This CE activity is approved by EMS World Magazine, an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS), for 1.5 CEUs. There are two ways to take the CE test that accompanies this article and receive 1.5 hours of CE credit accredited by CECBEMS: 1. Click here to download a PDF of the test. The PDF has instructions for completing the test. 2. Or go to www.rapidce.com to take the test and immediately receive your CE credit. Questions? E-mail editor@EMSWorld.com.
To download this article in pdf format click here.
- Introduce and describe burnout.
- Define and explore the clinical symptoms and diagnostic criteria for post-traumatic stress disorder.
- Discuss strategies for improving mental health and improving individual coping mechanisms.
Many people, particularly those in the emergency and medical fields, go through emotional turmoil. In our careers in EMS we’ve had coworkers commit suicide and several partners with depression and alcohol abuse problems. In Melbourne, Australia over 36% of paramedics suffer some form of depression.1 In the United States, the Chicago Fire Department experienced seven suicides in an 18-month period between 2007 and 2008.2
EMS workers are subject to the high use of 9-1-1 systems and relatively frequent exposure to stressful situations, such as abuse cases, assaults, motor vehicle crashes, deaths, etc. All of this places providers, who otherwise have no training on how to personally deal with emotional stress, at high risk for emotional unrest and exhaustion. Without intervention, mental and emotional fatigue can rapidly lead to burnout in a provider.
What Is Burnout?
Burnout is typically described as an individual’s pattern of negative affective responses that further reduces his or her own job satisfaction, productivity and job performance and is known to increase absenteeism and turnover.3 It may also be an indicator of a more serious problem: post-traumatic stress disorder (PTSD).
Burnout, which is essentially the presence of a constant negative attitude toward any aspect of an individual’s work, goes through three phases: emotional exhaustion, depersonalization and losing one’s sense of personal accomplishment.3
There are many symptoms of emotional exhaustion, including a negative attitude, physical exhaustion, feeling “drained” and lacking the desire to interact with others. However, it can be best described as the provider who seems to have lost his or her sympathy and empathy for their patients.
When someone is depersonalizing in EMS, they speak negatively about their patients and belittle their own work. These attitudes are a coping mechanism intended to justify feelings that the affected patients are “less human” or “more deserving” of negative experiences, so no empathy for them is needed. A very dark example of this is thinking that someone, “got what they deserved.”
The last phase of burnout, loss of personal accomplishment, occurs when the provider with burnout gets only a reduced satisfaction, or no satisfaction out of their job.3
Burnout occurs for many reasons. In EMS burnout is attributed to: high call volumes—particularly with low-acuity patients; organizational limitations; limited medical scope of practice; and lack of rewards. Additionally, poor support and poor communication from leadership is known to further exacerbate burnout.3 One study found the top causes of emergency services burnout are: