This month, readers chimed in on an article in May JEMS, “The Fog of EMS: Debriefing sessions can help clear the air,” by Bernie Meehan, Jr., EMT-P. Meehan grew up in Newtown, Conn., and is a career deputy fire chief and a part-time paramedic. He’s also one of the founding members of the Connecticut Critical Incident Stress Debriefing Team. The article received both high praise and staunch criticism on the JEMS Facebook page, giving both the editor-in-chief and the author of the article an opportunity to respond.
Navigating Through Fog
Well written article. We need more discussion on this topic.
They should put their big boy/girl pants on before coming to work—they know what their getting into when they start school for this profession!
These debriefings should be by choice because some research has proven that debriefings can sometimes make things worse for the person by reliving the events.
I’m really disappointed to see this article written here when there is so much evidence that critical incident stress debriefing (CISD) is not only ineffective but actually causes harm. To see it praised in a JEMS article like this gives it credibility and that is unacceptable coming from JEMS, which should be promoting the most up-to-date research so that we can move forward with better practices rather than continuing to wallow in these horrible, outdated ones.
JEMS Editor-in-Chief A.J. Heightman, MPA, EMT-P, responds: I’m sorry you feel that way, Katie, but I was involved in development of this article and felt that the true value of the article was in the author/provider’s words about the emotions that build up over time that create the “fog of EMS.” I did not feel that he was pitching CISD as much as he was pointing out the need that we watch out for stress and get/give help wherever (and whenever) our colleagues need it. I am well aware of what CISD is—and is not—and do not feel JEMS endorsed/endorses it. The fact is that many areas still use a modified CISD counseling process (albeit not always in a group environment) and that this has shown to be effective. If you have a best practice that has been scientifically proven as a better alternative for EMS stress management, please write to me at firstname.lastname@example.org and we will focus attention to it.
I have not had a case that has left me truly shaken but I have been on a few incidents that management required us to attend CISD. My experience with CISD is that it, at best, is no help. The problem with CISD is that not everyone decompresses the same way. I believe this line of work as well as law enforcement, which I worked in prior to EMS, requires its workers to either have or develop coping skills that work for them. If you aren’t able to develop the ability to shrug things off in a reasonable amount of time, I believe that this work may not be right for you. Me, I like to take my dog and go up the mountains where I live to fish/hunt/hike/camp on my days off. This may not work for others or it may make things worse, but it works for me.
Author Bernie Meehan, Jr., EMT-P, responds via Facebook: Guys, ease up. Why do people in EMS always wind up bickering with each other? The intent of the article was not to endorse any one way to deal with stress; the intent was to point out that an EMS career can leave us in a fog. As many of you have aptly pointed out, we are all different, and there are many ways to deal with stress, whether it's personal or professional. As John R. points out, there is no need to tell people to “suck it up” or anything else so insensitive. We all have breaking points or limits to our coping skills, and when some of us finally meet up with those points, we need to have a strategy to deal with things, which most EMS people and EMS agencies don’t have.