In my family history, there are persons who have suffered, and continue to suffer mild, moderate and - in one case - severe mental health issues. Apart from the severe case, much of this was never diagnosed. As children we were told that such and such a person was ‘bad with their nerves’. My parents’ generation didn’t talk about such things, which only made matters worse. I guess all this puts me ‘at risk’.
This didn’t even occur to me when I joined the ambulance service and applied to become a paramedic. But after some years of being out there ‘on the road’, I came to realise a couple of important facts. Firstly, there are many, many families that have to contend with mental health issues on a daily basis, and some of these issues are utterly soul destroying. If I am at risk, so it seems is much of the population. Secondly, being a paramedic can be good (as well as bad) for my mental health. Let’s put it this way: in what percentage of the calls we attend is there somebody there who is really pleased to see us, and very grateful for all we have tried to do? The gratitude of patients, families and the general public, in my experience, far outweighs the abuse we get.
These days in practice, when I frequently find ways of keeping folk out of hospital, it seems to me they are even more grateful! All this is psychologically positive and has a great impact on my personal sense of well being. We all need to be ‘stroked’, say the psychologists, and alongside this positive affirmation, there is a great deal of job satisfaction in making a good referral. But what of the downside of the job? Maybe I’ve been lucky over the years. Compared to some of my colleagues, I haven’t seen too many mangled bodies, and the biggest major incident I’ve ever attended was a county-wide flooding which went on for a couple of weeks. But those severe mental health incidents in the middle of the night, they unnerve me. They are just a bit too close to home sometimes, which leads to another important realisation: we are all vulnerable over something. In some ways, to do this job, you have to harden up. If every messy injury or sad social situation gets under your skin, then you are probably in the wrong job. But no matter how strong you are in yourself, you are human, and there is always the risk that one incident you attend will find your weak spot and hit your mental health where it hurts. Fortunately, nowadays, it is ok to say that you are not ok.
For the many paramedics who move ‘off the road’ into another role, the risks to your mental health start to appear from other directions. In primary care, the patient that turned up late with a seemingly intractable problem, when you were already feeling mentally drained, well they may have left your clinic, but they just won’t leave your head. In education, it might be the pressure to take on more students or inflate grades. In management, you can have a great day, successfully completing the tasks you set out to do, then that one little email on top of all the others, whoever it is from, whatever it is about, that’s the one that punches a big fat hole in your resilience and wrecks you for the rest of the week. What do you do about all this? What do I do about all this? Think back...what is the first thing you are taught to do when approaching a scene? ‘Check for dangers.’ If you don’t do this, you may become a casualty and then we have a bigger problem. But how many of us check for dangers in our own lives?
These days I am much more aware of the dangers, and there are a few things I do that might be termed ‘preventative medicine’. They could equally be called: ‘switch off, focus on the positives and enjoy life!’ I love playing guitar, mostly bass guitar, and although I am not particularly proficient, playing in a band means having to concentrate and forget about work for a while, and being a paramedic helps in some ways: if I play a few bum notes, or we have a bad gig, well, well nobody died did they? After all, it’s only rock’n’roll. Recently I have been learning to sail dinghies, and again, I have to concentrate, or I am going to fall into the river. Most importantly, for all I said about mental health issues, I have some very positive relationships with family and friends, and here’s a tip: no matter how much you love this amazing profession, make an effort to keep up with your friends outside of work. They will still be with you when work becomes a thing of the past, and they will help to keep you sane. Finally, for me, there is a lot to be said for having an energetic dog. Like most of my patients, he is always pleased to see me, and on a miserable wet days like today, he insists I get some exercise!
National CPD Lead (Education), College of Paramedics