So I’m not going to lie, every time I look at an EMS conference and see a topic like managing burn-out or managing EMS providers mental health there’s still part of me that scoffs; not again, another hour of people telling me to take care of myself, another story that’s just not me or how I feel. Well after 18 years in EMS I think I finally get it, after being away from EMS for about 4 months doing some military training I came back to EMS and just started to feel like something was off. I had been tired before I left but now that 2am call didn’t just get me annoyed it got me thinking maybe it’s time for a change in career.

We all may define burn-out in our own way, many of us can even see the symptoms of it in others but not necessarily in ourselves. Let’s do some self-reflection and formally define it and list out these symptoms, lets take a hard look and answer this for ourselves. Burn-out is defined by the World Health Organization (WHO) as, “A syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” The WHO goes on to say “Burn out is classified in the newest addition of the International Classification of Diseases (ICD-11) as an occupational phenomenon. It is not classified as a medical condition.” Good so we are not all in lamest terms crazy. Stress is real, the repetitiveness of our jobs is real, and the feelings we all get over the years of doing this job are very real. Let’s take a minute and actually think about the symptoms listed below and fill out the check list

If you, like me put a check next to each of these symptom’s congratulations you have identified you might have a problem. For me I can definitely say sometimes just coming into work can be exhausting, which isn’t all that unusual on your 3rd or 4th shift but I started noticing it half way through a second shift. With increased mental distance, negativity and cynicism, beyond a doubt having been an issue. Recently my program has gone through some significant operation changes with a pilot shortage to the point where sometimes only half the fleet is flying, specifically on night shift. This leads to an increased demand on those on night shift, to crisscross the state to move patients and answer scene flights. For the most part providers seem to make jokes and get through it, but those joke always have a heavy dose of both truth and cynicism to them. As for a reduced professional efficiency, well for the first time in 8 years I missed a tube. While I guess that’s an ok record it still hit hard and it was at this instance, I really started to think about burn out in a more serious light.

With a clear definition and a set of signs and symptoms now established, let’s talk about coping mechanisms. The Mayo clinic suggests

  1. Talking with your supervisor, to gain more support from leadership and improve process flows.
  2. Talking with you peers, realizing others feel the same can give you a sense of belonging
  3. Try a relaxing activity, like Yoga or meditation
  4. Get some exercise
  5. Get some sleep
  6. Practice mindfulness

As exhaustive as that list may seem I can certainly understand how many EMS providers may feel these things are out reach for their reality. Complaining to the boss isn’t going to fix a pilot shortage, it’s not going to get you out of that long transport. But many times, just letting your frustrations be known can go a long way to feeling better. As for talking with your peers the same general rule applies. With this we want to be careful though, a negative attitude is contagious. No matter what there are still amazingly good part of our job, focus on that. Talk about the difference we made, be grateful for the opportunity to make a difference even if it’s just in a small way. Yoga and just general stretching have been an incredible game changer for me personally. I went from chronic back pain I thought would never go away to realizing it was my ITB and hips that were tight. Stretching just 5 minutes a day has completely done away with all that pain. Exercise and sleep are solely in our control there is nothing our employers can do for this; this one is on you. Either you turn up and work out, you turn that phone off at night or you don’t. About 3 years ago I started a weight loss journey so I could rejoin the military (mostly this time so I would know I have a pension, 12 more year!). In the process I have lost over 40 pounds and have kept it off for several years now. Exercise has become my daily routine, and I’d be remise if I didn’t mention CrossFit, (because the first rule of CrossFit is you must talk about CrossFit) it’s not just the weight loss but the community that keeps me going back. So really the lesson here is form relationships with people who are not in EMS or first responders, branch out, the change will be welcomed I promised.

In closing it’s important to understand two things, number one it’s ok not to be ok. But it isn’t ok not to find help. And number two it’s ok to change, you can change jobs or even careers. It’s ok to take a step back and make less money, it’s ok to choose another path even as you get older. I always joke with my partners after the 3rd flight of the night when my head hasn’t even touched a pillow yet and those tones go off again, “I should have just gone to law school.” …. Well maybe I’m right, maybe it’s time for a change.

If there is anyone out there who needs help, please utilize any resources you have available. Below are some excellent resources that are peer sponsored support to help.

 

The ECHO fast team: The ECHO Fast Team is available 24/7/365 by calling 1-833-AIR-FAST (echoflightcrew.org)

The First Responder Support Network: First Responder Support Network – Home (frsn.org)

 

References:

Burn-out an “occupational phenomenon”: International Classification of Diseases (who.int)

Job burnout: How to spot it and take action – Mayo Clinic

BRINGING OUT THE DEAD | Cleveland Institute of Art College of Art | 800.223.4700 (cia.edu)