As someone who spent 16 years in the emergency room and has friends who are/were paramedics …and almost married one years ago, I can honestly say that a recent article in The Austin Chronicle (5/8/15) is one of the most disturbing things I’ve ever read. Paramedic stress and burnout is beyond what many imagine in some cases.
The lengthy article chronicles what some call the fall and subsequent challenges today of the once highly acclaimed Austin-Travis County Emergency Medical System following not one, but two closely timed suicides of incredibly respected veteran paramedics.
From Affordable Transport Agents To Human Life-Sustaining Machines
As the traditional BLS medic system (Basic Life Support) of decades past transitioned into highly trained and incredibly skilled front line care providers in the field — paramedics — their responsibilities and, I should mention, personal and professional liabilities have also increased substantially. We have, some charge, and perhaps rightly so, expected these heroic men and women to perform more as machinery, able to act with the precision of their training while at the same time, manage, if not completely set aside, the emotional tolls that come with the job. And they do, for self-preservation itself, but at what cost and for how long?
Given that a high percentage of calls they respond to are not critical in nature, they spend a great deal of time transporting those who either simply lack their own transportation to a local ER, or in some cases, feel going to an ER via ambulance will guarantee a more direct route to care without waiting for hours in the lobby. Protocols typically dictate that transport is mandatory, not an option unless a patient declines the care.
But what’s overlooked is the all-too-often raw and unthinkable scenes that a paramedic endures as part of the EMS system, shift in and shift out, beyond the critical nature of a heart attack or some other stressful medical situation; the gun shot victim; the auto accident with both critical patients and those who didn’t survive; the crime scenes; the fire victims and other tragedies that would send mere mortals running at the sight. Their job is to stay …to deal …to care for and save if possible, those injured, maimed and clinging to life with few prayers.
As the Chronicle article points out, these heroic, yet dramatically stressful feats are endured without pause or consideration, as they complete what has become increasingly long shifts, mandatory overtime and little time off to recover. The increasing stress on these stoic pros takes it’s toll on their families, their children, their relationships, their health and yes, their ongoing ability to perform their jobs to the best of their ability.
As private providers and both city and county governments strive to meet demands while maintaining conservative budgets through often creative staffing means — typically at the physical and mental expense of the paramedics — the lives of those with the utmost integrity and purpose …the glue that holds any EMS system together, may be at risk.
Many who study the effects of stress in the field and the conditions under which paramedics routinely work, find concerns equal to that of wartime and equally challenging cases of Post-Traumatic Stress. For many, total ‘burn out’ results with fewer years on the job, averaging around 5 years in many cases.
Luckily for us, many paramedics are taking their years of training and transitioning into other areas of healthcare where they can play a valuable role, but where does that leave the critical nature of the field, and what responsibility do we, as health consumers, bear in protecting those who answer our calls, 24/7?
The claim is not that Austin’s failures represents the norm, but certainly Austin’s challenges are ones that plague cities and counties throughout the nation. Some manage better than others and appropriate funds, training, stress counseling, and time off accordingly and respectfully.
But I do believe that as health consumers, we need to be reminded of what we ask of these individuals, for our own sake and that of our communities. We need to be reminded that our own call is probably not the first call they’ve responded to on a given day, or the last.
We need to be reminded that there are situations and conditions that can predispose a climate of stress unrelated to our individual medical crises and for that reason, anything we can do to assist the paramedics in their job (on our behalf) is not only appreciated, but sometimes important to our own outcomes.
So ask yourself, if you had a medical crisis today and you knew that the paramedic had already spent 16 hrs on his/her shift, how important do you think it might be to hand them a simple document that clearly indicated your medical history, medications and ongoing needs?
Or, you can simply take for granted that the paramedic will carry the full (unfair) burden of your care as others did before you.
We can’t always provide paramedics with great information, or any information at all, but when at all possible, we should make every attempt to do so, for our own sake and theirs.
Whether you take advantage of the 911Snapshot™ program, or develop an outline of your own, don’t make paramedics guess. Be your own best advocate and provide them with what they need to ensure you the best care possible no matter how long their shift, or how stressful it’s been.
And the next time the agenda of your local government includes a discussion about your EMS services, plan to be there and take an interest. We owe them that much.