Serving Those Who Serve in EMS with Naturopathic Medicine

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Written by: Dr. Seth Enos ND, EMT-P. Gumshoe Health Seattle

 

A career in Emergency medical services is a difficult one to perform. It is tough to do well and still yet more challenging than most will admit willingly, but it is a calling which we all take a certain pride in. That we run in when all others are running out.

Often we don’t acknowledge the sometimes overwhelming obstacles we face. Our culture takes a dim view to both whiners and braggarts alike, but this has also created a difficult atmosphere to reach out for support when we reach our breaking point. When does being a professional mean professionally acknowledging that we need help?

Many fear that the simple act of asking for help will end the career which we love most, and for many the only job we’ve ever known or wanted. Worse, those fears are not always unfounded. The risk of seeming unfit for duty, either physically or mentally, is often deemed too great to seek help in fear of losing all that we have worked so hard to do, that which gives us purpose, and keeps us around those who understand what we have been through. If this is starting to sound familiar then it is no surprise, a national survey in the spring of 2015 with more than four thousand responses found that these are common place thoughts, feelings, and realities that we all share. (Abbott, et al., 2015)

Physical perils abound in EMS, our work environment is ever variable along with the conditions we face in that environment. Control of our work area is temporary at best and taking a wrong step with a stair-chair or lifting a patient from the ground to a stretcher can result in a back, knee, or shoulder injury. Any of which can end a field career in a moment and leave a provider with years of surgery and physical therapy to deal with while being out of work. Training, experience, and patience go a long way to preventing mishaps but inevitably they happen. With long shifts and late night calls the odds are against providers. Protections surrounding physical injury on the job have improved with time but there is still much to be done. Physical therapy, osseous adjustment, medical massage, proper exercise, and good nutrition can go a long way. They can improve the odds of preventing physical injury on or off the job and improve healing post injury. Working with these tools I have seen many patients decrease their pain and recovery time while increasing their range of motion and energy levels. Combining these therapies has helped many to be as able, active and pain free as they wanted to be.

Mental, emotional, and spiritual fatigue are much harder to identify and deal with effectively. Collectively the culmination and breaking point of these stresses on the psyche have been termed Critical Stress (CS). (Abbott, et al., 2015) Less widely discussed but all too present is the stigma of a diagnosis or even the suspicion of a mental/emotional disease. Difficulty arises from all angles in this area starting with what defines a critical stress point and ends with what defines effective treatment.

There is great strength in understanding, confronting and dealing with one’s own challenges. Lao Tzu wrote: “Knowing others is intelligence; knowing yourself is true wisdom. Mastering others is strength; mastering yourself is true power.” (Tzu, 1992) While this is a lifelong, personal practice; having help and guidance with a health professional can improve clarity in your decisions and decrease anguish and the time it takes to achieve your goals. Many health professionals can offer tools like counseling, biofeedback, cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR) therapy, among others to help deal with the stresses of the job. Often just having a voice of reason to bounce ideas and feelings off of is enough to maintain a sense of order and stay grounded.

We all do things to relieve stress once it’s there, but what about changing how we perceive or process stress as it arises? Stress will always arise in our lives, we cannot avoid it and be functional, so changing how we deal with stress initially can go a long way to preventing the long term, chronic conditions associated with repeated, unresolved stressors. Many traditional techniques within yoga, meditation, qi gong or tai chi practices already focus on this process through routine and daily training. The ability to process stress or perceive it differently when it arises comes on like a side effect from the development and practice of the skills in the discipline. Western medicine has tried to catch up to these practices in its own, more quantitative rather than qualitative way through biofeedback therapy. Many people that I have worked with in EMS find biofeedback therapy to be helpful in that we can track both qualitative results, how they feel and react, as well as quantitative results, via the computer programs and sensors used in biofeedback sessions to track progress. Every person will find a mental/emotional/spiritual therapy or practice that works for them if they are honest with themselves and spend the time and work necessary to evaluate the therapies available to them. However, not every therapy works for every person. Thus it is usually a trial and error process to find what will work and what is fun. Often, whatever is fun, or at least enjoyable, is what works.

Ultimately treatment is a journey of experimentation and examination that is either aided or hampered by an individual’s understanding of what they need, the strength and vivacity of their support network, and the experiences they have undergone. Finding guidance through this process with the aid of a trained professional can be frustrating, depressing, and/or galling even in the best of conditions, especially when that counselor has little or no experience with EMS or PTSD. (Newland, Barber, Rose, & Young, 2015) As a paramedic I have witnessed this frustration first hand on numerous occasions. From the mundane issues, paperwork, management, and unions that erode our morale to the dramatic crises of human nature that play out before us and can leave us scarred for years to come EMS workers face challenges that wither even the most hardened without support and a chance for rejuvenation.

We never know what the next call will bring. Be it a routine frequent-flyer or a mass-casualty traumatic call; seeking the right help before physical and mental stressors set in puts you in a better place to adjust to the demands of the job and reduce the impact of long term, chronic damage from stress.

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References

Abbott, C., Barber, E., Burke, B., Harvey, J., Newland, C., Rose, M., & Young, A. (2015, 4 12). What’s Killing Our Medics? Reviving Responders, pp. 1-29.

Newland, C., Barber, E., Rose, M., & Young, A. (2015). Survey Reveals Alarming Rates of EMS Provider Stress and Thoughts of Suicide. Journal of Emergency Medical Services, 30-34.

Tzu, L. (1992). Tao Te Ching. New York, NY: Harper Collins.

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