I'm Fine: Systemic Affect of Critical Incidents in Emergency Medical Service Personnel Communication

Abstract

EMS personnel experience emotionally charged calls, such as CPR, trauma, or domestic violence. This study examined the changes on communication by these events. Communication Complex metaframework allowed use of other disciplines. There is a lack of scholarship surrounding EMS communication. Research from other military and other fields was translated into the EMS community. Mental illness is a growing concern in EMS as 37% contemplate suicide and 6% complete it. Part of understanding the affect is an exploration of how the culture of EMS (i.e. training, traditions, machismo) shapes the way new EMS are acculturated. EMS have repeated exposure to trauma over a career. These exposures change communication patterns. Using a three-chapter autoethnography, I was able to examine my communication and mental status changes from rookie until retiring 14 years later with PTSD and constant suicidal ideation. Ethnographic interviews of veteran EMS provided insight into the old school ideology of emotional repression and shelving. I analyzed using the NREMT Patient Assessment skill sheet as a guide in a three-step process to discover and reassess themes. The primary survey indicated common job-related stressors- pedi calls and staffing problems. The secondary survey revealed themes of emotions, senses, and support. Finally, the reassessment revealed subtle changes in EMS culture, including decreased PTSD stigma, increased resiliency training, and increased administrative support. Future research could examine the effect of spousal support and changes in cultural emotional suppression. The goal is to develop programs to help allies understand the emotionality in EMS and create dedicated support structures to increase EMS mental health.