The Stressful Demands of an EMS Provider

“911, what is your emergency?” The familiar question that gives dispatch the information to send police, firefighters, or emergency medical service (EMS) providers to individuals in need. The first medical care some patients receive in times of critical care is from an EMS provider. EMS providers are separated into four levels based off training and the services they can provide: emergency medical responder, emergency medical technician (EMT), advanced EMT, and paramedic [1]. Medical emergencies are categorized as either basic life service (BLS) or advanced life service (ALS), which dictates which level of providers need to respond to the scene. Responding to emergencies is undoubtedly stress inducing, as evident by a study that showed paramedics demonstrated greater increases in anxiety (P < .05) and salivary cortisol levels (P < .05) after a simulated high-stress event [2]. What aspects of responding as an EMS provider contributes to the high stress of the occupation and more importantly, what actions are being taken to minimize the stress of EMS providers?

A study of 119 EMS providers showed that crisis situations, role conflict as a professional job, social factors, and involvement in an EMS organization were the most significant factors contributing to stress. The same study also found that there was a relationship between the degree of stress, fatigue, and job satisfaction of subjects [3]. Another study found that the characteristics predicting higher stress were “EMT-basic (A) licensure, basic life support (BLS) only service provider, volunteer status, new employee working in a small EMS organization, and providing service to a small town” [4]. In other words, career providers with more advanced training and more years of experience demonstrated lower levels of stress. One explanation given these factors is that EMS providers learn how to manage stressful calls more effectively after more experience and guidance. In the long term, high stress levels contribute to health conditions such as high blood pressure, heart disease, obesity and diabetes [5].

To address these factors and reduce the stress of an EMS job, there are currently many programs in place such as “financial assistance, social events that encourage communication and interaction, recommended/sanctioned time off, and a clear recruitment/retention plan” [6]. Additionally, humor provides comical relief to mitigate the negative effects of stress. Specifically, cynical and dark humor was found to be helpful for first responders in various relationships [7]. Social support also helps first responders manage stressors and EMS providers are encouraged to talk amongst their crew following a stressful call.

As a nationally certified EMT, I have had personal experience living through the stressful demands associated with being an EMS provider. Especially as a newly certified EMT, there were situations I was placed in where I felt additional stress performing tasks that I had only practiced in scenarios. The most stressful case I have had to respond to was a major car accident on a highway that unfortunately involved multiple children. With the additional danger of providing treatment on the side of the highway with only a neon vest to protect me from passing cars, I felt a constant rush of adrenaline assisting the paramedics on scene. Nevertheless, the stress was all worth being able to help transport the families safely to the hospital. I believe that the stressful nature of being an EMS provider should not deter anyone from pursuing becoming one. Furthermore, stress minimizing measures that are implemented in the EMS field can also be applied to fields beyond and help reduce the stress of working in general and help foster happiness in workers.

References:

1. The National Highway Traffic Safety Administration. (2021). National EMS Education Standards. EMS.gov. Retrieved November 11, 2021, from https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems-Approach/National_EMS_Education_Standards.pdf.

2. Leblanc, V. R., Regehr, C., Tavares, W., Scott, A. K., Macdonald, R., & King, K. (2012). The impact of stress on paramedic performance during simulated critical events. Prehospital and disaster medicine, 27(4), 369–374. https://doi.org/10.1017/S1049023X12001021

3. Park, K. W., &amp; Park, K. (2012). Influence of job environment, job stress, and fatigue on job satisfaction of nurse: Focused on medical treatment departments of General Hospital. Journal of Korea Service Management Society, 13(5), 59–79. https://doi.org/10.15706/jksms.2012.13.5.003

4. Cydulka, R. K., Emerman, C. L., Shade, B., & Kubincanek, J. (1997). Stress levels in EMS personnel: a national survey. Prehospital and disaster medicine, 12(2), 136–140.

5. How stress affects your body and behavior. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987. Published March 24, 2021. Accessed November 19, 2021.

6. Folwell, A., & Kauer, T. (2018). ‘You see a baby die and you’re not fine:’ a case study of stress and coping strategies in volunteer emergency medical technicians. Journal of Applied Communication Research, 46:6, 723-743, DOI: 10.1080/00909882.2018.1549745

7. Rowe, Alison & Regehr, Cheryl. (2010). Whatever Gets You Through Today: An Examination of Cynical Humor Among Emergency Service Professionals. Journal of Loss and Trauma. 15. 448-464. 10.1080/15325024.2010.507661.