EMS World

JAN 2019

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

Issue link: https://emsworld.epubxp.com/i/1061435

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Page 46 of 51

46 JANUARY 2019 | EMSWORLD.com TRAINING AND EDUCATION T oday EMS providers respond to more calls per 24-hour shift than their predecessors and perform more invasive procedures with newer medications and equipment. 1,2 They complete more documentation, deal with a public that's more demanding, and have their skills and performance reviewed by medical directors who hold their licenses to function. Violence in their jobs is a con- stant, and shortages in many places keep their workloads and overtime high. It's no surprise that emergency services personnel are at higher risk for stress-related disease and death than almost any other occupa- tion in the world. 3 In some EMS systems paramedics can experience multiple traumatic event s (e.g., incidents involving children, burns, gunshots, mass casualties) in a single shif t. Ex trapolating that, an individual could experience any where from 500 to more than 3,000 traumatic events during a 20-year career. Stress may also cause poor-qualit y ser vice to the public 4 and resulting financial costs through lawsuits from patients who felt their ser vice was inappropriate. These stressors and effects are often ignored or denigrated as just part of our jobs. Rarely are they dealt with proac- tively, through awareness and training. But procrastination does not solve prob- lems—it merely delays them. Something needs to be done about stress in EMS, and sooner rather than later. What to Do? The solution starts with a holistic mind- set toward stress—one that encompass- es understanding the nature of stress, research needs, formal training, appreci- ating the frequency of traumatic events, awareness of the impact of stress on employees and organizations, leadership, and mentoring. Narrowing the scope of investigation is a more traditional scientific approach, but many factors influence what hap- pens to humans and how they view it. These factors must be considered in their entirety, not piecemeal. There is a need to define stress in EMS, explore its depths and effects, and determine how to miti- gate some of its consequences and cope with stressors holistically. One point of this multipronged solu- tion would be to expand stress aware- ness/management to the EMT/EMT-P c u r r i c u lu m . Tr a i n i n g c a n i m p o s e a directed sense of purpose, intent, and understanding on the capriciousness of traumatic incidents as well as reduce the emotional threats that accompany them. The goal of training is to enhance task and performance capabilities and accel- erate the recover y of workers affected by traumatic events. 5 Agencies must also continue the education of their members to the insidiousness of stress and pro- mote specific methods of assisting their employees (peer suppor t, professional inter vention, etc.). Super visors are looked to for empa- thy, ad vice, and leadership but of ten receive lit tle education or training in ba sic mana gement tactics and skills, let alone the higher concepts of leader- ship. A more cohesive national effort is needed. Good leaders are not born with the skills required but learn their trade th ro ug h e d u c ati o n , e x p e r i e n ce, an d obser vation. Bad leadership can unnec- essarily subject subordinates to stress, causing a decrease in self-confidence and self-wor th, an increase in somatic complaints, and the ef fects of micro- managing or abandoning their charges. 6 Along with leadership development, mentorship can have a role in reducing By Dawn Dow, EMT-P, PhD A COMPREHENSIVE APPROACH TO STRESS IN EMS Reducing it requires a combined eff ort that involves education, leadership, and mentoring

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