Chapter 4 of 5
Welcome back, my friends, to the blog that never ends…well, it will, but we still have some important things to discuss, so come inside, come inside.
For the record, if you didn’t do your homework – watching/reading “Bringing Out the Dead” – it’s okay. There’s obviously no grades here. But I highly recommend it when you get some free time (what’s that, right?).
So, we left off with a question: What do we do about the stigma? The PTSI? The suicides?
The obvious answer is: we have to eliminate the stigma. We have to stop treating mental health as the elephant in the room no one speaks about. We have to spread the word that it’s ok to talk about these things, that it’s ok to not be ok.
Everyone in emergency services needs to know, that just because you have problems dealing with the things we see, with the demons in your head, that doesn’t make you a bad EMS provider/firefighter/police officer/dispatcher, and it doesn’t make you a bad person.
We always talk about how we are a family. Well, guess what? We are. We spend a lot of time together. We understand each other, sometimes better than our blood relatives. The situations we find ourselves in are usually similar to another’s experiences. We need to be there for each other. We ARE a family! Act accordingly.
And you don’t need any degrees or certificates for this. Sometimes all someone needs to do is just talk. And all you need to do is just listen. And, conversely, sometimes you may just need to talk, and someone will be there to listen to you. Will this solve the whole problem? Of course not. But it’s a start. It has to start somewhere.
Of course, we have to recognize when someone may need help, even if that someone is us. We need to know the signs of Post Traumatic or Cumulative Stress. The nightmares, the lack of sleep, the mood swings. Avoiding the scene or subject of a critical incident. Being easily startled. Having trouble remembering the incident. Feelings of guilt. Feelings of low self-worth. It’s critically important we know the warning signs.
And for the love of all things holy, when you say “I’ve got your back” you have toMEAN IT! Those are not hollow words in this business. That and “Be Safe” are among the nicest things you can say to an emergency services provider. But they can’t be just words.
A fellow paramedic once said to me “You know, when this happens, we wring our hands and tell everyone ‘I’ve got your back” and we hug and then two weeks later we’re back to the same stuff. It’s just one big cycle.”
You know what, he’s right. You know what else? We MUST break this cycle.
On the night before we buried Matt Clancy, my crews and I responded to an attempted suicide of a health care worker (hospital based). The police officers who arrived before us did an awesome job of saving her life with a tourniquet. We got some IVs in her and got her prepped for the trauma room. And we tried to talk to her. We tried to be there for her since we could not be there for Matt.
When we got done, we went back out to the ambulance bay to clean up. And we talked about it. And we talked about Matt. And we hugged. And, yes, we cried. We cried for Matt and hoped we were there for her like we couldn’t be there for Matt.
And then, a funny thing happened. We got back in our ambulances and went back to work. We did our charts and we answered more calls. And you know what? The world kept turning. The calls kept getting answered.
Just because we showed emotion, it did not affect our ability to do the job. We didn’t think any less of each other. I think I am still a pretty good supervisor. And I am very sure thatthe rest of the shift is still excellent at what they do.
The next shift, I bought the crews ice cream so we could talk some more. OK…the chief sprung for it but it was my idea. And in true EMS fashion, we got a call as soon as I paid for the ice cream. But we have talked. And we check up on each other. And we cope.
And coping mechanisms are important. They are needed to help us deal with the things we go through. Go sit by a stream or go hiking. Go to the beach. Go fishing.
Spend time with the people you care about. Your friends and family. Enjoy yourself, but don’t eat or drink to excess – that leads to a whole slew of different problems.
Go to a comedy club…after all, laughter is the best medicine, right?
Watch a Disney movie. Trust me on this one…parents, you feel me? There’s plenty of stuff in there for adults. Don’t believe me? Take Zootopia. It’s about a rabbit who becomes a police officer. A bunny who earns a badge. Judy Hops is literally (am I using that correctly?) a badge bunny!
Of course, violence is never the answer, but sometimes you may just feel the need to hit something. That feeling is ok. The solution? Go to a batting cage or driving range. Go to the gym and hit a heavy bag or do some other sort of workout.
And if something doesn’t work for you, try something else? The possibilities are endless.
And the reality is, it’s not about what happens to you. It’s really not. It’s about how you respond to, and react to, what happens to you. That’s resiliency. And it is important to build resiliency in yourself, and those around you.
How do you do that? The National Alliance on EMS Resiliency (it’s a thing…) has 10 steps to this, developed by Dr. Philip Callahan.
1) Recognize that, due to your job, you experience critical situations at a rate much higher than the rest of the population (excluding the military, of course, they see it much more than even we do).
2) Realize our training has not prepared us for the mental and emotional trauma we experience.
3) Understand the stressors we experience may not affect us right away. It may take days, weeks, or even months for it to manifest.
4) Be aware of the signs of PTSI in yourself and those around you.
5) Make sure you have a social support system, friends and/or family both on the job and outside the job. People you can trust.
6) Practice positive coping skills, recognizing that you can’t change the problems facing you, but you can change how you face the problem.
7) Recognize that changing a challenge or belief may not occur immediately. You must set realistic goals and take realistic steps towards attaining them.
8) Keep up your physical strength through proper diet and exercise and getting proper amounts of sleep (stop laughing, I know this is difficult in our business but it is possible).
9) Recognize that as you build your social support system, mutual trust will develop. Some days you lean on them, some days they lean on you.
10) Recognize it’s a process. Continue to practice your coping skills and adapt as needed.
Now, the National Alliance on EMS Resiliency isn’t just another form of alphabet soup, it is made up of many of those agencies. The NREMT, NAEMT, IAFF, IAFC, NAEMSP, the Code Green Campaign, Reviving Responders, JEMS, EMS World, Zoll and many other agencies and companies are a part of it. They think our mental health is pretty important.
Someone else who thinks it is important is James O’Neill, former commissioner of the New York City Police Department, which has been racked by over a dozen suicides this year. Several years ago, on the suicide of a 24 year old police officer with 2 years on the job, he said, “Your job requires you spend your day helping others. But before you take care of anyone else, you must take care of yourself…..seeking out help is never a sign of weakness, it is a sign of great strength.”
Help is out there. If you don’t have anyone you feel you can talk to directly, if you don’t feel you can go to EAP or counseling, please consider calling one of the numbers in the lead in graphic. Or use one of the online resources listed. If that doesn’t appeal to you, and you think what I have had to say over these four weeks has had an impact, email me firstname.lastname@example.org or hit me up on Facebook messenger. I’ll listen to you, because I’ve been there. I’ve got your back!
We’ll wrap up this blog next week. I wanted to hit this point this week with the holidays upon us. We all know this is a bad time of year for suicides. Please don’t add to the statistic. There ARE people willing to listen. Just give them a chance. And always be willing to listen yourself.
Until next week, I wish you all a very Merry Christmas, Happy Hanukah, Joyous Kwanza, Happy Festivus, or, just have a great week. You know what, if you celebrate or not, it is a season of giving, a season of wonder, and a season of love for one another. (My favorite Christmas song…have a listen, yes it’s the Muppets https://youtu.be/WlRpGj7LWS4)
Be safe and come back around for the finale. Please.
Matt Giacopelli began his EMS career as a cadet at SUNY Maritime College in 1991. Since then, he has spent time in urban, suburban, and rural agencies, doing 911, interfacility, and critical care transports. Having earned his Paramedic certification in 2000, he's been around a few different blocks a few times, but will never say he's seen it all. Matt is currently getting acclimated to his new position as a Captain with Southern York County EMS in Pennsylvania.