Paramedic safety is a hot topic because creating a workplace safety culture for first responders is a 24/7 deal.

Whether a team member needs to discuss a cranky co-worker who picks on the underlings without worry of churning up the gossip mill or wants to escalate a safety concern up the chain of command, having solid protocols around safety culture in place creates a safe haven for everyone.

Creating a workplace safety culture where it’s safe to talk about difficult subjects doesn’t happen by accident.

Airing your grievances at work needs to be part of the workplace safety culture, and it takes a commitment from upper management to ensure the right communication channels are in place, said Bruce Evans, MPA, CFO, SPO, NRP, fire chief with the Upper Pine River Fire Protection District in Bayfield, Colo.

Chief Evans is the incoming president of the National Association of Emergency Medical Technicians, effective January 2021.

Evans said it is essential to have multiple support systems in place to foster open communication, such as dedicated peer support and employee assistance programs that provide counseling services.

The systems also should include creating disciplinary protocols for supervisors to follow if staff exhibit behavioral or attitude problems, he said.

In a 2016 NAEMT National Survey on EMS mental health services, it examined the extent that EMS agencies provide mental health resources for employees.

According to the survey:

  • 37% of agencies do not provide mental health support for employees.
  • 42% provided no health and wellness services.

The survey suggests many EMS professionals were reluctant discuss challenges they faced at work because of the stigma of appearing weak.

Peer support leads to a safety culture

Peer support personnel are team members ready to offer a supportive ear to co-workers.

Evans said Upper Pine River has two trained peer support people and two more coming on board to support a staff of 30. Peer support ratios likely depend on the size of your agency and call volume.

Peer-to-peer discussion topics range from venting about job stress and safety concerns to problems at home to excessive drinking or substance abuse.

“Hopefully you have identified peer support people in the ranks so [employees] can talk to their peers first, someone who can help give resiliency tools,” Evans said.

Resilient people bounce back, and they usually have good coping skills in place. While some naturally possess these characteristics, others must develop them, says Mark Fleming FF/NREMT-IV, who works with Evans as a peer support leader.

Resiliency tools Fleming uses with his peers fall under four categories:

  1. Goal setting
  2. Mental rehearsal
  3. Self-talk
  4. Arousal control

Take goal setting as one way to boost resilience and manage stress.

“Your goal is to stay focused on something. It keeps the prefrontal cortex of the brain engaged so the amygdala does not go into fight or flight,” Fleming said.

Try starting with small goals, like slowing down your breathing, before taking on larger goals.

Goal setting helps people stay anchored to an outcome. This helps them stay positive while planning for the future. It’s not peer support’s job to assign goals, but rather to listen and bounce ideas around.

Fleming suggests ResponderStrong.org and NAEMT resources to learn more.

“There needs to be a solid system in place, combined with a culture within the department that caters to a support system where people can open up and be confident that it stays confidential and that they won’t be shamed,” Fleming said.

What do the symptoms of job stress look like?

Here’s what job stress can look like, according to The American Institute of Stress.

Knowing what to look for can help you spot the signs within your team.

  • Looks tired or overwhelmed
  • Disengages or socially isolated
  • Appears easily frustrated
  • Overreacts to small stuff
  • Lies to cover up problems
  • Excessive belching
  • Rapid speech
  • Impulse buying or excess gambling

Being aware of these signs will help to increase the safety culture of your team.

Employee assistance programs can help

According to Evans, an employee assistance program is a confidential way for people to access mental health professional services.

“All I get is a bill when someone has accessed the employee assistance program system and it exceeds a certain amount of employee assistance program visits. Then we are notified,” he said.

But the notification does not include identifying employee information.

If an employee shows erratic behavior on the job, Evans said it cannot be ignored. Sometimes this behavior even requires a “supervisor intervention” with the employee assistance program.

Employee assistance programs are beneficial for the employee and employer. Evans said he sees the best outcomes when employees self-refer as opposed to having a supervisor ask.

“People find employee assistance programs by self-referral or they are suggested to go (get help) from their front-line supervisor,” he said.

According to Evans, when mandated to use an employee assistance program, employees usually have exhibited at-risk behaviors on the job.

“Either putting patients at risk, crew at risk, the agency at risk and putting yourself at risk,” he said.

Learn more about mental health in our course Individual ALS L-11 — Includes Psych and Behavioral Emergencies, Field Triage MCI today.