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10 ways to make bad days better in EMS

Mix a little science with lots of trial and error to reframe a tough call or a challenging day


How do you handle bad days in EMS? That was a big problem for me when I got started – not so much because of patients or employers, but because of my own quirks. I expected my work to be flawless, which it never was, and I thought my role as a caregiver would help smooth out the rough edges in my life, which it never did.

The first bad day I recall involved a 12-hour shift on a New York City ambulance. I’d been in paramedic school only a couple of months and was eager to impress my preceptors, two of the best and most understanding medics I’ve known. They were giving me my first chance to practice ALS on a real patient – a hypoglycemic diabetic. One of my instructors secured an IV as the other handed me an amp of D50. I was familiar with the drug, but I’d never actually pushed it through a port. That needle sure was long.

I pierced the rubber stopper but couldn’t get the sharp past the plastic receptacle. When I forced it, the needle snapped close to the hub. My patient was too obtunded to care and my partners simply treated it as a teaching moment, but I was mortified. I couldn’t shake the embarrassment for the rest of that shift. Maybe I wasn’t cut out to be a paramedic, I started thinking.

It took me a long time to stop expecting the worst from the system and from myself. (Photo/Pixabay)
It took me a long time to stop expecting the worst from the system and from myself. (Photo/Pixabay)

By next morning, I realized I’d overreacted. I’d been in EMS long enough to know a broken needle was pretty far from the worst that could happen. Still, I had to do a better job of managing bad days in real time and maybe even prevent some of them. I tried establishing a positive, yet realistic attitude before each shift – rebooting, in a sense, my desire to be a paramedic. It took years for that technique to become a habit.

On my way to work, I’d remember how much I enjoyed being one of the few willing to do my job. It wasn’t about saving lives; that almost never happened. I just wanted to solve the little mysteries of patient care and make good decisions. I knew I’d get aggravated sometimes – who doesn’t in EMS? – but I imagined myself overcoming obstacles like bad calls and system abuses before they monopolized my day.

When frustration started to build, I’d break that cycle by trying any of these ridiculously simple pace changers:

1. Sit

After dealing with difficult situations, we often remain animated, waiting for self-actuated catecholamines to disperse. Seeking a position of comfort helped my mind and body reorient to a relaxed state.

2. Think

Thinking goes well with sitting. We can start making sense of whatever happened by asking ourselves a few basic questions. For me, the process went something like this: What just happened? Is it still messed up? How did I do? No, really, how did I do?

3. Talk

When I’d feel preoccupied with negativity after sitting and thinking, I’d try speaking with whomever happened to be around. Often, I’d do more listening than talking. Whatever was said was less important than the distraction offered by pleasant conversation.

4. Write

This was one of my favorites. As entrepreneur John Rampton suggests, write a note to someone who’s treated you well. You don’t even have to send it; the mere act of expressing gratitude should stimulate optimism.

5. Eat

Have you ever become so preoccupied with badness that you ignore basics like hydration and nourishment? By the time I realized I’d skipped a meal or two, I was already irritable and not in the best frame of mind for decision making. That’s when I’d try to take a break from problem solving and have a snack.

6. Stall

I still find rote activities therapeutic during times of stress. It’s refreshing to shift my brain into neutral and do something mindless, like restocking an ambulance.

7. Plan

I’ve always been a list maker. I feel I can bring order to chaos by writing down what needs to be done, by when and by whom. That process helps me see problems as finite and solvable.

8. Play

Watching TV, playing cards, surfing the ‘net; or any other form of safe, interruptible recreation forces a change in focus.

9. Teach

This isn’t always an option, but it’s the most constructive way I can think of to dodge stressors. All you need is a co-worker who’s curious about something you know.

10. Leave

No, not permanently, although I considered that more than once. Just step outside. Take a walk. Sometimes, I’d sit in my car with the radio on for five to 10 minutes.

Don’t borrow trouble in EMS

There’s not much science to share about bad days, but a conclusion I’ve seen from quasi-researchers is that the more we expect trouble, the more of it we find.

“There is absolutely no such thing as a bad day,” says blogger and engineer Steven Schwarz. “A bad day exists in our interpretation of reality, which then becomes a self-fulfilling prophecy.”

Peter J. Bentley, PhD, author of Why Sh*t Happens: The Science of a Really Bad Day, is even harsher in his assessment. “Those who have a negative attitude are more likely to endow normal little mishaps with some mythical significance. Some psychologists even suggest that it’s a way of subconsciously avoiding responsibility for our actions.”

Not all mishaps in EMS are “normal” or “little,” but I can relate to the part about negative attitudes. It took me a long time to stop expecting the worst from the system and from myself; and to see bad days as isolated, short-term events rather than career-threatening burdens. I couldn’t always stop bad days, but at least I learned not to cause them.

Additional Resources

  • Schwartz S. The Science behind “having a bad day” (and how to solve It). Available at: www.lifehacker.com
  • Cyr C. The science of a really bad day. Popular Science. 05/12/09.
  • Rampton J. 9 ways backed by research to turn around a bad day. Available at: www.entrepreneur.com
  • Moss G. Why do bad days get worse? Available at: www.bustle.com

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