EMS chaplain support during the pandemic
In an especially stressful time, EMS chaplains are finding creative ways to offer emotional, psychological and spiritual support
People working in emergency services and healthcare have the added pressure of jobs that put them in closer daily contact with all of these stress-inducing ingredients than most people.
As leaders grow more and more concerned about the physical and psychological health of their team, it’s important to activate all of the support resources we can muster. Chaplains are one of the groups stepping up to help. We reached out to some EMS chaplain friends – Russ Myers, Nikki Holm and Gwen Powell – from Allina EMS to explore their role, how things have changed and how they can help.
Russ Myers has been a chaplain since 1993 and is board certified by the Association of Professional Chaplains.
Nikki Holm works for Allina and provides spiritual care support and health education to clients and staff at a local outpatient mental health facility. She was board certified with the Board of Chaplaincy Certification Inc. in 2017 and graduated with a master’s degree in spirituality from St. John’s School of Theology in 2007.
Gwen Powell serves as on the chaplain team for EMS at Allina Health. She worked for five years as a chaplain with the behavioral health team at the University of Minnesota Medical Center. She earned her M.Div from Luther Seminary in 2014 and her Master of Science in Psychology in 2010 from Kansas State University.
EMS1: What was EMS chaplaincy like before the pandemic, and how has it changed?
Myers: Like so many other expressions of human interaction, we’ve had to re-think our model. In my work of supporting frontline EMS staff over the past dozen years, I rode with supervisors, went on calls with ambulance crews, and met 1:1 with paramedics and EMTs. In late March, we welcomed Chaplains Nikki Holm and Gwen Powell to our staff. Instead of the ride alongs they were expecting to do, they came into EMS just as crews were utilizing PPE in new ways and we were starting social distancing. It quickly became apparent that we would have to innovate and find new ways to connect with employees.
What are some strategies you came up with?
Myers: The first thing we did was a Facebook Live chat, to introduce Nikki and Gwen to the organization.
Holm: Since then, we’ve been working in collaboration with our employee wellbeing team to host some remote chats and interviews around topics related to employee mental health. In my other job as a chaplain at a mental health clinic, I work with both first responders and the general public on topics related to boundaries, mindfulness, emotional expression, the stress response, trauma education, resourcing and self-compassion, among other things. As in so many places these days, we’re now holding those sessions via Zoom. I am looking forward to start implementing similar virtual conversations with our EMS team members soon!
What are some of the topics you’re addressing in the live online chats?
Powell: Some topics include the science of stress and stress reduction, critical vs. chronic stress, healing rituals, living well in a job that carries a lot of emotional weight, and open forum discussions with staff. My thing has always been narrative, and how we can interpret and re-interpret what we go through in order to have a healthier outlook that leads to feeling more hopeful, and having a sense of purpose and agency. I hope to teach some concrete skills around this. I love DBT (dialectical behavior therapy) and CBT (cognitive behavior therapy) and finding creative ways to apply these outside the clinical setting.
Holm: One thing I think we’re all being conscious about is flexibility. We really want these conversations to be relevant and meaningful to the team members we’re hoping to support; as such, I know I am really welcoming on-going feedback from our EMTs, medics, dispatchers and leadership about what they are needing and wanting to explore. Things are changing even faster than normal these days, and we need to be open to adjusting our plans spontaneously to meet the needs of those we serve so that they can continue to serve their families, each other and our communities.
This is more mental health-focused than some of us are used to hearing from chaplains.
Myers: Professional chaplaincy has changed a lot in the past generation. We have our roots in faith and spirituality, and continue to bring those resources to the conversation. Many people find meaning and hope in formal and informal expressions of spirituality. But this job isn’t really about religion, it’s about providing care and support to the people we’re here to serve. It’s about building relationships, and being there to listen, outside of the chain of command structure.
Powell: It’s funny, when I was working on inpatient units at the University of Minnesota, I spent a lot of time explaining what a chaplain was and why I was there. The image most of the older folks had was an elderly priest bringing communion or last rites. The young people had no idea what a chaplain was. I explained it like this: I see my role as helping people use their own resources (beliefs, philosophy, hobbies, practices) to make sense out of the things they are experiencing, or to learn new skills. I often found that the mental health providers and I pulled from the same bags of tricks but with different foci. Whereas they might talk about their life history or the disease process, I might talk about what these things mean in terms of big questions like “why am I suffering?” “is everything random?” “where is hope in all this?”. I’m a scientist at heart and want to do evidence-based work, but a lot of life is subjective with no concrete answers, and so I am concerned with blending what we know about the brain and the body with the lived experience and all of the stuff that makes us who we are.
Holm: In my longer-term role at the clinic, I have a very unique position where I provide spiritual care to clients seeking mental health treatment for a variety of reasons. One of the things I’ve learned doing this work is how interconnected our physical, psychological and spiritual parts of self really are. For example, it’s hard – if not impossible – to make meaning of things if our psyches are stuck in shame or negative thinking patterns, just as it can be very difficult to healthily express our emotions if we’re lacking a deeper sense of hope or trust.
As such, it’s vitally important for me to have an awareness and appreciation for the complexity of the human experience. I have been able to offer both health education and spiritual care in our programs to a variety of first responders whose mental health at the time was compromised to the extent that they were in need of such intensive support. In doing so, I have seen firsthand the toll that this very difficult, very rewarding work can have on people and am passionate about doing what I can to mitigate such potential negative consequences pro-actively. My role at the clinic also encompasses providing both personal and professional support to our clinicians and administration staff. This entails creating a safe, nonjudgmental, confidential space for my peers to talk about their own fears, losses, and struggles both at home and at work. This too is not unlike the support we hope to offer our EMS members.
What else are you doing differently than in the not-too-distant past, before the pandemic?
Holm: We’re not doing ride alongs, but we continue to show up in person, making the rounds of the ambulance bases. Shift change time is a great opportunity to visit with employees, before and after their shifts, as well as between calls for those teams posted at a base. We’re also spending more time on our organization-specific EMS Facebook page. Collectively, we’re trying to post an offering, whether it be a mindfulness practice, self-care tip or an inspirational poem, at least once a week. Facebook has been a surprisingly effective resource for seeing what is going on with our members and letting them know we are here and available.
Powell: Well, I’ve been doing a lot more baking! I have always found it relaxing but since we’ve been staying in, my poor daughter is so bored, I find myself offering to bake more just to entertain her. I realized that folks out doing this hard work on the front lines were probably feeling bored and disconnected too, and what better way to share connection than through food (a universal connector)?
Myers: We’re also aware of the stresses brought on by schools being closed, and the pressure on families of employees who have school-age children. The popular media has stories about people who are at home, looking for ways to fill their time; our employees are working and then going home to monitor their kids’ distance learning.
What suggestions would you make for other EMS chaplains, or for agencies that don’t have a chaplain? What tips can you give to supervisors and managers for supporting their people during the pandemic?
Holm: In my short time working for EMS, it has become glaringly obvious how powerful the culture and atmosphere are, for better and for worse. Supervisors, managers and chaplains must be the instigators for creating an environment where self-care, emotional and mental wellbeing, and providing for our caregivers is both welcome and encouraged. Toward this end, team members need to know that they can confide their hardships in confidence. I’ve been told by medics that they don’t seek counsel or support from the EMS chaplain for fear that what they say will be taken back to leadership towards unhelpful and potentially detrimental effects.
If you are going to offer to support your EMS crews and dispatchers (which I believe is necessary), those individuals need to be assured that such support will be safe, competent, effective, and non-judgmental, whether that support comes from a chaplain or another person designated for such a role.
Powell: I think it’s important to be intentional about caring for the person first, employee second. What I mean by that is, as much as supervisors and managers may be concerned about job performance, the surest way to burnout is to feel isolated, shamed, and alone. This is a stressful time! I would advise those who don’t have support staff like chaplains to just be aware that it’s impossible to separate the stress of life from the job, even though we try our best. A partner being laid off, kids grieving losing graduation or other things -- that all takes a toll and affects concentration, stamina and attitude. If you notice an employee struggling, don’t just dress them down, talk to them about what’s going on. Make space to lament losses and share fears, and hold that without judgment. Even if a supervisor or manager can’t fix what’s going on, just feeling heard and cared for makes a huge difference for people under stress.
Myers: Start with listening. EMS personnel tend to be wired to assess and solve problems. People usually have or find resources to deal with their losses, be it a difficult call, death of a loved one, working during a pandemic or other of life’s challenges. So while they’re not looking to their employer to take care of them, they deeply appreciate the outreach. An honest expression of concern and a willingness to listen are the strongest message you can give. The message that speaks loudest is, “You’re not alone or forgotten. You are important. You are valued. I’m thinking of you.”
What are you doing to take care of yourselves during this time?
Holm: What an important question. The outdoors is really healing and restorative for me. During this season in particular, I have been spending increasingly more time outside with my husband and daughter taking walks, planting things, having bonfires, etc. On days when I am getting caught up on paperwork at home, I am being more intentional about taking breaks outside whether to sit and enjoy a cup of coffee or just to stretch and take a few deep breaths of fresh air. I’m also trying to invest time in other life-giving and nourishing actions for myself such as taking a bath, reading a book for fun or journaling. Finally, I am being even more intentional about connecting with my own support systems in whatever way possible, including participating in my own regular equine therapy over Zoom! It’s amazing what peace my therapeutic herd of horses can bring me even through a screen.
Powell: I'm trying really hard to be compassionate with myself and have good boundaries. I find Zoom meetings exhausting, so I'm trying to limit those, but chat and talk to friends on the phone where possible. I love social media but am finding that it gets my anxiety up, so I'm trying to read some light fiction to give myself a break from the news cycle. I'm acknowledging that this is hard on everybody and I'm no different, so if my kids watch six hours of Disney movies one day or I don't get to everything I'd hoped for that day, I'm telling myself that unusual circumstances call for grace and re-evaluating priorities. I'm learning how to navigate this pandemic like everybody else, so I'm just taking it one day at a time.
Myers: I gravitate toward things I can see, taste, touch or smell. So much of our work in EMS is intangible. We know we’ve made a difference in the lives of individuals and communities, and the world is a better place because we’re here. The dilemma is that, at the end of the day, we don’t have much to show for it – some run reports, interesting stories, and good conversation with coworkers. All are important, but I can’t touch or see any of those things.
Since our jobs don’t provide much in the way of tangible rewards, I find it necessary and rewarding to create those in other areas of life. In my case, it’s the simple and mundane tasks of cleaning the bathroom, weeding the garden, doing the dishes, cooking or doing the laundry. Then I can step back and look at those things. That’s the same suggestion I give to medics, EMTs and dispatchers. It is so important to have activities in our lives that give the tangible, sensory rewards that we don’t get from our jobs.
Taking care of the caregivers
There’s no doubt that people in general need more emotional, psychological and spiritual support than ever and with the extra stress EMS providers face it’s likely that they need it more. I’m grateful for Russ, Nikki, and Gwen’s thoughtful perspective and dedication to taking good care of our colleagues.
Additional stress management resources
Learn more about stress management strategies with these resources:
- Book Excerpt: ‘Super-Charge Your Stress Management in the Age of COVID-19’
- Video: First responders, stress management and coronavirus
- Podcast: How to reduce stress during a pandemic, with Mike Taigman
- Q&A: How can leaders identify and help EMS providers who need support?
- EMS Chaplaincy: Evidence-based professional practice
- Self-care is critical for managing stress levels in EMTs and paramedics responding to COVID-19
- First responders, COVID-19 and stress: Tips for finding peace