An Ounce of Prevention

“An ounce of prevention is worth a pound of cure.”  -Benjamin Franklin

Throughout my career, I have been to maybe eight or nine critical incident stress debriefings.  I attended my first one when I was 17 years old after caring for a man who self-immolated as a means to take his own life.  Without getting into the details of this confidential event, the outcome for my family, who was on the call with me, and I was a long standing bond with the dispatchers in attendance.  About once a month for many years following, we used to take coffee and donuts down to the dispatch center to catch up with our new friends.

I have always been a person who encouraged everyone involved to attend CISM’s, and I think I have spoken about that here before.  To those who have said, “I am not going to get anything out of it” I am quick to remind them that it’s not all about them.  Sometimes the best thing that we can do is offer something in our own personal experiences to someone else in attendance.  Sometimes, knowing that you are not alone is the greatest reassurance that a person can receive which is why I push people to stand together.  I would never mandate anyone to attend a CISM, and neither should anyone else, but I always strongly encourage people to show up.

I do think, however, that we rely on CISM a little too heavily as a means to deal with the stress that people in our field shoulder day in and day out.  We sit back and watch people who struggle go to work every day.  We have all watched coworkers whose personal lives are crumbling around them, and have watched those personal issues spill over to their professional lives.  Heck, some of us have been those people.  We sit back and let people deteriorate because we don’t know what else to do.  Until something happens.

Until that bad call.  That big call.  CISM is usually tied to major events.   It’s that nasty wreck on the interstate, or that pediatric cardiac arrest that results in a crew begging to take the rest of the shift off.  It is at this point, this breaking point, that we finally intervene.  If the “right” person is on the call that needs some level of intervention, they might benefit from it but why do we always wait this long?  Despite the benefits of CISM in some of these cases, I have seen many, many people simply not recover from that low point that they hit.  It’s a sad testament to the stress that we face in the field, but even a sadder testament to our willingness to suppress our feelings and the struggles of those closest to us.  I don’t think that we do it maliciously, I just don’t think that we know what else we are supposed to do.

I took a stress management class the other day, and while much of it retreaded many points that have been made in classes before, there was one thing that stuck with me, which was the desire and overwhelming need for regular prevention.

Provider suicides are something that happen far too often.  In many instances, and in instances that I have personally been close to, people have been left saying, “I never expected them to take that route.”  We don’t see it coming, maybe because we choose to ignore it, or maybe because that person has just enough strength to put on that “everything is fine” mask when they don their uniform and head into work.  In other cases, however, when we retrospectively look at the deceased, the warning signs scream at us loudly, and clearly.

Hindsight is 20/20, but learning from the past and recognizing the warning signs, and doing what we can for our EMS family might make more of a difference for them than we realize.  I encourage everyone to take the time to check out the Code Green Campaign and read through the website, and the message that it delivers.

Finally, don’t rely on your employer to offer you prevention training.  There are plenty of resources out there that can tell us a lot about the warning signs that depressed and suicidal people exhibit.  Take the time to read up, especially on the Code Green Campaign’s resources, and make yourself informed.  Share it with your coworkers.  Take the first step and look out for each other.  Don’t wait to someone else to do it for you.

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