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EMS and grief: Understanding your emotions

For EMTs, grief is often a surprising reaction to every day interactions with patients and their loved ones


By Erica Sloan

In the emergency medical service, the well-known five stages of grief may have been touched upon in training, but are not often elaborated on or discussed further. The five stages of grief are often taught in a linear manner, and only mentioned briefly. In reality, the five stages of grief are much more relevant to EMS than is often indicated:

  1. Denial.
  2. Anger.
  3. Bargaining.
  4. Depression.
  5. Acceptance.
(Photo/Utah Bureau of EMS and Preparedness)
(Photo/Utah Bureau of EMS and Preparedness)

The five stages of grief are absolutely real. What no one ever tells you, though, is that it is not an “emotional roller coaster.”

It is an emotional pinball machine.

EMS five stages of grief

The grief stages are not linear, and once you experience a specific stage, you do not get to check it off your list and move on to the next one. You can go from depression to anger to bargaining to acceptance, back to anger, then to denial, back to acceptance and back to depression; you will get kicked around between the five stages for a while. It is confusing, scary and everyone’s timeline is different, so there is no set time that the pinball game will end.

For many, the grieving process never ends.

Emergency medical technicians are exposed, on a daily basis, to situations in which they will experience grief. The goal is to get the patient to the hospital alive and in good shape. When that doesn’t happen, an EMT will often experience grief on a personal level, even if there was no personal connection between the patient and the care provider. It can make even the best EMT feel as though they’ve failed.

There has been a long-standing stigma behind emotional responses amongst first responders. There is an idea that, as a first responder, if you show any type of emotion towards a traumatic situation, you are weak or can’t handle the stress of the job. Often, an EMT is told to “brush it off,” or “suck it up,” when the truth is, EMTs are humans, not robots. Just because you are exposed to more stressful situations than the average person does not mean you are required to become immune to any emotional response.

It is important to understand that grief is a normal response. There is a fine line between caring about your patients and becoming invested on a personal level, which can lead to stress disorders. When you understand why you are feeling what you are feeling, you can better learn how to create some distance between your work and your personal feelings.

Addressing feelings of grief in EMS

It is also important, however, to not disregard feelings of grief. In doing so, it is possible to become so disconnected from your feelings that you lose your sense of compassion, becoming cold and apathetic. Disregarding your own feelings can be detrimental to your patients and their loved ones, as EMS is a career based on compassion and caring for others.

Understanding how grief works also helps when interacting with loved ones of patients. When a patient can’t be saved, their loved ones present at the scene will experience a variety of emotions. It is not uncommon for loved ones to be angry, and lash out at the care provider. It is important to understand that while you know you did everything you could to save the patient, their loved ones often feel that more could have been done. When you understand that their feelings are a natural response to a traumatic event, you can separate your personal feelings from their anger, and better mitigate the stressful situation.

Even though grief is a natural experience, it can be a difficult experience to manage. When you overcome the stigma, and understand that it is okay for you to feel the way you feel, it’s easier to reach out to resources for help. That could mean utilizing mental health resources provided by your company or department, or reaching out to a trusted friend, family member or advisor.

Reaching out and speaking out is essential to your well-being; bottling up your feelings because you’ve been told you are not supposed to feel them can lead to stress-related disorders, both mental and physical. Grief is never easy, but it is natural, and you’re not alone.

About the author

Erica Sloan has been in EMS for 14 years, on both private ambulance and volunteer 911 rescue services in Rhode Island. She currently provides EMS services for construction sites.

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