Spiritual Health in EMS

In our chosen profession, we know that it is essential to keep physically fit, emotionally balanced and psychologically sound. One element that always seems missing is how healthy we are on a spiritual level.

Whether we believe in a God in heaven, a higher being, or the power of nature, I think we can all agree on the fact that there is a life force within everyone, regardless of our religious beliefs. We are not merely electro-chemical robots.

Very simply put, cardiac cells have automaticity, when they no longer make the heart beat, they still give off electricity, causing the heart to move in a dysrhythmic and uncoordinated manner. Finally, the heart ceases to perfuse the body and the result is clinical and/or biological death. If we "shock" the heart in the chaotic state of ventricular fibrillation or pulseless ventricular tachycardia, it does not jump-start the heart as most non-medical people believe. We do not have a car battery in our chest.

As we know, electrotherapy stops the heart, allowing it to reset and theoretically beat normally once again, providing much needed blood to the vital organs and the entire organism. The question is not what makes the heart beat again, but what makes the heart begin in the first place.

As pre-hospital health care providers on the front line of medicine, we are closer to life and death than most of our neighbors and colleagues would ever want to be. When a sick heart suffers clinical death and suddenly comes back to viability, how does it happen? Shock three times, sometimes stop the heart with a drug we give or make the heart beat deliberately faster--give it the gas or take the break off... Whether we use the life pack 12, the Zoll, push adenosine, atropine, epinephrine or the other drugs in our arsenal to fight death, what the heck makes it work? More so, what makes it work only sometimes? All of us have seen a healthy young individual die from cardiac arrest and an elderly, unhealthy individual come back to life.

Death is a disturbing prospect for all of us. When life finally ceases, what is left? Yet some of see it on a monthly, weekly, or daily basis.

Remember, along time ago, when your office was not the front seat or rear of an ambulance, a plane or a helicopter, when death was a tragic thing that only touched your life occasionally? Now, look at how many times a year you deal with death and dying. Now, you experience death a hundred or a thousand fold more than most individuals do. There is no phone call in the middle of the night to tell you that a relative has "passed on." Death for you is in as close proximity as your partner in the next seat.

Dealing with not dealing with it

As with any other living being, survival is the highest level of priority. If we stop and contemplate the reality of death and dying, we would be as troubled as the most disturbed of all our patients. To deal with horrific situations, our survival instincts kick into gear and we go into a necessary form of denial. Is this good? Probably not. Is this coping mechanism essential for us to continue to do our assigned work? Of course! How else would we be able to function?

Let us go back to the earliest days of our training. A part of any EMS curriculum, taught the different strategies of coping with our upcoming vocation. We learned the dos and don'ts of dealing with stress. Most of us remember what not to do.

Don't drink in excess, don't bring the job home and take it out on loved ones, don't internalize too much, in short don't fall into clinical depression. Physical exercise seemed to be the cure all for relieving stress. Just what I want to do after a twelve-hour shift. It will probably be the first thing I will do after stopping off at Krispy Kreme for a cup of coffee and a couple of freshly made donuts. I hope I am the exception and not the rule. However, sometimes all of us feel wiped and don't take care of ourselves properly.

Multifaceted Approach