Saturday, May 24, 2014

CIS and PTSD

I've been thinking a lot about critical incident stress (CIS) and post-traumatic stress disorder (PTSD) lately. They taught us the list of symptoms in school as well as the requisite 'ask for help if you need help' routine, but it is so much more real than that. I had a partner a few weeks ago who exhibited at least half a dozen symptoms within the first 2 hours of our shift, and many more medics show signs as well. It is impossible to do what we do and not be impacted by it, to not have it change us in some way.

The response I've seen to it so far is twofold. On the surface, there is support and cheerleading, both management and medics say the right thing when asked, post supportive links on facebook and champion CIS/PTSD causes. However, when actually faced with somebody who is having difficult, the actual response is much less by-the-book. Medics who are struggling are faced with ridicule on the street level, as if nobody actually realizes what is happening. Comments like "they need to just grow the f*** up" or "somebody needs to find a new career" are not helpful. They minimize the difficulty that medic is going through, turning their struggle into a maturity issue or personality flaw.

I'm not sure that there will ever be a solution. Retirement rates for paramedics are dismal, sitting around 4%. I am a big fan of the work the Tema Conter foundation is doing, and the more I watch Flashpoint reruns, the more I realize that they brought a personal touch to CIS. There is a lot more work to be done, and it comes down to the need to change attitudes of all the street-level staff. When a supervisor makes disparaging comments about another medic at role call, anonymously or not, it sets a terrible tone for everybody. When a crew is begrudgingly given an hour max by dispatch to decompress after a terrible call, like a murdered child or an MCI with multiple fatalities, it drags down both the personal and collective moral. I know we have to be tough to deal with everything, but there has to be some room for compassion. Not just for our patients, but for each other. More communication, less gossip. More support, less judgement.