Pandemic, Short Staffing, Record Call Volume, Oh MY!

 

It's really like every day is a full moon lately isn't it? The Call Volume has been incredible, we and our colleagues are burnt out, book offs are at an all time high, and the level of staff off on physical or mental health injury is higher than it's ever been. I want you to know that I see you! 

I see everyone of you. I see you SHOWING UP wherever you are, including if you are off! This last two years has stolen so much from all of YOU! I see you! At work, you are tired, you are angry, you are hurting. I. SEE. YOU. 

The point of this post is that the only thing we have left to rely on is one another! Management has failed us, the government is determined to destroy us, our biggest fans have turned against us and the only people who appreciate anything we do, are our patients in the moment they need us. I want us to change our thinking! We have to be fully aware of each other. 

You are way too important to be left out here on your own. You have worked your ass off during this pandemic and you deserve to be recognized, however don't hold your breath. It seems that there are people that would like that work to be unrecognized. But I recognize you! You have pushed yourself beyond the limits of your believed end and found new strength and resilience. I am so proud of every one of you, as you continued to show up day after day, and continued to bust your ass. You still generate high positive patient satisfaction. I have not forgotten those of you that were injured, and had to take a rest. You pushed yourself further than the rest of us, and your health and healing is the ONLY thing you should focus on! DO NOT push yourself back to work, HEAL FULLY PLEASE! 

There is no more message to this post other than, I SEE YOU! I see our newest staff, coming in, and immediately being thrown into the fire! I see you excelling despite the lack of support that is there. I see you excelling through equipment failures, truck failures, shift disruptions, partner book offs and more! I want everyone to know that I am here for you! If you need to talk, or at least know you are supported in some way, I am here! Keep being the amazing paramedics and health care staff that you already are. YOU have NOTHING TO PROVE! If you are hurting and have had too much and need to take time for you and your family and time for healing, TAKE IT!!! 

Thank you for continuing to follow me and read what I write, this article was a long wait, and I will always continue to try to be more consistent. If you got some value or you want people to know they are seen, please like, comment and share this post with everyone! 

The Holidays, Grief and Loss.

 

This Christmas season has seen a lot of loss for many in our community. These losses are felt to our soul and shake us to our core. They test our resilience, and they put our mortality in plain site. We lost an amazing person in our local and provincial EMS system and I know he touched the hearts and lives of people outside of Alberta as well. 

I want to speak to all of you that are suffering in this loss, take the time you need to grieve your own way. Don't let duty, or obligation cloud the grieving process. It is ok to feel anger, and sadness, and it is ok to have disbelief. I worry for so many of you that have been worked to death through this pandemic and are now facing grief and loss during the holiday season. Be gentle with yourself and let your feelings happen. Reach out to close friends, and mutual friends so that you can share in his memories and the joy he brought to us all. Check in with each other, not everyone grieves out loud and some people may be really struggling and it is important that they know they are not alone. As the Christmas season ends and we head toward the new year, let's make a pledge to one another to always be kind to each other. The system is and has been broken for a long time. We can only control what we can control and at the moment that is our behaviors towards each other. 

Those of you that I work with, if you need anything in this time, please reach out and we can talk or chill or what ever you might need. Those of you that maybe suffering other losses, even though we may be strangers, reach out if you need an ear. This is a short post today, but needed to address the loss we are all feeling this season. I have not mentioned names on purpose as I know all of you know who I am speaking of and his families privacy is important to me. 

Take care of yourselves and check in with each other, I will see you all again after the New Year with more musings. 

Journey To Resilience (part 2)

                                                                                                                                                                           

Beware the path to darkness

    I will preface this with a warning. I am going to try to stay vague, however there is a trigger risk for some that may still be struggling. I also believe that the parts of my story that I am going to share here may provide guidance and a safe place for someone in a similar place to reach out to. This story is my story and how I wound up in a place I never thought I would end up. It also shows how I, with help from a professional and some special people, got my self back. Ok, let's dive in shall we? 

    The story begins after I had been a medic for a fairly long time, and that is not to say that these things can't happen early in the career. I will also say there was more at work in my situation than just work. A lot of people talk about slippery slopes, sudden changes, and red flags. Those are all great tools for hind sight. The truth of the matter is that the path to darkness is a well lit, beautiful place with friends and family who are unaware (more on this later). It is fun, scenic and you have no idea what's happening, until it happens. 

How does it happen?

    We are all taught very little about resilience and self care in school and it is brushed over in a lot of training. The reason that is, is that resilience, PTSD, moral injury and occupational stress injuries are dynamic, and every single person experiences them differently. This makes training others into how to prevent these types of injuries costly, dynamic and many systems don't take that time or expense to explore it. There is a lot of work being done in prevention, but as long as there are careers that involve dealing with the tragedy of others, there will be these types of injuries and our best hope is to become resilient, as well as learn how to recover from them when they happen. 

    Under a continuing pandemic, and opiate crisis, coupled with short staffing and the inability to get time off for regular rest and relaxation we are seeing an increase in these psychological injuries at a rate I have never seen before. This is how it happens. When people in these careers, who care about people, see the system in crisis, we tend to double down and work harder. The system stays afloat because of us on the front line. It is in our nature to care this much, as much as we deny that. Even when we take some time for ourselves, there is a twang of guilt that hits each of us, thinking that someone else is going to have to pick up the slack. That mind set is what sets us on the path to darkness. This mindset is normal for us, and is one of the root causes of psychological injury. There are many others, but I am not qualified to speak about the complexities of PTSD and all of it's causes. This is how it happened to me, and I believe I am not alone in this path to psychological injury. 

My story:

    As I mentioned earlier, my story involved more than just work. I had been carrying a lot of debt throughout my life, like many people do. This debt had accumulated after a divorce, and a couple of breakups. Carrying the debt was not much of a struggle and I had a lot of plans for when the debt was paid off. Buying a home, travelling more, spending more time with friends, and investing and supplemental retirement savings. Unfortunately that is not what ended up happening, and the reality is a reminder that bad things can happen to anyone. 

    It was about six years ago now I had gone through a pretty nasty break up, but due to my debts, I had to live with my ex for a period of time. Innocently enough I tried to stay away from home as much as I could and spent time hanging out in a local pub. This is where things began to go down hill, although I did not notice it at first. I had a nice group of social people at the pub and spent my time drinking beers, and tossing money into VLT's. Things were ok as far as I could tell. I was giving the ex space and I was keeping my mind busy and it didn't seem like I was spending or losing that much money at the time. It was also during this time that I purchased my condo. I was super proud of myself for that as I had purchased it without a down payment and it would be my space. My ex could have her space, and we could both get on with our lives. 

    As time went on I moved out of the ex's into the condo, and found a new pub to hang out in. Again, I was just getting to know the area, meeting some new people, drinking beer and tossing money into VLT's. I still had no idea there was a problem. As time went on, I started losing a lot more than I was winning, as the old saying goes, "the house always wins". I was sitting at these machines, night after night, beer in hand, saying things like, "it's just one spin away!". The debts and bills started to pile up. I was still showing up for work every day, keeping up appearances. I was losing entire pay checks in a single night, and then having to get pay day loans to get food in the house. Those pay day loans I would get a few groceries and then head to the casino to "win it all back". As the problem got worse I would find myself arguing with myself that this was a bad idea, and I needed to stop. At this point, I realized I was addicted to gambling, but still continued on the path. 

    Things at work were also beginning to get worse as I was stressed about money, and angry about operational issues, long responses, no trucks, forced overtime and being unable to take much needed time off. When the bank foreclosed on my condo, and I was eating sandwiches from the hospital on a pretty regular basis, and I snapped on a patient, is when the light shone down that I was a mess. In all that time, almost no one knew what had been happening, because I hid it. This is a normal reaction to these sorts of things, shame, and hiding what's happening. When a paramedic friend of mine approached me and told me they were worried about me, I shared what had been going on. I was in shock as to where I had ended up, I knew better than this, and it just didn't seem possible that I was here. But here I was, and it was time to make a change. Again, I don't blame my story entirely on work, I had a habit of dealing with many stressors in a poor way. These bad decisions led me down this path and it was a fun path, until it wasn't. That is how the trap works. 

    Watch out for one another, and keep an eye on yourself as well. If you are doing anything excessively it might be time to take note and do some self reflection. We are in a place where it is ok to talk out loud about struggles, and it was something I should have done more often, and to more people. My recovery has been a journey of growth and self awareness that we all need to learn to ensure we stay healthy, both physically and mentally. I encourage you to share this story with others, in hopes that if they are at any point in this journey they will have the courage to reach out and turn themselves around. 

My recovery

    After  my friend had noticed I was in a bad way and I shared some of my story with them, they recommended a psychologist who specialized in occupational stress injuries. I also got myself an accountability partner who had access to my location at all times through my Google Maps. These seem like a couple of small things, but they were instrumental in my recovery. During that time my psychologist used a technique called cognitive behavioral therapy, which is subtle, but very effective. The change was amazing. As he, in a sense, rewired my brain, I found the urges to gamble and drink falling away. I learned how to take care of myself, and prioritize my feelings. I learned how to set boundaries with people and maintain them. 

    Since my recovery I would be lying if I said I haven't had the odd temptation to gamble, however, when I speak to that urge, it does go away. Through this process I have learned resiliency on a level that I didn't know was possible. Though I still get bothered by operational issues at work, I am far faster at catching them, and letting them go. My biggest lesson I learned was that things out of my control, are just that. Out of my control. If I can't effect meaningful change on something, it gets filed into the not my problem category and soon sinks away. Things that are in my control, I tackle those, I ensure I provide excellent patient care, I try and take care of my coworkers, and I make sure our workspace is always ready to go. 

    This is a condensed version of my story, but I hope it will help someone going through a shit time to reach out and get help before things get out of control for them. In conclusion, I am now virtually debt free, living on an acreage with my soul mate and life has never been sweeter, and I am looking forward to many future adventures. I am also happy at work again, (most of the time), and love my career still. Please take the time to read, share and comment below your thoughts or your stories! If you ever need an ear, reach out, I am here to talk as well. 

My Journey to Resilience (Part 1)

 

I know I left you hanging.

I have struggled with what I am going to share with you all as not very many people know my whole story and that has very much been intentional. I am not looking for sympathy or validation of any sort, however I am hoping that the details I share here will allow someone else who may be where I was to reach out and know that they are not alone. As the title suggests this is part one. I want to demonstrate how the road to darkness is not a slippery slope, it is a long winding beautiful path full of good intentions, machismo and a desire to never become a burden. 

How it all began. 

I have been in the emergency services for 23, no wait, almost 24 years. Starting as a volunteer fire fighter in 1997 after taking my EMR program I saw disturbing things from the very start. The training we had then definitely did some to desensitize us to what we would see, but critical incident stress and CISM debriefings were still new at the time. I never truly felt bothered by the calls I did at that time and thought I must be special, "built for this industry" as it were. I found that I seemed to be quite good at compartmentalizing things, or so I thought. 

As time went on, it was many years of seeing a lot of people die and a lot of disturbing scenes that no person should ever have to see before I had a call that "stuck". Due to the triggering nature of the call I won't share details beyond witnessing someone die and being absolutely helpless to prevent it, despite my training and experience. This call gave me some bad dreams, and I have vivid memories of it to this day. This was my introduction to an occupational stress injury that I could identify, though at the time it did not register. 

After that call there were several more that struck close to home, and also caused some changes in my behavior, that I didn't pick up on until later. 

Was I lucky, resilient, or both? 

That is the million dollar question isn't it? Many of you, new and old to the game, and some of you that have not worked in this industry have your own experiences, and this one is mine. One advantage that I had is that I had a strong network of friends and loved ones who would listen to me tell my stories, share my experiences and just let me get shit out. This is an important step in building resilience. You CANNOT keep that SHIT INSIDE! You need to vent, you need to regurgitate it as much as you can to get it away from your soul. I know that sounds different as many self help books and self help gurus tell you to not relive the past. They are right in their way, but when it is fresh you must expel it. It is not unlike when someone has taken a handful of pills, you have a limited amount of time to remove the source of the poison from the system before it takes hold, and you have to treat the symptoms instead. 

Trauma in my opinion is similar. Once it gets in, you have a limited amount of time to expel it from your system before it takes a hold of your soul and causes a larger scar. Let me be abundantly clear, every event causes a scar, resilience helps us reduce the size and longevity of that scar. Mental scars can be healed, and life can be enjoyed as long as you take steps to protect your mental health early, diligently and continuously. Resilience is an ongoing process. So to answer the question above, I was fortunate to have places to vent, and I had learned resiliency from other facets of my life. 

What actions can you take now?

As a practitioner it is important, no, it is your duty to protect yourself mentally from the stress of this job. Once you have broken mentally, it is far more difficult to be effective in your role as a medical professional. So to conclude part one, the lesson is learning to expel your experience. This is what a debriefing is for, however due to increased call volume and lack of resources I fear that they may not be able to happen as quickly as is needed. Find those people that you can talk to, not to judge the call, or judge the outcome, but to just get the details out of your system. 

As professionals we do our very best on every call and learning from each experience is vital to improving as a paramedic, but that is a different process than learning to go on after a bad call. You are beautiful souls that make the decision to do this as a career and your health matters. If you have no one to reach out to in your own practice, reach out to me, I will be your outlet. In the meantime, please like and share what you have read here, and take care of yourself and each other. 

Resiliency, What Is It? How Do We Get It?

 With the global pandemic slowing for a moment or two I wanted to get back into writing. I want to talk to you about resilience. Resilience is the ability to withstand the pressures of life and keep your head up. I used the GIF to show a samurai sword being made. This is one of the strongest weapons ever created by hand. 

    I want to spend the next few weeks talking about resilience, and how it applied to my life. Today I want to talk about what resilience is, and a very broad look at how it is developed in each of us. This does not just apply to first responders, but to all people that are making their way in this thing we call life.

    The bad news, resilience can only be built through challenges. Just like the samurai sword pictured above it is heated, folded, hammered, cooled, heated, folded, hammered and cooled over and over again. To my knowledge this occurs over two hundred times to forge the weapon. Once that weapon is forged, it is almost impossible to make it lose it's edge, and it will cut into concrete. This forging process is what makes it so strong and gives it the resiliency to last virtually forever. This is the type of resilience that we should strive for. 

    Now I am not saying you need to go out and get yourself a bunch of trauma so you can be forged and become hard as steel. In reality we have all faced challenges throughout our lives and have the recipe inside us. The goal is to take that recipe and increase our personal resilience. There is some work that you have to do to be able to face situations from a place of stength which we will go over bit by bit over the next couple of blogs. 

    Today I just wanted to give you the beginning of the formula that will help you build resilience in your own life. Quick disclaimer, I am not a doctor or a licensed expert in this field. I am someone that has built myself back up from a deeply broken place and have become resilient. Using my personal experiences and things that I did I will show you the path that I took. So without further adieu let me tell you the beginning of the formula for building your strength and improving your confidence and resilience. 

    True resilience comes from HEALING yourself from past trauma, current trauma and accepting yourself for who you are right now! Many people have heard the parable about the person who was stuck in a hole. As he sat there a person came by and he asked, "can you please help me?" The first person replied, "I have no rope or no ladder, but I will pray for you that you find a way out." With that they said a short prayer and continued on their way. A second person came by and said the same thing, but also added, "I will set a plate to get some money to buy a rope". A third person saw this person in the hole and without a thought they jumped in. The stuck person looked in shock, "what are you doing, now you are stuck here too?". The person replied, "I have been stuck here before and I know the way out, follow me!"

    I am the person, and I have jumped in the hole. With the pandemic, and increasing call volumes, isolation, long responses, job losses and terrible economic factors many of you are stuck in this place. I ask that you follow, share, like, and comment below and lets work together to get as many of you out of this place as we can! 

When That Call Happens

No one ever knows when it will happen. We can usually recognize that we are starting to have a problem, but we never know what will be the trigger that draws us into the darkness. Every one of us has a call that has stuck with us, most of us have several. Occupational stress injuries and PTSD have come to the forefront in Front Line Emergency Services over the past several years and I for one am truly glad that it did.

For years there was a mind set that we were required to be tougher than the average human. There was an expectation that regardless of what call was done, a Front Line Emergency Services person would "suck it up" and get back to work. There were calls to be done and there was no time to sit around and process the situation we were just in. When a Front Line practitioner does not get this opportunity the emotions that are felt on that call are pushed inside. They are buried with the thought, "I will deal with that later." This becomes problematic, because as the shift continues on, calls keep happening, there is paperwork to do, there are meetings to have, and there is education to be done. What did we do then, we continued to push it down and said to ourselves, "I will deal with this when I get home."

At the end of the shift, we head home, we are tired, we are carrying our day or night, and as we walk through that door we are greeted by those people or animals we love the most. We push those feelings deeper and concentrate on that time with our loved ones, before we go to bed. Once that day is finished and that call is buried deep inside we get up and we go to work the next day and as usual we are busy. So we sort of forget about it and think it is dealt with. This could not be further from the truth.

As this process repeats itself over and over again, the hole we push these feelings into fills up. For some it fills quickly, for some it takes many events, and many years to manifest. When it manifests though, it shows up slowly at first. Irritable behavior, maybe showing up late for work once in a while. Often people start to indulge a little too much, booze, smoking, gambling, yes even promiscuous behavior. These are warning signs that you need to pay attention to. These signs are almost like an early warning system to say, "hey friend, you need some help.."

If these signs are ignored, and the attitude of, "I'm fine, I don't need help." takes over, these signs become worse. The Front Line Emergency Services person starts to get more complaints, misses whole tours completely, lashes out at friends, and co-workers, lashes out at family members. These signs are a clear indication it's time to get help. This is the way it used to work which left so many people with deep scars that were never properly dealt with. I can assure you this had devastating results for some people, their families and their Emergency Services families.

Our new method of thinking, and practice, though slow in it's growing, is a vast improvement. Normally now Front Line Practitioners are given that time to decompress, even if it is busy. They are offered peer support from Critical Incident Stress Management teams, there are employee resources within every facet of Front Line Emergency response. This is to ensure people have access to better help and treatment after critical events. What does this do? It allows the practitioners to decompress, deal with their personal feelings, deal with each other's feelings and hopefully process the situation and allow the stress of the event to be greatly reduced. These resources will also  help to recognize early symptoms and allow the practitioner to get into the treatment they need.

If you are reading this and you are a Front Line Emergency Services Practitioner, Police, Fire or EMS, and you recognize any of these signs or symptoms please reach out. Reach out to a peer, a friend, a supervisor, reach out to me through my blog. The results of untreated Occupational stress injuries, or PTSD can be devastating. All of you are heroes, and you are all amazing, selfless and the world is a better place because of you. You are not indestructible though so please don't suffer in silence, you are NOT alone, we all have demons. Take the first step, and reach out for help. If you notice a colleague that is acting different, don't be afraid to approach them and just ask. Someone did that for me once, and it may have saved my life. Let's be safe out there, and watch out for one another. Please like and share this post if you found value!

What Is The Why?

What an incredibly long hiatus this has been. Feel like I haven't written in forever, and when a couple of people questioned why, it got me to thinking. The word why is a powerful word, and most of us take it for granted. This is the word that drives everything we do, and who we become.

Take a minute to let that sink in. The Why is what drives us forward. Without it we would literally sit still. Every day has a reason that we get out of bed, every shift has a reason we put on the uniform and every hobby has a reason we love it. It became very apparent to me in some recent training I attended that taught about de-escalating situations and disengaging dangerous situations.

While I sat through this training, I came to a realization, and it brought me back to why I put this uniform on in the first place almost 20 years ago. I was raised by wonderful parents who encouraged me to be the best me I could be(as corny as it sounds It is the truth). They also taught me to lend a hand to friends and strangers alike. They instilled a set of values in me that included helping others. Armed with this value system I heard a speaker in my young adult life who was greatly inspiring and also a former Paramedic in Ontario. This speaker spoke a lot about the impact Paramedics can have on a family. From that moment on the spark was lit and the rest is proverbial history.

Over the last several years the system under which we work has changed. Budget constraints, staffing shortages, long hours, long hospital waits, psychological ramifications of continually meeting people on the worst day of their lives just to name a few. The Why started to get lost and the focus changed, the focus became survival.

Just get through the shift, pray we don't get a late call, look out for ourselves, and when is pay day?

This isn't an exclusive problem to our service, it's an international pandemic that is causing paramedics to leave the industry at alarming rates. It is also causing severe psychological trauma and in several cases has caused self inflicted tragedy.

When I think about this it breaks my heart to see what I value as an incredibly noble career being ravaged by such problems. I do not claim to have answers but instead I thought I could bring people back. Try to shut out all of the noise, remember the camaraderie, remember the impact we have, remember the why that drove you.

The problems we face in EMS are not going away anytime soon. Bit by bit progress will be made, but it will take time. Only now have employers and the governments started to realize the toll this career has on us as individuals. If you or anyone you know is struggling, reach out to your friends, your loved ones, reach out to me if you need to. I will be there for any of you, as each of you is a brother or a sister to me and YOU are a part of my why.  For me, my why is the helping of others, families, patients, coworkers, strangers, anyone that I can help.

We are so much more than people realize, and that is something to be immensely proud of. Take the time to refocus on your why, look out for each other, and despite the system falling down around us, let's stick shoulder to shoulder and hold each other up. Please like and share this post with your friends and families!!