Ben usually sleeps like a baby after his shift is over, but lately he’s been restless and irritable. A couple of weeks ago, he and his partner responded to a call at a home in a nearby neighborhood where they found a five-year-old drowning victim. The little boy had managed to unlatch the gate to the fence surrounding his family’s backyard swimming pool, and by the time his mother found him in the pool, he had turned blue. Ben’s efforts to revive him were in vain, and now Ben finds himself waking up in the middle of the night thinking about the little boy and the family’s devastating loss. “I’ve got to snap out of this,” he says to himself as he lies in bed, listening to his sleeping wife’s steady breathing. If only it were that easy.
Stress – It’s Part of the Job
Being a first responder is tough work, both mentally and physically, and over time, stress can take its toll on your health. According to Nico Verykoukis, a licensed clinical social worker with Frank Horton Associates in Raleigh, North Carolina, cumulative stress is a common experience for people like firefighters or EMS personnel who work in chronically stressful situations. “Basically, it’s the steady accumulation of various stress factors that build up day after day, things like working long hours, a lack of regular sleep, conflicts with coworkers ... the list could go on and on,” explains Verykoukis. “Every first responder has stress factors that are unique to his or her job.”
For 30-year-old flight paramedic and clinical base educator Derek Bailey, the time he spends in the air can be draining on the mind and the body. When he and his crew transport patients, they’re in a helicopter, a fact that brings both comfort issues and safety challenges. “We’re required to wear helmets and long-sleeved, heavy flight suits while caring for acutely ill patients in a confined space,” says Bailey, who is employed by Denver-based Air Methods Corporation, the largest air medical provider in the world. “Even though the aircraft is air conditioned, the summer sun can cause temperatures to skyrocket in the cabin, and if the weather is turbulent, we have to stay strapped in our seatbelts while we care for the patient. We always have to anticipate birds and other aviation issues, and when it comes to night flying, we wear night vision goggles and have to be aware of obstacles that could endanger the aircraft like radio towers, power lines and other planes. Stress factors? Yes, we have plenty.”
Cumulative stress factors also exist at home, and, in fact, they can be even more difficult to handle than those at work. Troy Ratliff, a firefighter with City Station 9 of the City of Fayetteville Fire Department, agrees, saying shift work and the resulting time away from his wife and three kids can put a strain on family relationships. “My children are ages eight, seven and four, and they don’t really understand my work schedule,” says Ratliff. “Once, my oldest boy asked me if I still loved them because I was always gone, and that just about broke my heart. I’m actually home more now than I was with my former career — I owned a trucking business — but there are days when I don’t see them. But I love my job, so it’s a sacrifice I make.”
Many other first responders have made that same sacrifice. Daniel Gardner, a captain with the Raleigh Fire Department, has been parenting for 23 years and says he understands how tough it is to divide one’s time between firefighting and family. “When I was coming up through the ranks, I was fortunate enough to have some great supervisors who helped me out, giving me a little time off here and there to be at my kids’ events. But with four children, I’ve missed so much more than I’ve actually been at because of work obligations,” Gardner explains. “Their ball games, gymnastics classes, chorus concerts, family holidays ... those are memories I don’t have with them. And I can’t get that time back.”
It’s no secret that money — or the lack of it — can also be a source of stress for first responders and their families. Many of them pick up overtime or work second jobs to supplement their modest salaries, so when they’re supposed to be off between shifts, they’re still working to make ends meet. “I sign up for extra shifts at the fire station, and last year I worked in construction for extra money,” Ratliff says. “When you’ve got a mortgage and bills to pay, you do what you have to do to provide.”
When left to simmer, these types of cumulative stresses can boil over into major health problems, including migraines, muscle tension or pain, fatigue, upset stomach, and sleep problems. They can also result in behavior changes like overeating, angry outbursts, excessive drinking, increased tobacco use, and withdrawing emotionally from friends and family. If you recognize any of these symptoms of stress in your own life, it’s time to address them now, before they get out of control.
Tough Moments, Bad Memories
People choose a career as a first responder for many different reasons, but for most, they find great satisfaction in helping people. Unfortunately, if you spend any significant amount of time working as a firefighter, EMS professional, or law enforcement officer, you will eventually see disturbing physical injuries and deaths that could often have been prevented. According to Verykoukis, most first responders are able to separate themselves from the people involved in these incidents and remain unaffected by the emergency. However, occasionally, a first responder will personally relate to the victim, and the situation resonates with him or her.
“If you’re a parent and you’re sent on a call that involves children, those kinds of stories tend to stick with you for a long time,” say Gardner. “I hadn’t been a firefighter very long when my company was called to a home where a 10-year-old boy had hanged himself on his front porch. It was difficult, because I immediately thought of my own children and how precious they are to me. Those are the kinds of calls you wake up and think about during the night, even years later.”
At times, the first responder’s empathy will become a deeper issue that manifests itself in different ways. “A stressful event can begin to affect a person’s mood, which can lead to anxiety, restlessness, irritability, sadness, and even depression,” says Verykoukis. “That’s when it’s time to seek help, either by talking about your feelings with a friend or loved one, or even making an appointment to discuss things with a licensed counselor.”
And while there has historically been a stigma among first responders when it comes to seeking mental help, which is often seen as a sign of weakness, the tide has begun to turn with the implementation of Employee Assistance Programs (EAPs) in businesses and organizations throughout the state. “EAPs provide a safe, neutral space to talk about this stuff, which is an environment first responders may not have access to,” explains Verykoukis. “We start immediately with phone support, and when the first responder comes in for an appointment, we provide an unbiased counselor who truly listens to what’s going on in their lives and can help them make a plan to address their issues. These sessions are covered by the first responder’s insurance, but if they need longer-term care to deal with more difficult situations like drug or alcohol addition, we can help them find that as well. Counseling is also available to their family members.”
In addition to counseling options, there are many other activities first responders can do to help them de-stress and take control of their professional and personal lives. “Anything creative or involving exercise or nature really helps people to relax,” says Verykoulis. “Whether it’s a hobby or special interest, these things are healing. We simply encourage people to choose whatever nourishes their spirit.”
For Troy Ratliff, relaxing involves watching live bands perform and playing his favorite instrument, the guitar. “I get together with my next door neighbor, and we pick some chords and make music together. I immediately feel the stress leave my body.”
For Daniel Gardner, making things with his hands is a hobby that relieves stress and brings him closer to his kids at the same time. “My daughter asked me to build some planter boxes for her, which I loved doing,” Gardner says. “My family and I are also very active in our church, and we try to give back by volunteering our time and support at Camp Caswell.”
Meanwhile, Derek Bailey likes to go to the gun range to practice target shooting with other first responders. “I do enjoy scuba diving, as well as spending time with family at amusement parks,” says Bailey. “My spiritual life is also very important to me, and my faith helps calm me, especially in critical work situations.”
Amar Patel is the Director of the Center for Innovative Learning at WakeMed Health and Hospitals. Mr. Patel is responsible for integrating technology based educational programs to include human patient simulation, healthcare gaming, and hybrid education into regional educational programs. As a member of the Center for Patient Safety, Amar strives daily to make changes to processes in healthcare that will directly improve patient and provider safety.