It sounds unthinkable. EMS is thought to be fast paced, dynamic and exciting. It can definitely be that, but it can also get a little stale. Every call is different, but after a number of years you’ve definitely seen a lot of very similar calls with slight variations.
They blur together. On your third geriatric ground level fall of the shift and the 500th of your career, it starts to seem like these are not individuals but the same person calling again and again. You get your assessments and treatments so dialled in that individuals are reduced to their complaints. Chest pain. Abdominal pain. Anxiety.
Every once in a while, you’ll get some outstanding call that will break you out of your rut and you’ll exclaim “Yes! This is why I’m here!” and you will ride that high for days. But then it gets back to the day to day. Same calls. Same patients. But it does not always have to be so. Here are some tips to keep yourself motivated over the years.
Know the Signs
Burnout and complacency can be insidious. Sometimes you can be pretty deep in a hole before you even know you’re in it. Are you getting irritated by being asked to do your actual job? Sure, 911 is abused and it’s OK to be annoyed by that.
But if you’re getting annoyed because someone at the nursing facility is calling for chest pain, there might be an issue. Do you dread going to work? Do you wish longingly for the collapse of civilization so you don’t have to go to work tomorrow?
If you used to like your job, but now you find it boring and soul crushing something has gone off the rails. You don’t have to skip into work full of sunshine and rainbows, but some level of desire to serve your community will probably reflect well on your mental health.
Become an Expert
Pick something that interests you, and learn everything you can about it. At my service, we have someone who is a genius at EKGs. We have someone amazing at airway. My personal focus is responder mental health. Maybe ultrasound interests you, or the dynamics of lights and sirens driving.
Once you become a resource on this topic people will seek you out for it. You know those emails about the lectures that you ignore and delete? Consider going to one of them.
There are so many topics and possible subspecialties within the broad scope of EMS that there is bound to be something that you can really sink your teeth into.
Teach
Teaching was a big one for me. There is nothing like the fresh enthusiasm of a new provider to remind you of the days you were excited to go to work. I remember vividly one student who was just so excited to give D50 and bring someone from approaching death to signing a refusal.
A call I’ve done 100 times. But when they were so excited and exclaiming “We just saved that guys life!” it occurred to me that they were right, and that was pretty remarkable. There are many challenges that come with adult education to keep you on your toes, which makes it much harder to feel complacent about it.
The feeling of sending a provider out into the world that benefited from your knowledge is another layer of satisfaction that can come from the job.
Explore Other Facets of Your Agency
Many services don’t just do medical transport. See what else there is to do at your agency. Is there a protocol development committee? Chart review? Peer counselling?
Fire agencies are blessed with a wide variety of subspecialties and things to learn, but private agencies also have things to do. Some have search and rescue or even tactical squads.
Some agencies may have specialized water or wilderness rescue teams. Special events such as concerts or festivals can really shake up the routine of your regular job. See what there might be to do that’s right under your nose.
Talk to Your Patients
It’s easy to let your patients become their symptoms. Instead of Betty from Wisconsin, they are “74 YOF ground level mechanical fall head lac no thinners no LOC.” While a certain amount of clinical detachment can be beneficial, it can go too far. Every one of our patients are their own whole person with a vibrant internal and external world they live in, and you are guest starring in what is probably a very important moment in their lives.
This might be a routine call for you, but they will remember you for quite some time. My grandmother used to comment on the EMTs that transported my grandfather 30 years ago, speaking of their kindness. The patients like chatting also.
There is the issue of whatever they called for, but then also the fear about that issue. The fear you can treat just by being nice. I’m not particularly gifted at small talk, but it’s a skill you can develop.
People love to talk about their medical problems, their kids and their pets. Did you see a book you’ve read on their bookshelf? Ask about it. What about that movie poster? Let’s have a conversation. I’ve heard some extraordinary tales of people’s lives and experiences.
Are You Depressed?
Lack of interest in things that used to interest you is one of the classic hallmarks of depression. How’s the rest of your life going? If you are coming in on four hours sleep, working a 12 while pounding energy drinks and monsters and using nicotine pouches, then hitting the bar with your coworkers on the way home, then there are some very basic and fundamental changes that you can make to improve your mental health.
Consider seeking out some therapy. I believe that there are some people that sail through their EMS career without acquiring any substance or mental health problems, but I put these people in the same fantasy realm as unicorns. Most of us are going to suffer.
It’s up to you to seek out help. Find yourself a good trauma informed, ideally first responder specific therapist and make an appointment.
Don’t start drinking. As I tell people in peer counselling pretty regularly, the problem with alcohol is that it works in the short term. In the long term it will destroy your life.
I guarantee you have some functional alcoholics in your agency, some of which you know about and some you don’t. You’re going to want to leave EMS with as much a sound body and mind as you can manage.
Work/Life Balance
At some point, especially if you go to paramedic school, EMS will have to be your life. From waking to sleep, you’ll be thinking about cardiology, stroke, trauma or whatever else you have to learn about. This is not sustainable.
I can’t even imagine those folks that date their coworkers. Yes, it would be nice not to have to explain what intubation means, but being “at work” with EMS brain on 24/7 is problematic.
Do something else. Start a new hobby. Meet people that are not first responders or in the medical field. Hanging out with only EMS folk tends to just land you in an echo chamber of cynicism and sarcasm propped up on some load-bearing coping mechanisms of dubious structural integrity.
During peer counselling I give the most annoying advice ever that no one wants to hear : “Exercise. Eat healthy food. Get enough sleep.” While those things are not a panacea, it’s amazing how many people neglect some or all of these basic self-care fundamentals.
Conclusion
There’s a story on this topic that I like to tell. I was really burned out for a while. I didn’t care much about any of our patients. We ran a code and literally brought someone back from the dead. My only emotion was to be vaguely annoyed at the paperwork I had to write.
Doing even the minimum for my patients was a chore. We were going to a call for something really non-emergent. I told my partner that I was going to be nice. So nice. Sarcastically nice. Like I was going to be so concerned about this person’s problem that it would be obvious that it wasn’t an emergency.
So, I did. I was kind, empathetic and caring. I listened to her, treated her complaint, and took her to the hospital. And you know what? It felt great. Shortly after that I found myself in a therapist’s chair talking about my problems.
You may never get back to the excitement and enthusiasm you had when you first started, but you can get close. Don’t give up!
