Ask any first responder why they do this type of work and it’s likely you’ll get an answer that involves “serving the community.” Essex Rescue, with a mix of dedicated volunteers and full-time employees, was founded on that sense of service.
Much of the time on the emergency calls that we respond to, we can really feel that rewarding community service. Sometimes we drop off a patient at the hospital looking much better than when we first met them. Maybe they even thank us. Those are the good calls. But any EMS provider will admit that they aren’t all “good” calls. The nature of emergency medicine means that we see difficult, sometimes traumatic situations. We will always do our best in every situation but unfortunately, sometimes there’s nothing we can do and it’s important for the public to understand that this can take a toll on the mental health of some providers. Studies have shown that first responders and frontline health workers are more likely to develop symptoms of Post-Traumatic Stress Disorder and Depression (PTSD) than the general public.
For Vermont EMS services, part of the toll is the increasing call volumes. In 2019, licensed ambulance and first response agencies in Vermont had just over 100,000 calls for service. In 2018 that number was 97,000, so the increase has been about 6 percent year over year.
At the start of 2020, it’s safe to say that call volumes reflected that upward trend. Then the COVID-19 pandemic hit. According to VT EMS, the shutdown actually brought a decrease in call volume. However, the pandemic brought a new kind of stress to frontline health workers—the risk of exposure to the virus and the difficulties of managing that risk. We were thrust into a scary and unfamiliar world where we weren’t sure exactly how widespread the virus was. We wore full personal protective equipment for every patient. The hospital’s procedures for arriving patients was changed. Makeshift hospitals were built. Most aspects of emergency medicine were altered by the virus, even for non-virus-related calls.
The good news is that we are a resilient bunch. My first hand observations have been that many of us can acknowledge the difficulties and be open and honest about them with our colleagues. Simply talking about all of this and admitting when something is bothering you goes a long way. But these extra challenges from the virus are only added on top of the more difficult and critical calls.
After dealing with a traumatic scene, everyone handles it differently, but the days of simply sweeping these feelings under the rug and moving on to the next call are over. Services and state agencies now encourage confronting this head on in a compassionate way. Three years ago, Vermont became the first state in the nation to provide first responders with workers’ compensation coverage for mental illnesses with a bill passed by the legislature.
In addition to the coverage, it is becoming increasingly common to find long, sometimes full-day trainings devoted to this topic. At the forefront of these discussions is PTSD, which can appear with a variety of symptoms such as insomnia or nightmares, uncharacteristic temper, irritability, difficulty concentrating, difficulty managing emotions, flashbacks, depression, suicidal thoughts or substance abuse and addition. First responders are now much more familiar with those symptoms and able to recognize them in themselves or colleagues.
Thankfully, counseling is always within an easy reach for us, and slowly the culture of hiding the pain is giving way to a more open and accepting approach to this vulnerability.
In December of 2019, the first annual First Responder Wellness Conference was held in Montpelier, gathering emergency workers from across the state for an entire conference on the topic. Vermont even has its own first responder wellness center, so first responders in this state are fortunate to have a healthy support system in place.
Of course EMS, firefighters and police are not the only people affected by higher levels of stress these days. If you recognize the symptoms of PTSD in a loved one, it can be helpful to talk about it, but only when they are ready. If the conversation is getting too intense, take a break. There’s no need to cause further stress. Most importantly, if the talk escalates or suicide is mentioned, it is time for professional help.
First responders of all kinds pride themselves on being able to handle extreme situations and how we don’t hesitate to try to help. But all of us, as well as the public, would benefit from understanding that it’s not always easy to forget the difficult situations that unfortunately occur. Dealing with these difficulties in a healthy way will ensure that we’re able to continue to serve the community.
Patrick Crowley is a volunteer EMT with Essex Rescue.