Women in EMS: Part 1

Disclaimer: This is not a political article nor will I allow it to become one through the comments. It is simple facts and observations about the women who work in EMS and how our health and fitness come into play in this field.

I tried to come up with a catchy title for this article but realized one was not necessary.

Those of us in EMS are often called calloused, heartless, direct, brutally honest, no-nonsense, and the list continues by those who are not in EMS. This applies to both men and women. My own sister was the first to call me heartless after I came home frustrated by yet another OD. I approached it from a more logical stand-point, and she said just stared in shock and said that not even our parents – both in the emergency medical field longer than either of us have been alive – had sounded so heartless or disgusted after a shift. I told her to ask them about the time they got beat up by a grieving and worried family member – we both knew it happened – of that OD patient…who was potentially going to be the second death in that family in less than two weeks. My heart was breaking for that family member. I wasn’t mad when I looked in the mirror and realized that, unless I wanted to explain the developing bruises around my shoulder, I wasn’t going to be wearing tank tops for a week or two. To bring to mind everyone’s favorite Tin Man, I knew I wasn’t heartless because, instead of upset about those bruises, my heart was breaking for that family.

We go through a LOT in EMS. We have to be strong in every aspect of our lives to be in EMS without burning out.

Starting with mental health which ties in with emotional health, let’s look at the effects of stress on our body. The story above was honestly not stressful for me. It was frustrating, but I did not lose any sleep over it. I honestly probably wouldn’t have even mentioned it to my sister (HIPAA compliant of course) if she hadn’t seen the bruise and jokingly asked what I ran into or fell off of now. That incident was an acute stress for me – something that happened, got adrenaline going as my brain processed what was happening and what may need to happen if the situation changed. A chronic stress for me that did have a negative impact on my health was an awful partner and poor leaders who wouldn’t do their job regarding that partner for one month short of a year.

Breaking stress into acute vs chronic is simpler for me to explain than the more detailed categories mental health professionals have created for further clarification. (Here is an article that goes into a little more detail about those in-depth categories.) Acute stress can have a negative impact on one’s health depending on pre-existing conditions. My mother, for example, has a cardiac condition where acute stress – good and bad – could trigger a bad cardiac event. Chronic stress can lead to a whole plethora of problems, not the least of which is poor sleep.

Our bodies use sleep to reset. The brain uses the time we are sleeping to basically organize itself and reset for the next day. Neurotransmitters that have built up over the day due to different events and physical and mental responses now have the chance to break down to their base level for the next day’s events. Think about how crabby a child – or you – is when they didn’t get their nap or had to get up early. Now think about that happening every single night with you. Lack of sleep has been associated with mood disorders such as depression and anxiety. EMS providers are already at risk for these disorders and others because of what we see and experience in the field. Add lack of sleep to that experience…well, PTSD and suicidal attempts are rising problems in our brothers and sisters in our line of work for a reason.

Lack of sleep often leads to a compromised immune system. When our bodies are required to be constantly moving, our immune system does not have time to reset and build on messages it’s received. We get exposed to a LOT of lovely illnesses. I quit worrying about catching TB after only 6 months as an EMT in private transport due to the number of TB positive patients we transported before finding out they had already been declared TB positive, just no one bothered to tell the responding crew. Our immune systems should seem invincible, but if we don’t give it the time of sleep to strengthen, it will simply maintain and not be strong enough to fight infection when we do get sick.

Not getting enough sleep has also been tied to increased risk of cardiovascular disease, diabetes, obesity, stroke, and sleep apnea (when you do sleep). All of these possible effects of poor sleep habits are also risks of chronic stress – not just because chronic stress affects sleep. Don’t forget that lack of sleep slows the thinking process and reflexes, both of which are needed for driving something like a car or a squad.

Think about it. If your body is constantly in that state of fight or flight, your heart is working overtime on a constant basis with moments of working even harder still with acute stress that comes with our job when those tones drop.

How do you reduce your stress levels? How do you let your body rest and reset?

I like yoga. I took a semester of yoga at my local college which benefited my lifting as I was taught how to be aware of each individual muscle and how to activate each muscle. I learned different breathing techniques which has helped me and my patients on calls. My personal favorite was deep relaxation. In short, you are putting your body into such a relaxed state that you may fall asleep during the deep relaxation time. I used this when I was working 7p-7a and going to school full-time during the day (usually 8/9a – 3/4p). My yoga instructor said 20 minutes of deep relaxation – when done right – could give your body a reset as if you had just slept 2- 4 hours. I used every day between getting home from class and leaving for work.

Going outside for a walk in the park or a nature preserve can help; taking your shoes off while walking around a garden or by a lake has a calming effect for most people. (There is actually a huge scientific reason for this which you can read more about here.) I also have a Himalayan salt lamp which basically cancels out things like technology which can mess with our neurotransmitters. It has been shown that those salt lamps can help people with anxiety and different forms of depression. I personally have found that to be true. Right now, researchers are looking into cardiac and respiratory benefits of salt lamps with early results appearing promising.

Other coping strategies include talking with someone whether they are a trained counselor or psychologist or someone who is in our field of work and can relate to how you’re feeling. Exercise produces neurotransmitters which combat the overload of neurotransmitters resulting from chronic stress.

In Women in EMS Part 2, I’ll talk more about exercise and the fitness aspects of our field. I considered putting it all into one, very long article but felt this mental health, stress, aspect of our job was too important to just barely touch on as would have happened if combined with the exercise portion, which is also incredibly important as you will see next time if you haven’t realized it already!