The Handover: Burn out

So after participating in only a few of these Handover's I just realized I've never allowed

those who dont follow other EMS Blogs to get a taste of whats out

there on the Blog-o-sphere.

I hope you'll take a moment to head over the this months Host

and see what the others in the world of EMS 

have to say.

The Handover EMS Blog Carnival

Burn out

Hosted this month by:
Rescue Monkey

The Night Terrors

The Handover- Episode 21 "Burnout"
Hosted by Rescue Monkey

I swing my legs out of bed and sit on the edge, taking a deep breath as I sit in the calm of my bedroom at night. I wipe the bead of cold damp sweat from my brow, I have no intention of going back to sleep, so I lay in bed with eyes wide open, glancing into the pitch dark and wonder if its all worth it in the end. 






Is reliving these experiences worth the time and effort of this job? Is being haunted in my sleep worth the pride I get?  Are the choices I've made actually making a difference?  


My first infant death, a result of SIDS, was thanksgiving night. Only a month after being cleared from the New Employee Orientation and forty five minutes till the end of my shift. We got the call from county, a two month old down not breathing, Echo priority. The actual events have become a blur after reliving it so many times but the feeling and sensation is forever imprinted in me.

The guilt lasted a few months, always second guessing what I did, and if I did it well enough. Constantly judging every call I did, second guessing myself after any run I had. Though I was not prepared for the relentless mental bombardment experienced in the silence of sleep. Night after night after night, a restless sleep in which I felt stuck in the call and even more helpless than during the call. The night terrors have never really went away though. Reliving the calls over and over again feeling that there should have been more I could have done. Feeling that young innocent life slip through my fingers again. I thought the terrors were just going to last for a few days, which became weeks, then months later and now years later. Tonight was a repeat my first terror ever experienced, not surprised seeing it was on this night that it happened. It's the call that now makes me get up in the middle of the night to check on my son six years later, just to make sure.

Pulling up on scene my medic tells me not to run, always walk because there is no time to treat me too. I'm frozen in time. Before we even get to the front door, a fire medic comes out holding what looks like a baby doll in his arms. Small, lifeless and grey, a peanut of an infant, limp on his forearm. I turn to return to the rig and suddenly I'm in the back of the rig. My Medic yells to get us to Trauma One as fast, but safe, as I could. The rig begins to roll but I feel as if still in the back and I'm supposed to be driving. Terror fills my heart, I feel cold and all my training I can not recall.

Now no matter how fast you get to the hospital it wont feel fast enough. No matter how much your told you did all you could, it doesn't sink in. No matter how much time passes I still think of the identical twin who will never know their sibling. Never able to keep secrets with, never able to stay up late at night, never able to celebrate the holiday season.

If I'm lucky I wont have another terror for a week maybe two. Unfortunately its usually not the case, typically they are only days apart. My only relief is that the terrors rarely repeat them selves on consecutive occurrences.

Tomorrow begins like any other day, with me putting my boots on one at a time. The terrors wont get the best of me, I can't let it. Not everyone has the ability to take that step towards a limp child being carried your way, and because I can, I'm needed. Because of this fortunate or unfortunate ability to burden the life and death challenges I have no other solution than to continue, I just hope that maybe next time it will be different.

I have felt the pain of Burnout, I have felt the darkness and utter frustration which has chained me down into a deep depression. The constant self doubt, the constant questioning, the constant fear. The only way to over come it? The only way I've gotten back to the job I love? Taken that first step. Whether that step is debriefing, talking with crew mates, or time to over come it just needs to be taken. The first step is of most importance, and is for the individual to decide.

For me the First step was literally putting my boots on and taking that step back into the station.

I hope this will help someone Take that first step.

Be Safe
Ambulance Junkie

What Would I teach Lizzie?

-The Handover-EMS Blog Carnival Aug. Submission-

So your proficient in your skills, able to back board with the best of them. Fully capable of putting on a traction splint, vacuum splint and can sling and swath a shoulder. You've studied all the acronyms needed, DCAP-BTLS, PERRL, SAMPLE, and have a solid understanding of their use as it pertains to the patient.

You have a sound understanding that majority of calls will fall in the "grey realm". You'll have some black & white calls laid before you, but over all you'll have an unproportional amount of grey calls. Understanding that once on the streets the clinical decision making is in your hands. You do not solely rely on your initial education, rather the trends in EMS you have been continually researching and the Con Ed classes participated in.

When all else fails Lizzie, you know when to call for help. People become afraid to show weakness in this line of work, but don't be. The simple fact is the nature of the beast that is medicine is ever changing and progressing. It is impossible to be on the cutting edge of every single change in EMS, but hopefully some one else may have the knowledge where you haven't gotten to yet. We must never forget that we are serving for one single reason, and that is to do whats best by the patient. Sometimes that means to ask for help, but you know that already.

Solid fundamentals, capable clinical decision making skills, and the ability to admit to one's self that you need help. That pretty much covers the whole lot of attributes a newly carded EMT will need for the field, and you have them.

So what do I hope I've taught Lizzie? Keep your sense of humor girl! This Career/Stepping stone/Hobby/Calling surrounds us with people having the worst day of their life potentially. We are always in the thick of their crisis, and are the ones they have summoned to help. That is a lot of pressure on an individual, to be the sole saver of life, the Grand Puba of help. the Sultan of Assistance. In order to maintain our sanity we have to be able to keep our sense of humor. Humor is really just a matter of perspective after all. When in the appropriate times it lightens our moods and gives us that little extra to make it another call.

But I'm sure you already knew that Lizzie, you were always a great student.

Be Safe
Ambulance Junkie