Check Your Fabric

Early on in my EMS career, an event occurred in one of our neighboring communities that changed my life forever. When the responding units pulled up at a horrible crash, with debris and bodies everywhere, the captain on the engine company, one of the old-dog EMTs in the system, saw something that caught his eye. As he moved closer, he realized that what he was seeing was the remains of a person who had been literally blown through a chain link fence. What moments before had been a living, breathing person was now a mass of nonliving flesh in 2½-inch squares. At that point, he took off his helmet, set it on the ground and, without a word to anyone, walked off the scene and walked home. He tendered his resignation that day, sold his home, moved his family out of state and went into a new line of work. In one call, an EMS career was over.

There is little question that we in EMS respond to calls and experience things that no person should have to see or deal with. However, if no one entered the EMS profession or responded to 9-1-1, people would unnecessarily suffer and possibly even die for lack of competent prehospital care.

The event above remains one of the most horrific experiences I have ever heard of—a singular event that instantly ended the career of a seasoned EMS veteran. Over the years, and out of thousands of calls, I’ve only experienced one event that even comes close to that, and it almost ended my career. As with most terrible things, time does indeed heal many wounds, but every now and then, I think of my experience and that of my colleague and wonder why I survived to continue my career, while his ended. However, that is not the focus of this month’s BTB. Rather than focus on these, to some degree, once-in-a-lifetime events, I’d like to look at everyday EMS and the so-called routine calls.

Where these big events may literally tear the patch off your shirt by comparison, I see the day-to-day little things that pick at the very fabric of your emotional well-being as much more insidious. You see the unfairness of life. You see bad things happen to good people. You see administrators focus on everything BUT good patient care. Each and every one of these little things picks at your emotional fabric.

To me, EMS is a kind of mathematical event. You are caregivers and, as such, you give care. On the other side of the equation are your patients—what I term “care takers,” because they take the care that you give. In the long haul, it all has to balance out. Unfortunately, I see repeated instances where EMS providers allow their emotional bank accounts to become overdrawn. They have given all they can until they just can’t give any more, and they leave EMS. Sadly, many of those in the exit line are seasoned veterans, who take with them years of savvy and street smarts that aren’t taught in any textbook; they’re far more than just a person with a patch.

Whether you are a career or a volunteer professional, collectively, you are what makes EMS happen day to day across America. Please take a moment to see where you are at this moment in your journey in EMS and consider the following:

• Develop/maintain a support system.

Ideally, a support system should include family, friends and coworkers, at a minimum. Each of those three main groups would know you in a different way, and, as such, would bring a different perspective to situations and problems you encounter. For special needs or situations, clergy or professional counselors can provide additional insight and support. There is real meaning in the expression “there is strength in numbers.” While we as EMS providers are tested and certified to perform our skills as individuals, I see little logic in attempting to look at all that life throws at us, both on and off the job, and then deciding to “go it alone.”

• Strive for balance in your life.

If someone asks what you do for enjoyment and your answer is “teach CPR classes,” consider that you are somewhere between a bit and a bunch out of balance.

EMS can be intense, not just when you are challenged with patients with multi-system trauma or multiple disease etiologies grinding them down at the same time. Just being charged with the well-being of other humans is plenty intense. Add to that the whole giving and taking care issue, and you’ve got a potentially dangerous situation.

Make time to do things with friends and family. Try to avoid medicine off the job, so you can be more focused on the job.

When you do need to add more EMS to your plate, make a conscious effort to do something fun to compensate.

• Keep a close eye on YOU.

With every day you spend in EMS and with every call you respond to, your skills, and in particular your assessment skills, should improve. Believe it or not, those skills aren’t solely for your patients. On a pretty regular basis, say every week or so, take a few moments to intentionally assess YOU. How are you performing your job as an EMSer? Look at your daily attitude, the way you get along with peers and the care you provide. Are you motivated or not? Do you remind yourself that the job you do in EMS is important, not just to the people you serve, but to you as a person?

• If you think you need help, GET IT!

Just as you are frustrated when a person with heart disease sits home for three hours and denies the crushing pain in his chest before finally calling 9-1-1, so should you be frustrated if you need help and don’t seek it promptly.

If you are having trouble sleeping, your value system seems to be breaking down, you are far more negative than positive in your overall assessment of life and EMS, or you think alcohol is the answer to everything, then it’s time to take action. Work with your support system, and seek additional help, when necessary, to get back on track.

I appreciate you taking time to read this piece and considering my suggestions. In closing, I would like to share the following: Think of a time when you got a small hole in your favorite T-shirt. Every time you washed it, the hole got a little bigger. Every time you wore it, you twisted and turned and pulled at the fabric, and the hole got bigger yet. At some point, the hole got so big that you had no choice but to throw out the shirt.

When the day-to-day little things in EMS pick at you, they can slowly unravel the essence of you, and we certainly don’t need to unnecessarily lose any more of our most valuable assets in EMS—our people. Do your part to prevent that, and every now and then, check your fabric.

Until next month…