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ems basics fundamentals of bls care for the working emt about us topic index links scenarioville scenarioville information scenarios digital research library about the drl drl shelf: spinal immobilization drl shelf: cardiac arrest library blog medical quotes talking green april 18, 2016 by brandon oto 2 comments there’s a secret behind this job. you go to work. you run the calls: the boring, the exciting, the obnoxious, the weird. occasionally, the terrible. you see, you do, you move on. like everything else, it runs off our backs. like rain off a tin roof. at least, that’s what we tell ourselves. but there’s a secret. the secret is that hidden beneath the uniformed cowboy swagger of no-problem, we-got-this, no-big-deal, a thick vein of psychological stress is flowing. you don’t see it in your coworkers, because they hide it away. when it reaches you, you do the same, because it’s not okay to show it. our professional image is unflappability, and you can’t be unflappable if you let things get to you. so we push it under the rug. until one of us takes their own life. ptsd, depression, anxiety, substance abuse, and yes, suicide, are a fact of life in ems. but we never talked about it. at least, not until a few of our colleagues were brave enough to start shining light upon the problem, in an effort called the code green campaign . code green collects anonymous confessions from our brothers and sisters who can’t speak them out loud, reports the (all too frequent) suicides, collates the research exploring first responder mental health, and performs outreach to build awareness. explore their website for more information about their basic mission. after that, come back, because i asked them to unpack a few of the subtleties behind this problem and how they’re trying to solve it. question : while most first responders agree with the need for the code green campaign, most of us haven’t actually done anything about it. you did. how and why did it first come about? what was the impetus and how did the early days take shape? answer : in march of 2014 one of my co-workers died of suicide. after his death i was talking about it with a group of friends, and we realized that even though we worked for different agencies in different states, we all knew someone that had died of suicide or had a serious attempt. we knew that this couldn’t be a coincidence, so i started looking into it further. i couldn’t find a lot of data, but what i did find told me that this was a much bigger problem than anyone realized. once we established that there was, in fact, a mental health problem, as well as a stigma problem, we started discussing what could be done — particularly about the stigma. it occurred to us that if there was one thing first responders like doing, it is sitting around telling stories. we thought that if we could come up with a way for first responders to share the stories of their own mental health problems, other people could read them and realize they weren’t the only ones struggling. we started collecting the stories and posting them on social media every monday, wednesday, and friday. things blew up from there. in the early days things moved fast . my co-worker died on march 12th, and on march 16th we came up with the story sharing idea. we came up with our name a couple days later, and i think it was by march 23rd that we had our facebook page up and running and stories being shared. q : let’s get down to the elephant in the room. why is this a problem for us? why do ems providers seem to be at higher risk for mental health issues in general, and for suicide in particular, compared to bakers, librarians, and schoolteachers? a : i’m going to preface this answer with the warning that this is a lot of supposition, extrapolation, and educated guesswork. ptsd has most extensively been studied in the military population, so that is the best info we have. this is also a simplified answer, since the long answer would probably beat a doctoral dissertation in length. we are frequently exposed to known risk factors for ptsd, such as seeing people hurt or dead, feeling helplessness or fear, having poor social support after a traumatic event, and having extra stress outside of work (marital, financial, etc). we are poorly prepared for the realities of the job. yes, we’re warned that we’ll see blood and guts and gore, but we’re not told that we are going to feel helpless on a regular basis, or that we’ll be scared we hurt a patient or made them worse. we’re not taught about how different this job can be from normal jobs, and how hard it can be for spouses and other family members to understand what we go through. aside from stressful calls, we’re exposed to higher rates of assault, vehicle crashes, and workplace injuries than many fields, which can add to the trauma. we seem to have higher rates of depression, anxiety, and substance abuse, although it is unclear why. we work in a very macho field and we’re supposed to be the helpers, not the ones that need help. there have also been reports of people being suspended or fired after admitting they have a problem. that combination helps create a huge stigma against admitting any sort psychological problem and asking for help. we have more knowledge about lethal means of suicide. q : okay, so let’s contrast ems against some similar fields. other first responders like fire and police, or medical personnel like doctors and nurses, all seem share most of the qualities you listed. are they in the same boat? or is there anything that puts us at greater risk compared to them? a : other first responders like fire and police are in the same boat. in fact, we don’t separate ems numbers from fire service numbers because the employee base is so entwined. there are almost no fire departments out there who don’t do any ems at all, so it is tough for us to draw a line as to who counts as ems and who doesn’t. just because an agency doesn’t transport doesn’t mean their employees/volunteers aren’t exposed to the same trauma. if you can’t draw the line at transport versus non-transport, where do you draw it? in the long run, it becomes almost impossible to separate people out. with police officers it is easier, but their suicide rate is on par with fire/ems. i believe that in 2014 there were over 140 reported police suicides. as far as other medical professionals go, we do know that doctors do have a high rate of suicide, to the tune of 46 per every 100,000 (for first responders we’re looking at about 30 per 100,000). we don’t know what the suicide rate is for nurses, pas, or nps, but we wouldn’t be surprised to learn it is also high. this is purely supposition on my part, but i do think we are particularly susceptible, because ems is less developed than other medical fields. nurses and doctors have well-established professional organizations representing them at the state and national levels. ems is much more fragmented. the one big difference we’ve especially noticed with nurses and doctors compared to ems is that many states have license preservation programs in place for rns and physicians, but not for first responders. that is, if they have a mental health or addiction issue, their state may have an official program in place to help them keep their license while getting help. few (if any) states have a similar program for first responders. ems doesn’t have that kind of well-organized advocacy yet. q : i expect many of our readers aren’t familiar with license preservation programs. what are they and what are the possible ramifications when we lack one? a : my answer is based on the states i’ve lived in. from what i understand, most states have such a program set up for either doctors and/or nurses. basically, the state has recognized that nurses and doctors spend considerable time and money to obtain their licenses, and that it is in everyone’s best interest to keep them on the job, rather than automatically revoking their license. here i

URL analysis for emsbasics.com

http://emsbasics.com/2011/03/
http://emsbasics.com/about/topic-index/
http://emsbasics.com/#wrap
http://emsbasics.com/tag/self-protection/
http://emsbasics.com/digital-research-library/spinal-immobilization/
http://emsbasics.com/tag/resuscitation/
http://emsbasics.com/category/administrative/
http://emsbasics.com/2016/03/
http://emsbasics.com/tag/pulse/
http://emsbasics.com/2015/09/24/a-saga-of-spurious-spines/
http://emsbasics.com/2012/06/
http://emsbasics.com/tag/people/
http://emsbasics.com/2015/03/
http://emsbasics.com/welcome-to-scenarioville/
http://emsbasics.com/2012/09/

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Domain Name: EMSBASICS.COM
Registry Domain ID: 1641854213_DOMAIN_COM-VRSN
Registrar WHOIS Server: whois.godaddy.com
Registrar URL: http://www.godaddy.com
Updated Date: 2017-03-01T14:53:18Z
Creation Date: 2011-02-24T02:40:03Z
Registry Expiry Date: 2019-02-24T02:40:03Z
Registrar: GoDaddy.com, LLC
Registrar IANA ID: 146
Registrar Abuse Contact Email: [email protected]
Registrar Abuse Contact Phone: 480-624-2505
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Domain Status: clientUpdateProhibited https://icann.org/epp#clientUpdateProhibited
Name Server: ELSA.NS.CLOUDFLARE.COM
Name Server: SAM.NS.CLOUDFLARE.COM
DNSSEC: unsigned
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  REGISTRAR GoDaddy.com, LLC

SERVERS

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  ARGS domain =emsbasics.com

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DOMAIN

  NAME emsbasics.com

  CHANGED 2017-03-01

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  ELSA.NS.CLOUDFLARE.COM 173.245.58.111

  SAM.NS.CLOUDFLARE.COM 173.245.59.141

  REGISTERED yes

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