Adrian McGrath MCPara from Northern Ireland discusses perceptions of stress in the current paramedic role
My dream was to be a paramedic back then, in those days we lifted stretchers into ambulances as the troubles in Northern Ireland alerted my colleagues to something gut wrenching minutes away. Where casualty departments inspired me as I saw consultants and young doctors being taught and managing in a timely fashion the sick trauma or medical patient that had just came through the door. Inspiration is a little harder to come by these days in that context. I achieved one of my dreams and I've probably grown, matured and absorbed what I could over the years. Currently, stress has a strong penumbral edge to it, as the wide measure of society and its illnesses and those increasing accidents of life demand our skills and energy on a much larger scale than what was needed in the past, with fewer resources. So where do we (I) go from here?
Personally, stress can subtly tease out the unseen good or hidden ability in us, where that propensity to overcome and to adapt to unforeseen situations (or delayed time) on scene enhances one’s ability to cope. However, that said, there’s a fine line in that sticky medicine of service and self-balance, whilst caring for another in that acute phase of trauma or illness. To be your best you have to feel your best. This only comes from re-energisation of the self with careful gentleness in how you approach the busy mind, the mind which most likely has seen something nasty, as the sensory and visual response post-shift kicks in. This is a necessary quality we must fulfil and master, in order to live a long, mentally healthy and purposeful life, whilst we work on that escalator of fuelled adrenaline at times! I've considered a complete alternative to this new era and changing face of the pre-hospital world I inhabit...thou that is yet to be decided! However, there is something honest and pure in being able to help another in their hour of need...so time will be my judge on that decision.
There is no quick fix here, the system is fractured and continually fracturing; and like any spiral fracture it can take a long while to heal itself, but undoubtedly it leaves its mark and weakness creating a fissure upon the system. My colleagues, who I admire give 100% everyday as they travel the highways and byways carrying out life-saving procedures at times whilst on route to hospital, whilst interacting with that multidisciplinary team of professionals we encounter each day; for that one, or perhaps multiple casualties we have to treat on the roadside, or in the various communities that we are invited into. The system is impinging on us and our response, in my opinion, is that we must be more visceral in how we react to this demand upon our physical wellbeing; and to recognise when we need to nourish the body as well as the soul, through our shared experiences, recognising when we need genuine time out. In order to carry on providing that cutting edge professionalism we offer to our patients.
We've got to try to hinder ourselves from becoming attached to that second victim syndrome, through that loading dose of stress which may be unresolved from previous calls, due to demand, or from re-living a terrible incident, where perhaps lethargy, mental fatigue or negative self-worth spirals our thought processes in these difficult, challenging and demanding times that we find currently ourselves in.
Maybe the periscope with how I see the world may need a new optic to recast and renew a fresh inspiration for me, as this New Year offers me its blank canvas of invitation and surprise. Other crises when one looks back into the history of turbulent times, would perhaps suggest at that time they also had to deal with such challenging structures of change in their communities, in accessing their necessary social or health needs; for life is merely passing through us and the only inherent gift we all have is to be resilient and kind towards our toughest challenges, to meet and filter stress with a fresh objective whilst we look after ourselves and each other, the best we can in these challenging times...
I don't want to lose any of my colleagues to terminal burnout or something even worse…