LEARNING FROM TRAGEDY - Well-being for EMS and Police

LEARNING FROM THE TRAGEDY OF DOMESTIC VIOLENCE HOMICIDE
The health and well-being of emergency service workers like police officers and paramedics requires the balance of physical and mental wellness. Greater attention is being paid to educating students in the emergency services to proper nutrition, the importance of exercise, lifestyle balance and proper stress management techniques. Wellness is not something that happens by itself. Many officers and medics alike believe they are just fine when everyone can see they are not. Why? Police officers and paramedics are exposed to a complete range of human experience and tragedy. Most “suck it up” and keep their feelings to themselves when unresolved issues percolate in their psyches. The resulting stress adds to career burnout and in the worst case – arguably, a frank psychosocial crash and burn. Enhanced training in personal and professional wellness is essential for optimal long term resiliency of the first responder.

GALLOWS HUMOR

        The camaraderie among EMS and fire service personnel is well documented. Similarly, police officers tend to “hang” together whenever they get the chance and share stories from their departments – big and small. There are usually plenty of laughs as stories are shared. These sometimes take on a “gallows humor” as cops and EMTs process and integrate the scenes they cover. I once sat at a local bar with a vice presidential secret service detail and it was no different with them. Humor is a coping mechanism to an otherwise woeful system that often fails its membership – especially when events exceed what is thought to be just an “average call.” Police, EMTs, and fire service personnel have high rates of alcoholism, drug abuse, suicide, and ironically, domestic violence. There is a high price paid when this brand of humor leaches into the professional conduct of front line practitioners and can affect the delivery of pre-hospital intervention.

CAREER BURNOUT

As the American population gets older the need for pre-hospital care and inter hospital transfers is likely to grow. It is unlikely that the demand for pre-hospital professions is going to decline in the coming generation. According to Bledsoe et al., a paramedic may find themselves providing a wider range of care in the future – including primary care (page 5). Therefore, paramedic training should include specific direction about post-incident debriefing in order to assure that medics remain healthy and focused.

It is well documented that the body responds to stress by a build-up of cortisol—a hormone that depresses autoimmune functioning and can contribute to hypertension, pain, and disturbed sleep. Continuing education also fails to address the cumulative effects of stress and the impact this has on personal health and wellbeing. The response to stress differs from professional to professional but many choose maladaptive coping mechanisms blaming the “job” or “company” for low wages, valuing profit over human capital, and other frustration unrelated to internal conflict – expressed as anger and resentment.

CONCLUSION

Paramedicine is an exciting and rewarding field. Nowhere else can an average person practice emergency medicine without having attended medical school. However, along with this lofty responsibility comes the awareness that an important price is paid when the paramedic believes he is above being human. Arguably, the profession needs to be accountable for the wellbeing of its membership including post-incident support. The tragic reality in Maine brings home the impact that we are all exposed to experiences that most human beings avoid or never witness. Most of us are able to cope and process the images in adaptive fashion. Following the horrific events of 9-11, the incidence of suicide among police officers, EMS and fire service personnel was excessive and unnecessary. Most did not receive the help they needed early on. Resiliency training has been shown to be a viable professional development and may better inoculate the police officer and paramedic against the range of emotional contagions faced on a regular basis. In Dexter, Maine at least one public service employee is at high risk for post-traumatic stress and its potential to corrupt long-term health and well-being.  When calls for service become solely a transaction between medic and customer it may be a sign that professional resiliency is over taxed and career burnout may be rising from the proverbial ashes of the calls we did before.