EMS Degrees

EMT and Paramedic Burnout - Learning How to Cope

By Jamey Perkins EMT Paramedic Burnout

Nearly all emergency personnel, EMTs and paramedics included, eventually suffer from a phenomenon known as "burnout" and it is not unusual for personnel to last around 5 years before the stress becomes almost intolerable. Burnout is defined as "exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration". The key here is the stress is prolonged, typically over a period of several months and the stress manifests itself through an individual's key life areas, such as psychological, physical, work and family. It is common to see effects in more than one area simultaneously.

Emergency personnel suffer very high levels of this type of burnout and it has been the subject of considerable research.

The research has shown that emergency personnel are subjected to five unique stressors:

  • The level of uncertainty is high. When a EMT or paramedic goes to work they have no idea what to expect. It could be a fatal road accident, or a serious industrial injury. Most other professions have at least some idea of what they will face when they arrive at work.
  • The sounding of an emergency alarm produces a physical response and the body prepares itself for the event. Physiological responses include heightened blood sugar levels, increased adrenaline and blood pressure and an increased heart rate. These are likely to remain high for several hours and it's possible that another emergency may occur before the reaction to the first emergency has subsided.
  • The level of interpersonal tension is also high. Emergency personnel work in a crisis environment and this increases the tension between people to a greater degree than a non-crisis environment. Effects which would be benign in an everyday situation become of vital importance in the theater of an emergency.
  • The exposure to human tragedy is frequent. While most people may never be exposed to a serious emergency situation in their lifetime, emergency personnel can be exposed on a weekly or even daily basis.
  • The fear factor can be extreme. Emergency situations are often frightening and emergency personnel are expected to both deal with the fear and also the situation itself. The increase in legislative action against them if they make what is perceived to be a mistake can also add to the pressure that the emergency worker faces. Adding to this, the amount of strain involved trying to uphold a perceived image.

Once you examine these five stressors it is easy to see why emergency personnel suffer high levels of burnout, and most cope with it for a low number of years before seeking a route out, either via promotion away from the front line or a change in career.

Saving a career by managing the difficulties

So can this burnout be avoided? Again the research has examined this in some detail and it is clear that recognizing the stress early and managing it is the key. There are some well known and obvious symptoms including irritability, fatigue, anxiety attacks, and loss of appetite or weight gain due to lack of exercise or overeating. Less obvious symptoms include an increasing reliance on alcohol and tobacco, insomnia and a general inability to concentrate.

Many departments have instigated a physical fitness program, including medical evaluation to assess the most effective program for an individual. The facts are proven that regular work-outs reduce stress but they are insufficient alone without other forms of support.

Stress questionnaires have also proven effective in recognizing the early signs of EMT or Paramedic burnout, sometimes before any obvious physical signs are apparent. Such questionnaires should be properly designed, confidential, voluntary and non-punitive to be properly effective. The stressors are divided into what the department can and cannot control.

Another method which has been found to be effective is education of the sources of stress and self help techniques to reduce the effects. All this flies in the face of traditionalists who demand that the profession should stay tough, but effective programs can reduce stress related deaths, alcohol and substance abuse and also significantly reduce sick leave and low productivity.

The more advanced emergency departments are changing the old mentality of "asking for help is a sign of weakness" to one of real systematic support with real measurable benefits. It is this type of employee assistance program which is reducing burnout as an expectation in the emergency services.

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