didn't have to worry about the first two of those three stressors. Even the third -- the unknown -- was less of an issue because I knew something about my family members' medical histories.

Also, I'm not sure if working in the mental health field is analogous to running 9-1-1 calls. I've never done the former, but I'm imagining different skill sets. I think you already know that psychiatric emergencies are just a subset of the presenting problems you'd face as an EMT.

I'm not trying to discourage you from resuming your EMS career; I'm just suggesting that you should keep thinking about the problems you faced last time, and be honest with yourself. I might be wrong, but I get the impression you're trying to resolve some dissonance by minimizing the issues you faced and over-estimating your chances of success. There's nothing unusual about that, but it's sometimes hard to recognize when we do it to ourselves.
 

GooMan

Forum Ride Along
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Hi! Thanks for your input, and thanks for your questions.

Yes, I use church and SMART Recovery. Not too big on AA. The former works and has worked very well, whereas the latter never did. Why fix what ain't broke?

I would have to retake the course.

You may be right. Here's a fair assessment: I am not a fast thinker. I am highly intelligent, but process immediate incoming information slowly. It takes a second to really "get" what's happening around me. This is related to ADD. I have in the past had trouble adapting to chaotic, fast-paced, wild work environments. I am able to adapt at least to the point of functionality ONLY when I am highly confident in my skills. I always did much better in environments where I could focus on one thing at a time. In my EMS training I did very well with assessments, as I could break it down into a step by step process. I had it down to a science. However, real emergencies force one to improvise in their patient assessments, and how it actually plays out is often "jumping" all over the place, which is difficult for me. The high pressure of emergencies and the resulting anxiety only made things worse. The only thing that has me questioning is this: it depended on the call. For whatever reason, on some calls I did well, and others not. Looking back, it depended on a variety of factors. My confidence level, my anxiety, my focus. Regardless of how functional I am able to become in a chaotic work environment, there is always a certain level of discomfort. I can never quite get "comfortable" in situations where I have to think and act fast. It feels like I am working outside the scope of my capabilities; pushing my boundaries. Like I am working from a weakness, not a strength.

My coworkers picked up on this quick, and chastised and berated me for it. I wasn't getting any help there. After awhile, my motivation for doing well was pretty much not getting yelled at.

All of this sucks, because I certainly had passion and ambition. I wanted it bad. It sucks to not succeed at something you want.

I guess my only question is, is functionality in emergencies something that can be learned, or is it something you either have or you don't?
 
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GooMan

Forum Ride Along
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Alright, so I just watched a few episodes of Paramedics to assess my reactions. No way. No freaking way. I must have been insane to try to get into this profession. I must be more insane to think about going back.

Just watching the videos, I can FEEL the stress level I felt on my EMS calls. I'm physically shaking. It would take a TON of work in centering, mindfulness, and anti-anxiety technique just to get to the point of not losing my mind on a call. I have NO IDEA how you amazing men and women function under these conditions, and my hat is certainly off to you.

Thank you for your replies, and sorry for wasting your time. Mods, go ahead and close. I have my answer.

As much as I want to be the guy who can do this job, I'm just not the guy. Too many factors working against me, and not enough factors working for me.
 
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