Jack Daniels on Your Cereal

   Simply put, EMS is a stressful job, and, like the stress that comes with any job, it needs to be managed. Part of the challenge of managing our stress is to first understand the multiple stressors we commonly encounter on a routine basis.

   First is simply the stress that comes with dealing with other human beings in crisis. Whether it's a palpitating heart, crushing chest pain, shortness of breath or the myriad other problems your patient may be complaining about, all create a stress-laden working environment, if for no other reason than every patient you encounter is complaining about something. This is the most insidious type of stress, because it is the day-in-day-out stress that quietly depletes your emotional bank account.

   In addition, depending on the nature and severity of the call, your stress barometer rises and falls, call by call. I consider this more an "acute" stress that is generally obvious and more of the in-your-face variety. We each have our own personal stressors that are unique to us as EMS providers. For some folks, it's being vomited on or getting yelled at. For others, it's the smell of gangrene stuck in your sinuses for a full 24-hour shift. If there is one universal stressor, it's probably pediatric trauma/cardiac arrests.

   Yet another variety of stress results from the structural elements of the job, like being "posted." This occurs in a system that uses system status management/flexible deployment, which moves units to various geographical locations where they are able to respond in a more timely manner, i.e., from the center of the city vs. the outer edge. In this format, you can move from post to post as rigs go into service or become available. While you aren't actually running calls when posted, neither are you free to go back to quarters, slip off your boots and relax for a few minutes until the next call. Sitting parked behind a local burger shack while you and your rig slowly take on the unmistakable smell of French fries is a low-burn stressor, but a stressor nonetheless. It's not going to take you over the edge, as might happen with some acute, catastrophic event, but it's a nagging type of stress that, in the long run, still has a negative impact.

   Another job element that can become a real stressor is being required to get the rig clean and back in service and your patient care report completed at the hospital in 10 minutes. If you are not back in service within the magic 10-minute window, you can bet your last nickel that someone from dispatch or administration will be calling to find out why. This is another version of the nagging category of stressors.

   Given this laundry list of stressors, how do you best manage them and limit their impact? Ideally, you want to remove any and all of the stressors you can, i.e., get your reports written and submitted in a timely fashion so you don't get the calls from dispatch or administration. But what about the stress that comes from hearing people complain day in and day out? Obviously the only way to limit this stress is to quit running calls, so removal is not an option. As is the case with any stressor that you cannot remove, your only viable option is to somehow try to limit the negative impact as much as you can.

   Without question, your best stress management strategy is to get in regular workouts. If you are in decent physical condition, you need to work out a minimum of three times a week to maintain your current physical state. If you want to get in better shape, you will need to exceed the three times a week minimum. If you want to lose weight and get in better shape, you need to eat healthier, limit caloric intake AND work out more than three times a week.

   I understand that this is easier said than done, and the work environment and our work schedules do not make it easy to eat healthy and work out regularly. Notice I said "do not make it easy." I did not say impossible. You need to commit to a plan that involves both making better diet choices and working out regularly, and then execute your plan. Do this and you will reap multiple benefits, with one of the most significant being drastically reducing the stress of EMS in your life. There are certainly other choices for stress management, but if you find yourself putting Jack Daniels on your cereal in the morning, you need to know that is more than just a red flag, to be sure.

   Until next month...

   Mike Smith, BS, MICP, is program chair for the Emergency Medical Services program at Tacoma Community College in Tacoma, WA, and a member of the EMS World editorial advisory board.