It seems like every day there is another story on first responder fatigue, poor resiliency and stress. Has the job gotten that bad that no one can survive it anymore? Or does the problem lie within us?
I will argue that much of the problem lies with us. Let me explain.
There is no arguing that in the past call volumes were not nearly what they are today. EMT’s had to do a lot more with a lot less yet it was, for the most part, a career that people retired from. This begs the question; were previous generations tougher and more resilient than todays current cadre of EMT’s or are they just different?
Allow me to draw some parallels.
The EMS Diet: In the past we can argue that life moved at a slower pace, this was reflected in the limited options for going out and purchasing food. Meals were often planned and eaten at the base or at a sit-down restaurant. Of course, call volume and transport times have also affected this however back then there was not a convenience store on every corner with an endless array of nothing healthy.
Our nutrition has changed so much and so quickly that first responders are simply not eating a balanced diet of healthy natural foods. Foods that allow the body to heal, repair, recover and grow. Instead many first responders have fallen into the processed, fast food, sugar laden and chemical filled world we now live in.
Did you realize that in 1977 when fat became evil and sugar became good there was an almost immediate spike on obesity, cancer and many of the diseases we treat today. 1
Further, we can look at a simple study that shows what happened when we became a carbohydrate (added sugars) rich diet and not a balanced diet with few refined oils, meats or processed foods. The bottom line is that food should heal and not harm; what we eat harms us.
Fit for duty:
There is no debate that we have become a very sedentary country. Gym class is gone in many schools and with the advent of technology we spend an increasing amount of time sitting, usually with a screen in our face. This presents two distinct problems.
- We are creatures of motion not meant to be sedentary or take on the shape of a chair. Previous generations were not tied to a screen. As more and more jobs, hobbies and past times become sedentary we have seen the predictable, yet preventable, shift in first responder fitness, wellness and I will argue physical resiliency.
EMS is a 100% physical job, an argument that I have made many times before. No matter how much we throw engineered solutions at the problem we still have to move the patient. We still have to able to lift and move our gear. Having written and validated over a dozen EMS physical abilities tests plus administering over 5000 tests its truly chilling to see how deconditioned and immobile the current generation of first responders has become.
The solution is radically simple. Test all your employees at hire and annually after that. Fit for duty is not a luxury, it’s a down right necessity as fit employees get hurt less then un fit first responders. Give them access to fitness equipment and teach them how to manage the aches and pains of the job, something I personally have been fighting to change for over a decade in EMS.
How can we expect EMT’s to remain resilient and with risk averse behaviors when by the design the system breaks them down? From an operational perspective it is far cheaper to keep an employee healthy and on the job to retirement then to constantly hire new employees that will only stay for a few years.
It’s far less expensive to have a fit employee that is free from injury then to pay for the claim when they have an MI on duty, a CVA, a MSI or an MVC.
It is far easier on an operation to invest in an EMT’s education before they have substance abuse issues, poor health, PTSD, anger issues, risky behavior or worse. It is up to us as a profession to teach new and incumbent responders how to survive the job. Stop rushing new employees through haphazard training just to get them on the street, this is the true definition of insanity.
Instead teach them how to be fit for duty, teach them how to employ sleep hygiene strategies, teach them how to eat in the field, make them experts at safe patient handling and equipment use. Educate them about risk in EMS, the root cause of injuries, exposures, slips and assaults before they hit the street.
Resource: Injury Free University by Fit Responder www.fitresponder.com
- National Center for Health Statistics (US). Health, United States, 2008: With Special Feature on the Health of Young Adults.Hyattsville (MD): National Center for Health Statistics (US); 2009 Mar. Chartbook