Saturday, March 6, 2010

Stress

I was recently interviewing prospective employees as a senior medic on the peer review panel. I came up with a number of questions to get the applicant talking and to try to get an impression of their experience level. I asked them “How do you deal with stress?” The majority of replies were “Good” or “I’m good with stress”.

Clearly these people had no idea what I was talking about. And why would they? Most of them have not been medics very long. Or they work in rural areas with low call volume. I wondered if they are really prepared for a position in a very busy urban system.

Much like Nicholas Cage in “Bringing Out the Dead”, I see ghosts. Not on the streets but in my memory of those streets. Every street I drive down in this city brings out a ghost. Calls gone well and calls gone bad. I frequently point out addresses to partners and say “Remember that call?” It is an unrealized hazard of a great memory. Some of them I don’t want to see, I would rather forget much of my experience here. Who wants to remember the smell of death, decaying bodies, the sights of suffering? But it has made me who I am, for better or worse.

But there are other stressors, the lack of respect and abuse of the system. There are also frustrations with shift work and working weekends. The lack of a real career ladder offers no hope of advancement or recognition. The job has become repetitious exercise in futility.

I have had my share of demons to fight. I have been burnt out. A firefighter told me once he brought a bucket to the call so he could pick up my compassion when I spilled it in the lobby. My anger has been an issue as has been my impatience. I am a can do person and I don’t do well when I’m not allowed to. Yet I am still here in this love-hate relationship with my career. I haven’t gone it alone though. I’ve sought out help when I need it. Knowing when to get help is half of the battle.

So here’s what I’ve learned. Stress is yours and no one else’s. No one can fix it but you. It’s up to you to do something about it. The ghost Rose, that haunts Nicholas Cage, says “I didn’t ask you to suffer, that was your idea.”

If you find yourself suffering from

Insomnia, change in appetite, aches and pains, frequent colds or illnesses such as back pain, digestive problems, headaches or feelings of intense and long-term tiredness.

Bad moods such as defensiveness, irrationality, being irritable, being critical, aggressive or overreaction and reacting emotionally, increased absenteeism and negativity. Or a loss of interest in things you liked previously.

It is time to do something about it. These symptoms uncorrected will harm your health as well as your career.

What can you do? Let’s start with the EMS diet. We all know fast food is crap, the 99 cent heart attack. Limit your fast and refined foods. Eat more vegetables, fruits and complex carbohydrates. Take a vitamin and cut the fat.

Sleep, EMS people sure frig this up. Rotating shifts and multiple jobs ruin sleep patterns. Get into a pattern and get at least 4 hours of continuous sleep. More is always better, we all know we need 8 hours.

Exercise at least 20 minutes, 5 days a week. I have been doing P90X, I have lost twenty pounds and feel much better about myself. The yoga has been the most satisfying. It brings balance and clarity. I love to bicycle when the weather is good and I have time.

Talk, let it out. Burying it only makes it rot. Talk to your spouse, friends or coworkers. Someone in the field may understand but try to find friends outside EMS as well. Seek out your employee assistance programs, most EMS agencies have something. If all else fails, see your doctor. Your PCP can refer you to specialized help.

When at work be accepting and flexible. Your way is not the only way. Try to establish a routine, a regular schedule or pattern of good habits. I try to get here early so I can get the checklist and narcotic log done before I have to start running my ass off. Communicate with everybody supervisors and peers, friends reduce stress.

Most importantly, maintain a sense of humor. Laughter is the best medicine and people will seek you out for it.