Emergency medical services (EMS) workers may experience mental, physical, and emotional stresses every shift they work. It is a job which commonly has high levels of stress, increasing incidents of post-traumatic stress disorder (PTSD), and on the job injuries. These issues contribute to high rates of suicide, job-related burnout, clinical depression, and physical conditions which no longer allows the EMS provider to work in the field. Personal health and physical, emotional, and mental wellness play a critical role in helping EMS workers survive in their careers.
EMS workers are highly-trained, medical personnel who assist, or work as an extension of, a physician, usually in the pre-hospital setting. Modern-day EMS began after the National Research Council released their 1966 White paper titled, Accidental Death and Disability: The Neglected Disease of Modern Society. It found that due to the high incidence of accidental death in the United States, public safety needed to include national, standardized, and advanced medical training. This paper was the impetus for the National Standard Paramedic Curriculum. In 2014, the United States (US) Department of Labor, Bureau of Labor Statistics estimated there were 241,200 paramedic jobs with a predicted 24% job growth rate over the following 8 years. Since its inception, EMS providers have long been known for their ability to help patients in the most extreme circumstances. This may happen in any setting, from the middle of a major interstate highway during the heat of summer, to the open farmlands in freezing temperatures, to the highest of crime-ridden areas of urban areas. Along with dealing with difficult environments and high patient acuity, the release of catecholamines while driving “lights and siren” has labeled many in the industry as “adrenaline junkies.” These aspects of the job attract specific personality types to the EMS field. Dr. Jeffery Mitchell documented general personality traits of emergency personnel as:
- Need to be in control
- Highly motivated by internal factors
- High need for stimulation
- Need immediate gratification
- Easily bored
- Risk takers
- Rescue personality
- Highly dedicated
- Strong demand to be needed
Mitchell stated that these traits make EMS workers continue to work, even in the face of harm to themselves. In addition to the mental and emotional toll the industry can take on the provider, it is not uncommon to go from deep sleep to moving a 300-pound (136 kg) patient 15 minutes later. There is no time for stretching or warming the muscles up before they are stressed. Furthermore, until recently, most EMS agencies worked 24-hour shifts for their employees. This schedule, in addition to low wages and the need for multiple jobs, was a significant reason for the sleep debt providers incur. Sleep debt is defined as the difference between the amount the EMS provider can obtain, and the amount of sleep the EMS provider requires not to feel severely tired. Over one-half of all EMS workers report inadequate sleep, poor sleep quality, and/or poor recovery between shifts.