I am keenly interested in the intersection of behavioral health and emergency medical services (EMS). Specifically, I am interested in how burnout affects EMS professionals and the ways to prevent it. The matter is personal to me; when I am not working as a legal professional, I continue to work actively as an EMS professional.
It is no secret that burnout is a significant issue within the EMS community. Burnout can lead to behavioral health issues for EMS professionals like depression; substance abuse; anger issues; and, in some cases, suicide.1 Burnout can also create a multitude of human and legal headaches for EMS agencies. For example, it can lead to increased employee turnover, a greater likelihood of medical mistakes, and conflicts between coworkers. Managing burnout is key to the well-being of not only EMS professionals but EMS agencies and the entire EMS system. The management of burnout was necessary before the COVID-19 public health emergency (PHE) and is even more critical during the COVID-19 PHE after it is over. The key to managing burnout is first to understand the concept.
One of the first researchers to define burnout was Dr. Herbert Freudenberger, PhD, widely considered the founding father of the concept. He first described “burnout syndrome” in 1974. Freudenberger’s definition of burnout is exceptionally relevant to the current state of EMS during the COVID-19 PHE. In his article, “Staff Burnout,” Freudenberger described the state of being burned out as, “Becoming exhausted by making excessive demands on energy, strength, or resources in the workplace.”2 Freudenberger noted that burnout is more likely to occur in jobs that require a significant amount of emotional work and empathy, personal involvement, and intrinsic motivation. During the COVID-19 PHE, EMS professionals must do “more with less,” not only providing care for the sick and injured, but doing so while being ever mindful of an invisible danger that could be lurking anywhere. The COVID-19 PHE is the perfect environment for burnout to become a pandemic of its own. However, there are ways that EMS professionals and EMS agencies can manage burnout even during these stressful times.
Following are some ways to address the issue of burnout
Acknowledge the problem. There has always been a stigma in EMS associated with EMS professionals talking about burnout or behavioral health in general. Agencies need to acknowledge burnout and provide resources for employees. One such way is to give employees access to an Employee Assistance Program (EAP). EAPs are voluntary, work-based programs. They offer free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have either personal or work-related problems.3 EAPs also offer EMS professionals a confidential way to discuss their burnout and get help if they need it. If you already provide an EAP program to your employees, remind your employees of the program and encourage them to use it. The COVID-19 PHE may make EAPs even more valuable than they were before.
Stay connected. Although the COVID-19 PHE may make this harder than usual, it is not impossible. In these stressful times, consider using Skype, Zoom, FaceTime, or some other platform to communicate with friends and family. Personally, I have made it a habit of reaching out to friends and family often during these times. Even a simple text, asking how everything is going can make a world of difference. Staying connected can be beneficial not only for the EMS professional but for their loved ones, as well. Remember, although EMS professionals are working hard during the COVID-19 PHE, we also have loved ones at home who are concerned. Seeing each other and knowing that both are well can increase the EMS professional and their loved ones’ well-being.
Don’t forget the lessons learned. Burnout is not a new concept in EMS. Although the COVID-19 PHE has and will continue to contribute to increased levels of burnout, it is not the only factor. I could write many other articles on factors that contribute to burnout. The fact is that, once the COVID-19 PHE ends (and it will end one day), burnout will remain a threat to EMS professionals, EMS agencies, and the whole EMS system. Any idea that reduces burnout during the COVID-19 PHE can almost certainly help minimize burnout after things return to a semblance of normal. It would be a travesty to forget the lessons learned during the COVID-19 PHE once it is over.
The bottom line is that burnout can destroy the lives and careers of EMS professionals. The COVID-19 PHE can make the burnout even more acute. However, with work, burnout can be reduced, but it will take a team effort. The theme for EMS Week in 2018 was “Stronger Together.” When trying to prevent burnout among EMS professionals, we are truly stronger together. EMS professionals, EMS agencies, and EMS systems must work together to keep the burnout at bay.
1. EMTs, including firefighters and Paramedics, have significantly higher odds of death by suicide than non-EMTs. Vigil NH, Grant AR, Perez O, et al. Death by Suicide-The EMS Profession Compared to the General Public. Prehosp Emerg Care. 2019;23(3):340–345. doi:10.1080/10903127.2018.1514090.
2. Freudenberger, H.J. (1974), Staff Burn‐Out. Journal of Social Issues, 30: 159-165.
3. U.S. OFFICE OF PERSONNEL MANAGEMENT. https://www.opm.gov/faqs/QA.aspx?fid=4313c618-a96e-4c8e-b078-1f76912a10d9&pid=2c2b1e5b-6ff1-4940-b478-34039a1e1174.
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Matthew Konya is an associate attorney with Page, Wolfberg & Wirth, LLC, and has been involved in EMS for nearly 15 years. He obtained his emergency medical technician (EMT) certification at Penn State University. He then worked full time as an EMT for four years before attending law school. Konya now works part-time as an EMS practitioner. He can be reached at [email protected].