Understanding How to Manage EMS-Related Stress

nurse running with gurney

Ask any layperson and they would likely agree that working first response is stressful. Lives are at stake. Seconds count. Environments are life threatening and often hazardous. You don't have to encounter overdramatized Hollywood-style trauma to experience stress, however. Commuting Route 128 can give you plenty of stress.

There's no doubt that emergency medical service providers, firefighters and police are a special breed of people. They have elevated their ability to manage stress, perform admirably as a team and save lives to a level only peer responders—and the people they save—can fully appreciate.

The "Normal" World of EMS

In September 2015, the Journal of Emergency Medical Services (JEMS) released data from a survey conducted by Reviving Responders on how emergency responders are affected by what they term as "critical stress." 4,022 EMS providers responded to the survey, giving a startling glimpse into what is normal in the world of EMS providers.

Of the respondents, 3,447 (86%) reported experiencing critical stress, defined as "the stress we undergo either as a result of a single critical incident that had a significant impact upon you, or the accumulation of stress over a period of time. This stress has a strong emotional impact on providers, regardless of their years of service."

With these survey facts in hand, we know one thing for certain: critical stress—not just routine stress—is common among EMS providers. If you’re feeling these effects, you're not alone.

Stressors Come in all types

Whether related to personal or work challenges, stressors can come from a variety sources including:

  • Traumatic events
  • Last-minute schedule changes
  • Inadequate nutrition
  • Lack of consistent sleep
  • Self-doubt
  • Personality clashes
  • Racial tension heightened by current events
Taunton fire rescue

The Benefit of Support

Employee assistance programs (EAPs) and critical incident stress management (CISM) sessions are designed to help. Unless, however, these programs are specially designed to serve the EMS worker, the content doesn't address the real life situations unique to first responders.

According to the survey, the perceived effectiveness of formal support is directly related to the amount of encouragement and support given within a specific EMS culture. The more support EMS providers were given by peers and management, the more likely they were to find formal support to be helpful. This is the culture at Brewster and why our team stays strong even in the face of insurmountable challenges that create extreme stress.

Chart: The effectiveness of formal support in different EMS cultures

Although every stress factor can't be controlled by EMS agencies, there are actions individuals can take to relieve stress and stress-related problems. Some of which are very straightforward and can be suited to fit each individual's situation and temperament.

Here are two strategies on how you can better manage stress (note that some of these tips can apply to anyone, not just first responders):

Strategy One: Adjust Your Outlook

  • Shift Your Perspective. One way to stop stress from impacting you too severely is by changing the way that you look at the situation. Consider different ways you could perceive the event and note that perception drives the response you have.
  • Keep Your Distance. One of the keys to maintaining a healthy outlook in the volatile environment of emergency response is to maintain a sense of detachment. Although it's important to ease your patient's fears as you attend to them, resist the urge to over-empathize with them.
  • Consciously Choose Your Reaction. What is highly stressful for one person may not be as stressful for another. By deliberately choosing how you react to a given stressor, you can lower the amount of stress responses that cumulatively take their toll on your health and well being.
  • You Can't Help Everyone. Being on scene doesn't always make a difference even though you give your best effort and use all of the tools you've been given. Relax the need to feel responsible for outcomes and focus on delivering the best care you can, knowing you have the training and team support to be successful.

Strategy Two: Share with Others

Changing your outlook can be extremely helpful because you are then in full control of how you respond to what happens. However, there will still be stress that works its way into your life. Here are a few ideas to diffuse the stress that still occurs:

  • Take A Break. Use your off time to do things that are enjoyable and unrelated to work. Focus on things outside of work and give yourself permission to relax and have some down time.
  • Break A Sweat. Exercise reduces levels of the stress hormone cortisone. It also stimulates endorphin production, which helps to elevate your mood. Do exercise you enjoy and you'll be more likely to be active and make it a regular habit.
  • Communicate With Your Team. Your team knows you. Because they're usually by your side, they see what you're experiencing and can relate. Share your feelings at your comfort level with the team and be there when they need to share with you.
  • Seek Outside Support. Needing support is not a sign of weakness. Different people react differently to stress. When appropriate, lean on your team, but also be open to outside sources of support. Outside support can help you release the symptoms of stress by providing you an objective viewpoint and recommending healthier, more effective management strategies tailored to your unique situation.
  • Get Enough Sleep. This one may be tricky due to changing schedules and stress-induced insomnia. If you're not able to sleep well, at least make sure to get adequate rest during your off time.
  • Know When Enough is Enough. If stress from the job is taking over your life and you can't get control of it, consider taking a break from it. It's more important for you to do what's best for your emotional and physical health than to perpetuate a condition that negatively impacts your quality of life. If you're stressed and burned out, you can't provide optimal care to your patients. Take care of YOU so you can take care of others.

If the amount of stress you're experiencing is overwhelming and it feels as though no one can help you, ask for help as soon as you can. Also, your team members may be able to offer solutions that they found worked well for them. You may be surprised at how many of those you work closely with are experiencing the same thing you are.

Charlie Gannon and friends

Most importantly, know that you're not alone. At some time or another we all experience stress serving others and supporting those in the field. At Brewster Ambulance, our team is our most important asset. We can only provide top tier care to our patients and customers if our team is performing at their best. Our goal is to prepare our team for success by providing well-rounded support. This includes training and education, quality equipment, best-in-class pay and benefits and support for the stressors of being a professional EMS provider.