Journal Article•
Are you under stress in EMS. Understanding the slippery slope of burnout and PTSD.
TL;DR: Burnout and PTSD are closely linked and often underreported in EMS and providers experiencing burnout that doesn't resolve within a few weeks may actually be experiencing PTSD.
Abstract: Burnout and PTSD are closely linked and often underreported in EMS. EMS classrooms do little or nothing to prepare providers for the inherent emotional stresses of emergency response and the "thick skin" culture of EMS may make many providers apprehensive about sharing their true feelings. Burnout is triggered by many of the same stresses that lead to the symptoms of PTSD and providers experiencing burnout that doesn't resolve within a few weeks may actually be experiencing PTSD. Be mindful of yourself and your fellow coworkers, particularly after a very traumatic response. And remember traumatic responses don't need to be as dramatic as Sept. 11, New Orleans after Hurricane Katrina or the Aurora, CO shootings to bother an EMS worker. In contrast, these are the calls where providers often receive the most attention. Instead, watch for the new father who just performed CPR on an infant the same age as his own, or the provider who just watched his or her friend die following a motor vehicle collision. Pay attention to yourself and colleagues, and be responsible and honest with yourself and others about when coping strategies are enough, and when they aren't. Finally, don't ever be afraid to seek help.
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TL;DR: The very real and well-documented phenomenon of PTSD among EVD survivors, caretakers, and their immediate contacts is discussed.
Abstract: intRoduction Neither dramatic footage nor horrifying statistics from the most recent Ebola virus (EBOV) outbreak come close to reflecting the true impact of the EBOV disease (EVD) on affected countries, communities, patients, health-care workers, or their friends and families.[1,2] With focus squarely on containing the outbreak and dealing with the immensity of the task at hand, many fail to notice the associated emotional and psychological toll.[3,4] Posttraumatic stress disorder (PTSD) is defined by Diagnostic and Statistical Manual of Mental Disorders, 5th edition as a specified constellation of emotional and behavioral responses to traumatic events.[5] The affected person frequently reports an exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Within this context, one or more of the following are required to meet the diagnosis of PTSD: (a) direct exposure to trauma; (b) witnessing the traumatic act or event in person; (c) indirect involvement, by learning that a close relative or close friend was exposed to trauma; (d) if the event involved actual or threatened death, it must have been violent or accidental; and (e) repeated or extreme indirect exposure to aversive details of the event(s) has occurred, usually in the course of professional duties (e.g., first responders, collecting body parts, social workers repeatedly exposed to details of child abuse).[5] This does not include indirect nonprofessional exposure to above-mentioned events through electronic media, television, movies, or pictures. In this Editorial, we will discuss the very real and well-documented phenomenon of PTSD among EVD survivors, caretakers, and their immediate contacts.
52 citations
Cites background from "Are you under stress in EMS. Unders..."
...[11] However, this assumption is neither absolute nor universally applicable, and inevitably some of the health workers exposed to significant emotional and psychological burden may develop signs and symptoms of PTSD....
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...[20] Burnout and PTSD are closely related, and increasing duration of burnout may result in a higher likelihood of developing PTSD.[21] Posttraumatic stress is considered to be a well-established risk among health-care workers facing deadly outbreak or disaster events....
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...[20] Burnout and PTSD are closely related, and increasing duration of burnout may result in a higher likelihood of developing PTSD.[21]...
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...[40] In a relatively recent report from Sierra Leone, over 20% of individuals affected by EVD demonstrated signs of PTSD.[41] Authors cited significant contributory stressors to include loss of immediate family member, witnessing the death of a loved one, fear of re-experiencing the traumatic event, and the perception of being somehow “marked” or carrying a stigma....
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...In fact, preventive behaviors that are beneficial in the setting of Ebola outbreak, such as hand washing and avoiding large social gatherings, may be decreased in those with PTSD.[32] This raises the concern that not all PTSD in the West African population stricken by the most recent Ebola outbreak can be directly attributed to the disease itself....
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TL;DR: Polish paramedics who agreed to take part in the survey were shown to have a high rate of PTSD, and multi-center screening and early supportive management is recommended.
Abstract: Background Working as a paramedic carries the risk of witnessing events and personal experiences associated with emergency life-threatening circumstances that may result in symptoms associated with posttraumatic stress. This problem is well known but still underestimated. Objectives The specific study objectives were to 1) assess the influence of sociodemographic and occupational factors on posttraumatic stress disorder (PTSD) among paramedics, and 2) suggest preventive strategies in this population. Methods This prospective, descriptive study examined a sample of 100 paramedics who agreed to complete the Author Questionnaire comprising demographic questions and the Impact of Event Scale – Revised. Results The total prevalence of PTSD in the examined group was 40.0% (women = 64.3%, men = 36.1%). It was more frequently reported in paramedics working under an employer's contract than among those who were self-employed. It occurred less frequently in persons with more education. Other sociodemographic factors studied showed no significant impact. A statistically significant effect of exposure to certain types of traumatic events on the incidence of PTSD was found. There was no significant correlation between the prevalence of PTSD and the occurrence of problem situations in respondents' workplaces. Conclusions Polish paramedics who agreed to take part in the survey were shown to have a high rate of PTSD. Multi-center screening and early supportive management is recommended.
32 citations
Cites result from "Are you under stress in EMS. Unders..."
...Similar results were obtained in a study on Swedish and British paramedics (9,17)....
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TL;DR: Doctors working in the system are shown to have the highest level of burnout, while paramedics the lowest, among all the jobs analyzed.
Abstract: INTRODUCTION Occupational burnout is a multifaceted phenomenon and a problem often encountered among medical personnel. An example of such a group are workers of the Emergency Medical Services (EMS). The aim of the present study was to make an attempt to assess the level of job burnout among professionally active employees of the EMS and to compare the different occupational groups (paramedics, nurses of the system, doctors of the system) according to four analyzed factors. MATERIAL AND METHODS A cross-sectional study was performed using an on-line questionnaire. Four factors impacting the level of burnout were analyzed: 1) attitude to work; 2) workload; 3) contact with the patient; 4) attitude to stress). The minimum possible result on the scale is 36 points and the maximum - 252. Data were analysed by means of the Cronbach's alpha coefficient, the Spearman correlation, the Ramsey RESET test, the Chow test, VIF statistics. RESULTS The average score for occupational burnout was 131.0 points (SD ± 31.47). The tool's reliability measured by means of Cronbach's alpha was 0.910). Both nurses and doctors obtained higher results throughout the scale (βstand.0.147 and 0.215). Significant differences were shown between the group working only in the Helicopter Emergency Medical Service (HEMS) teams and the other services (land EMS, emergency rooms, etc.) at the level of p < 0.000. CONCLUSIONS EMS employees encounter varying degrees of threat by occupational burnout. Doctors working in the system are shown to have the highest level of burnout, while paramedics the lowest. Among all the jobs analyzed, the lowest level of occupational burnout has been demonstrated by employees of HEMS.
25 citations
Cites background from "Are you under stress in EMS. Unders..."
...It must be remembered that occupational burnout is caused by similar factors as Post-Trauma Stress Syndrome (PTSD) [23], that is the ability to view a situation objectively, as shown by older people, can influence their mental condition....
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TL;DR: In this article, the authors investigated the correlations between levels of burnout and other mental health disorders and searched for the presence of specific risk factors of post-traumatic symptomatology related to the COVID-19 pandemic.
Abstract: During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW's mental wellbeing. We analyzed the correlations between levels of burnout and other mental health disorders and we searched for the presence of specific risk factors of post-traumatic symptomatology related to the pandemic. A structured an on-line questionnaire and validated instruments were completed by a sample of HW from some hospitals in Genoa, Italy. Anxious, depressive, post-traumatic and other psychological symptoms were assessed and risk factors, related to the pandemic, were considered. Then, we investigated the correlation between levels of burnout and the risk of developing psychopathology. A total of 731 HW were screened, and we found increased levels of anxiety (61%), depression (62%), PTSD (34%) and high levels of burnout; especially emotional exhaustion (37%). A statistically significant association between burnout and insomnia, depression, anxiety, and post-traumatic symptoms was demonstrated. This study indicates that during the COVID-19 pandemic, HW showed high levels of psychological distress and that burnout is an important predictor of sufferance. These findings support the idea to provide psychological and psychiatric support for HW.
16 citations
TL;DR: Both univariate and multivariate logistic regression analyses showed that an anxious personality and EMS as the main task during the missions were significantly associated with PTSD risk.
8 citations
References
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Book•
01 Jan 1970
TL;DR: The human brain is a “spatially aggregating substance” and the goal of treatment is to “smooth out the spats” or “reduce the levels of inflammation”.
Abstract: THE ENCYCLOPEDIA OF MENTAL HEALTH , THE ENCYCLOPEDIA OF MENTAL HEALTH , کتابخانه مرکزی دانشگاه علوم پزشکی ایران
409 citations
TL;DR: Exposure to both chronic and critical incident stressors increases the risk of EMS providers’ developing a posttraumatic stress reaction, and attention must be paid to levels of stress associated with both critical incident exposure as well as the chronic stress providers experience on a day-to-day basis.
112 citations
103 citations
TL;DR: Gender, years of experience, the types of coping strategies used, and high levels of depersonalization and emotional exhaustion must be considered when developing mental health programs for chronic stress among volunteer Emergency Medical Services personnel.
64 citations
TL;DR: A common frame of reference is sought for debate and decision making at all levels of EMS over the ideal length of shifts and rest intervals to achieve lower operating costs related to staffing, a compressed workweek, and the ability to have more time with family or on a second job.
31 citations