Dear EMS: It's not you, it's me

Decoding the myth of poor responder resiliency, stress and responder fatigue in EMS

It seems like every day there is another story discussing first responder fatigue, poor resiliency or stress. Has the job gotten that bad that no one can survive it anymore? Or does the problem lie within; is it us?

There is no arguing that in the past, call volumes were not nearly what they are today. EMTs had to do a lot more with a lot less, yet it was, for the most part, a career that people retired from. This begs the question; were previous generations tougher and more resilient than today’s current cadre of EMTs or are they just different?

Allow me to draw some parallels.  

Has the job gotten that bad that no one can survive it anymore? Or does the problem lie within; is it us? (Photo/CDC)
Has the job gotten that bad that no one can survive it anymore? Or does the problem lie within; is it us? (Photo/CDC)

Simpler times made for healthier, more resilient EMTs

In the past, we can argue that life moved at a slower pace; this was reflected in the limited options for going out and purchasing food. Meals were often planned and eaten at the base or at a sit-down restaurant. Of course, call volume and transport times have also affected this, however, back then, there was not a convenience store on every corner with an endless array of unhealthy options.

America’s culture regarding food has changed so much, that first responders are simply not eating a balanced diet of healthy, natural foods; foods that allow the body to heal, repair, recover and grow. Instead, many first responders have settled into the processed, sugar-laden and chemical-filled world we now live in.

National Center for Health Statistics (US). Health, United States, 2008: With Special Feature on the Health of Young Adults. Hyattsville (MD): National Center for Health Statistics (US); 2009 Mar.

Many people don’t realize that in 1977, when fat became evil and sugar became acceptable, there was an almost immediate spike in obesity, cancer and many of the diseases we treat today.

Further, we can look at a simple study that shows what happened when we embraced a carbohydrate-rich diet and abandoned a balanced diet with few refined oils, meats or processed foods. The bottom line is that food should heal and not harm, and what we are currently eating is harming us.

Being fit is part of the job for an EMT

It’s common knowledge that we have become a sedentary country. Gym class has been removed from many school districts curriculum, and with the advent of technology, we spend an increasing amount of time sitting, usually with a screen in our face. This presents two distinct problems.

1. Exercise is crucial for those working in EMS

We are creatures of motion, and are not meant to be sedentary or take on the shape of a chair.  Previous generations were not tied to a screen, it’s only in recent years has this phenomenon taken place. As more and more jobs, hobbies and pastimes become sedentary, we have seen the predictable, yet preventable, shift in first responder fitness, wellness and, I will argue, physical resiliency. 

EMS is a 100 percent physical job, an argument that I have made many times before. No matter how much we throw engineered solutions at the problem, we still have to push, pull, slide, drag, lift, carry and transfer the patient. We are still required to lift and move our gear. Having written and validated over a half-dozen EMS physical abilities tests and having administered more than 5,000 tests, it’s truly chilling to see how deconditioned and immobile the current generation of first responders has become. This applies to current and incoming EMTs, as well.

The solution is radically simple. Test all your employees at hire and annually after that. Fit for duty is not a luxury, it’s an absolute necessity, as fit employees get hurt less then unfit first responders. Give them access to fitness equipment and teach them how to manage the aches and pains of the job, something I personally have been fighting to change for over a decade in EMS.

Stop making excuses that there is no time for pre-shift stretching; there is. A flexible EMT has a reduced rate of injury, is more alert and feels better while at work. Plus, it opens the door for investing in their own fitness when off duty.

2. Limiting light exposure from screens leads to better sleep health, more resilient EMTs

Sleep can be an elusive necessity for just about everyone, especially now. I recently came across a study that looked at the prevalence of light pollution, blue light exposure and sleep patterns. As we light the world and stare at screens all hours of the day we have lost the ability to sleep.

In addition, we know that chronic light exposure, especially blue light, can alter the effects of sleep hormones, increase cancer risks and drastically alter the ability of your body and brain to fight free radicals. This inability sets you up for disease processes that your body should keep in check, and even increases the risk of cognitive stress, often leading to stress-related disorders that further affect sleep health and, ultimately, resiliency.

EMTs can take resiliency issues into their own hands

The bottom line is simple: we can blame EMS for our problems, or we can step back and realize that times have changed, and so have we, but not in a good way. The blame game goes both ways, folks. We need to teach EMTs how to survive the job before they enter the field. This falls on the EMS educators, EMS systems and, of course, you. At the same time, EMTs need to make time to stay fit, eat well and sleep better. It’s really not that hard; I did it for almost 10 years in a very busy system.

The final challenge is finding a validated system to walk both the department and the provider down the path to success; there is a lot of myth and misinformation floating around so beware.

Some resources EMTs can utilize are the National Strength and Conditioning Associations TSAC group, The Fit Responder’s online course, the American Council of Exercise or start following some influencers in the health and wellness space to keep you educated and engaged.

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