EMS and Police peeps: want to hear your thoughts and opinions!
August 14, 2012 11:32 AM   Subscribe

For the EMS/medic/police/etc. group, a question - how do you cope with what you see on a daily basis? Does it wear on you, psychologically? Any other tips for someone looking at going into the EMS field? Tips for one looking into the police field, specifically women officers? [Bunch of long-winded questions inside! =P]

Medic questions:
I recently went on a ride-along with for my EMS dispatching job with one of our BLS units. The day consisted of visiting two different nursing homes/assisted living facilities (which were drastically different places) and taking the patients to their doctor's appointments and back. Over the course of the day I posed this question to both of the EMT's: how do you deal with or cope with going into these places every single day? Both of the guys were newer to the field but still have done it long enough to know what I meant. They both answered similarly: you learn to not think about that, you think about your 'here and now', the patient you have, and their well-being while in your care.
My question to you MeFi folks is the same...how did you/do you cope with it? I have seriously considered going through my local EMT program (possibly the paramedic program as well) after a very good talk with a long-time friend of mine who is one of the program's instructors. But I'm one of those people who gets teary when walking through a nursing home, so I don't know that I could deal with it on a daily basis.
--vomit. I'm not a fan, I can't even watch the videos where people throw up on Tosh.0 or AFV without gagging. [blood/guts/gore doesn't bother me in the least, oddly...] I'm sure you have the 'save the life and be grossed out later on' instinct that kicks in during most situations, but still...how have you all dealt with what grosses you out/makes you sick/turns your tummy during your time?
--though I'm sure I could ask the multiple friends I've got in EMS, I'd like opinions from strangers on the pros/cons of the EMS life and profession. (Don't be afraid to be blunt and honest!)

Police questions:
--I've been around this law enforcement stuff my whole life but have known very few females who were patrol officers. Most of the departments around here have one, maybe two female patrol officers and I think those few are part time, school officers, or reserve officers. I know it's a very non-feminist question, but how safe is it for females in the field? My fiance doesn't want me doing patrol because he makes a valid point: I'm 5'6" and fairly small, he is 6' and a former Marine...there is no way I could overtake someone his size in a life-threatening situation where I was on my own until backup arrived. However my counter-argument to that is always the same...I would be in possession of a gun, a taser, a baton, and other things. [Not saying that's always guarantee of safety, mind you...I know many who have been hurt or who have fallen in the line of duty in similar situations.] Any opinions on the matter of females in the police field?
--As with the EMS question...would like some honest opinions, pros/cons of the patrol officer/police field in general.

I love my dispatching job, it's a great feeling to know that I have played a part in helping save someone's life when I took their 911 call and dispatched my medic units to them. I just don't know that I would like to dispatch forever, much as I like doing it. I could always ask my co-workers in both the EMS and law enforcement fields about all the above things, but I would like some thoughts from MeFi about it all first.
Many thanks in advance! =D
posted by PeppahCat to Human Relations (16 answers total) 9 users marked this as a favorite
I am not a first responder but I know and have known quite a few, and most of them have quit (changed jobs so that they were less on the street), ended up kind of mental, or turned into calloused, and often prejudiced, jerks after 5 years. YMMV, of course.

However, the departments around me seem to use a lot of female officers, and a big part of why they're useful is exactly BECAUSE they're female and smaller. Most of the ones I've noticed are very small, even for women, in fact. People will talk to women officers when they won't to men. Men who are confronted with a female officer don't tend to get as chest-bumpy as they don when confronted with male officers. Kids don't get as freaked out. There are a lot of advantages.

Mostly I see two officers, a man and a woman, and the woman is usually standing closer and doing a lot more active listening.
posted by small_ruminant at 12:00 PM on August 14, 2012

I'm an ER doctor.

I don't have to actually go to where the patients are picked up (thank god), but I do have to deal with them when they show up, sometimes covered in every bodily fluid, sometimes with something wrong with them that is tragic, heartbreaking, or just plain horrifying (i.e. self-inflicted gunshot wound to the face in a cancer patient. Father runs in with his 2 year old who he accidentally backed into in the driveway, massive trauma). The mature defense mechanisms are what most people use: humor, sublimation, thought suppression, etc. Obviously with cases like the ones I just mentioned there can be no humor, but there are a lot of other cases where humor can really help. Others might be surprised or shocked to know how much joking sometimes goes on around running a code. This is how we can get through the day, it just takes emotional intelligence to know when you're crossing the line into inappropriate/offensive or if you're audibly joking around people's friends/family or the people themselves.

As for the physical grossness, there are a number of tricks you'll learn. Like wearing a surgical mask with something that smells strong/better inside it (cologne if you have it, benzoin if you don't). Or if you don't have a mask you can just smear that stuff on your upper lip under your nose. Or you just excuse yourself for a few minutes of fresh air if you need to.
posted by treehorn+bunny at 12:09 PM on August 14, 2012 [4 favorites]

I went through EMT school and a while ago Husbunny was a nurse. I loved everything about the emergency room. No fluids bothered me to begin with and as we went along, things didn't really get worse for me. I'm a dispassionate person by nature.

Husbunny worked with geriatric patients in a nursing home. He used to say, "You get to the point where you can change a man's diaper with one hand and eat a ham sandwich with the other." The point, you can get used to anything.

As for being an actual EMS person, I find that job low-paying and dangerous. Also, as we all get fatter, it's getting harder and harder to get folks in and out of their houses.

If you can dispatch, you're half-way to having the ability to be dispassionate, you can be calm when the person at the other end is losing his shit. That's an amazing skill.

You do get tough about these things, and unsympathetic. Which is best for everyone involved. No one needs their caregiver to be a sobbing mess, they need someone to help them.

You can take an EMT course at the local JC, it will include an internship. It's not that much of an investment, it can help you with your current job and you can see if it's something you want to pursue.
posted by Ruthless Bunny at 12:19 PM on August 14, 2012 [4 favorites]

EMT here. You learn to deal with the vomit, which is a good thing, because there is lots of it. Sometimes it's projectile vomit and it's dripping down on you from the ceiling. Mostly you're just focused on doing what needs to be done in that moment.

You never know exactly what you're going to find, which wears on you. You have routines and rituals post-call that help smooth things out. Your team becomes your family, very quickly.

As for the hopelessness, you just do the very best that you can for each patient at that time. My first EMS instructor liked to tell us that we were to be "the best part of the patient's worst day." Oftentimes patients are surprisingly grateful, especially when they're people who are not often treated with kindness and respect-- this includes the homeless, people in bad nursing homes, addicts, etc. Sometimes they're not grateful and they assault you. At one point, a very intoxicated patient simultaneously groped me and punched me. Thankfully, the police department was on scene and they... dealt with it.

The one time I really had to step away was when I got a really bad call involving someone I knew. That was rough. Consider your community and where you'd be running. Remember that the 3-car MVA you just got paged out for could be your worst nightmare. Also remember that every bad call is someone's worst nightmare. Behave accordingly.

Also, PS? The crustiest jerks are often the ones who connect most with the kids and the little old ladies. Sometimes it's an act.
posted by charmcityblues at 12:21 PM on August 14, 2012 [1 favorite]

I did EMT work when I was in college.

Vomit is pretty par for the course. There is a lot of it and if you are working evenings, it often smells of alcohol as well. The smell is strong because the truck is small. I used to put Carmex or similar under my nose sometimes. There is also a kind of instinct that turns on for me where I revert to my training. I get very calm and very organized. I do what needs to be done methodically and quickly, there are no emotions involved. However:

When riding an ACLS truck, you are often dealing with people who are having one of the worst days of their lives. Some of the things I saw are horrifying. While I was able to deal with the immediate situation, the emotional fallout was too great for me when it kicked in later. Honestly, it's been nearly 20 years and I still have perfect and awful recall of some of the scenes I responded to. I still don't know that I am emotionally equipped to do that kind of work. I'm glad to have the skills I do and I use them a lot since I live in an area where there is a lot of outdoor activities, but I couldn't do it for a living.
posted by kamikazegopher at 12:22 PM on August 14, 2012 [2 favorites]

After doing this kind of job for awhile, it dawns on you that it would be hard not to do something to assist with all of the things - problems, ailments, trauma, etc. - that you have seen. It's like knowing that these things happen means that you have to do something about it. And in my experience, you get used to the smells.
posted by analog at 1:21 PM on August 14, 2012

I'm a paramedic, and have about 15 years total in EMS. I think there's a nature/nurture combination that favors good coping skills. Certain people are more attracted to the field, and those are often the kinds of folks who are better able to process the disturbing elements of what we see. Bear in mind that the gross things aren't necessarily the troubling part of calls, although a sufficient level of grossness can even gross me out. What might bother you is seeing someone in a terrible situation (a hoarder on a slow mental and physical decline) or making a personal connection with a patient (spending time in a ruined car together trying to distract them as colleagues try to extricate their pinned legs). It can be almost anything. Certain people just like being in that position, and they'll bring their full coping abilities to bear in order to stay there. We deal with it because that's the price of running calls, and I can't imagine a career doing anything else.

Aside from some constitutional factors, coping skills are learned. The more you do it, the better perspective you bring to the next call. I've never turned into the bitter, uncaring, burned out ass that's the stereotype for the longtime EMS worker. I probably have more compassion for my patients than ever, because I feel confident enough about my ability to separate my own feelings from what I see. I don't worry too much about compassion fatigue, so I'm free to express compassion.

Humor helps, obviously. Many new people cultivate an attitude of dark humor, although I feel less need to do this nowadays. Having a good peer group that understands we're not superhuman and is willing to process human feelings helps a lot, too. What's increasingly important to me is the realization that I meet people on what may be the worst day of their lives, and everything I do or say is therefore important. I might not be able to make a difference in their outcome, but they may remember a supportive word, a gesture, a reassuring touch on the shoulder. All those things may have an enormous effect down the road. Having spent some time in ambulances and ERs as a patient, I can attest to that.

No small effort is wasted. That knowledge sustains me.

Now, as for sympathetic puking, it happens to some people. I know some people like that, and they've learned to deal with it. It helps a LOT when you have a job to do, because you just focus on the task before you. Many things that gross me out as a bystander have no effect whatsoever on me when I'm on the job.
posted by itstheclamsname at 1:25 PM on August 14, 2012 [5 favorites]

I am not a police officer, but I'm on the road to it.

I've had two police veterans as my instructors so far, one male, one female. Neither was physically intimidating.

Although I'm not a woman, like you I am 5'6" and not physically intimidating. I have often seen women as role models in my life, and I'm no different in my aspired-to law enforcement career. To be quite honest, I watch a fair amount of those "police women of X" shows when I need motivation or encouragement.

Being able to beat someone up in a one on one fight is not really a primary goal for police officers. Look at any video or photo of the arrest of a non-compliant person, how many officers do you see? It's almost always 3 or 4 or 5 or more. Look at this video of the arrest of one scrawny dude in a ferrari, there's a bunch of cops there within moments.

The police do not "fight fair" because that is not their goal or purpose.

Most of your time as a police officer would be spent talking and writing. Showing up to a domestic violence call at the same house for the fifth time in a month. Clearing the drunk guy out of the gas station. That kind of stuff.

Regarding dealing with it, well, obviously I'm not a cop yet so I'm not sure. I am a combat veteran though, and there are probably similarities. It's been five years since I got home and I'm still jumpier and more easily startled than I used to be. I still have those memories. But I have a boyfriend and family and friends that I can lean on for support on those occasions when I've needed it.
posted by kavasa at 1:28 PM on August 14, 2012 [1 favorite]

I had a friend who was an EMT, progressing to Sheriff and eventually DEA. When he was first on patrol as a Sheriff, he told me that not being able to talk about what they see is a common cause of divorce in law enforcement, since communication would reasonably fall apart once they starting holding back on talking out the disturbing (or annoying, or...) stuff they deal with.
posted by rhizome at 2:13 PM on August 14, 2012

Rule of Tactics #1: If you find yourself in a fair fight, your tactics suck.

If you are a cop, your police training on how to deal with non-compliant citizens will reinforce this rule and teach you how to make conflicts unfair (in your favor). Generally speaking you will be taught how to gain the tactical advantage by summoning additional officers, etc. You will also be taught several non-violent methods for deescalation of a situation or how to delay until the situation changes in your favor. And, if you're in the U.S., you will generally be armed to the teeth with some or all of the following: collapsible baton, pepper spray, taser and at least one firearm.

On the down side, many people who would not be inclined to take their chances with a 6' tall cop will feel otherwise about smaller officers. You will get into fights. You will sometimes get your ass kicked. If you are not comfortable with those things, policing may not be for you.
posted by Hylas at 2:43 PM on August 14, 2012 [1 favorite]

Along with what the others have suggested, I'll add my 2 cents based on 25 years in LE.

Give consideration to how the job will affect you and your fiancee. Whether it's EMT/FR or LE, the job can (will?) change you and your views of the world. Add in the shift work, the camaraderie on the job and it's easy to fall into the "Us vs Them" mentality that can seep into your personal life.

I talked to a neighbor a couple years ago who was going through the LE academy and warned him to watch for the temptations of the job. He assured me he would and that his wife and two little girls were first... he's divorced now.

The majority of folks are able to balance work and home just fine but you need to be aware so you can avoid potential problems.
posted by dknott123 at 3:52 PM on August 14, 2012

You do get tough about these things, and unsympathetic. Which is best for everyone involved.

I speak from experience when I say it's not usually best for the folks in your private life. I have only met a few people who can really separate their professional from their private life.

For instance, some anecdata: I don't know a single kid of an ER nurse or MD who didn't have a major medical problem (i.e., broken bones, septicemia, etc) overlooked because "it didn't seem serious." It gets so that if your foot isn't sticking out of your chest and you haven't completely stopped breathing, it doesn't look like any big deal to folks who deal with crazy trauma every day.
posted by small_ruminant at 5:13 PM on August 14, 2012

and what dknott123 says, in spades.
posted by small_ruminant at 5:13 PM on August 14, 2012

One of my good friends is a paramedic. I get the idea he's burning out on it. His sleep schedule is screwed up. However, he does a good job taking care of his patients, and he doesn't like vomit any more than you do. You can get used to about anything.

His main complaints are:

1) Nursing homes are often hellholes. He sees some awful patient neglect in some of those places.

2) He has grudges against certain local hospitals, because when they bring half-dead patients there, the doctors and nurses act like a bunch of put-out prima donnas about having to save these people's lives. He has given me a verbal list of ERs to skip, if at all possible. He is happy with most of the ERs around here, but he really hates some of them.

3) Family members of the patients very often make situations much, much worse than they have to be. He once picked up a teenage girl who had attempted suicide. The girl was a pretty cooperative patient, but her mother spent the entire time telling the paramedics about what a worthless pain in the ass her suicidal child was. He was trying to make the girl comfortable, but what could he do in a situation like that? He runs into a fair number of situations like this, and they suck.

On preview, I have to second small_ruminant. My friend doesn't have kids, but he doesn't take his own health seriously enough because his basis for comparison is kind of off. I was the one who insisted on calling 911 when our landlord filled our house with carbon monoxide -- he thought we'd aired out the house well enough and could just go to bed. The firefighters found otherwise. (We wouldn't have died, but we would have gotten pretty sick.)

So yes, getting too used to bad stuff is not a good thing.
posted by Coatlicue at 5:42 PM on August 14, 2012

Response by poster: Very interesting insight/input, gang. Much appreciated!
I'm still really on the fence about all of it but want to have some good ideas on what I'd be getting into, potential for things happening that I'd never thought about, etc. Is a lot to think about and while I'm sure I'd enjoy either profession for a while (who doesn't like their job on occasion, right?) I want to make sure I've thought things through pretty well first.

Thanks bunches!
posted by PeppahCat at 8:52 PM on August 15, 2012

You've gotten some excellent answers already but I'll add my own, for what it's worth:

I used to work as a nurse’s aide in a busy trauma center, where I dealt with puke, blood, etc. on a regular basis. The puke was never a big deal for me. I would just mask up and mouth breath until it was taken care of. A lot of my coworkers dealt with it by rubbing Vick’s under their nose a few times per shift.

As for all of the f*d up stuff I saw there (families destroyed by drunk drivers, mangled train/car accident victims, gang violence victims, etc.), I dealt with it by either talking about it with co-workers or family members in the medical field, or by writing about it in a journal. I found that once I had put an experience into words, it no longer (well, rarely) continued to weigh on my heart.

A few posters mentioned using humor. This is how many of the doctors, nurses and other aides I worked with dealt with it. If this is how you find yourself coping, please please please make sure you never joke about a patient or a situation anywhere near within earshot of any other patients or relatives/friends of any patients. I cannot possibly stress that enough.

I remember when a pair of senior nurses made a series of cracks on a busy night about an unconscious elderly stroke victim that had defecated on himself, not knowing that the victim’s wife was sitting out in the hallway and could hear everything. I noticed it, gave them the signal to knock it off, and quickly closed the door. When I turned to her, tears were streaming down her face and she started profusely apologizing to me for her husband, as if either her or her husband had actually done anything wrong. It was one of the most heartbreaking things I’ve ever seen in my life.

What I mean to say is, you'll get used all of it pretty quickly after a couple of months of seeing dozens of patients a day. Just try never to forget that each of those patients are not only people, but incredibly complex people with the same hopes, dreams and fears as you. Don't ever be responsible for giving someone the impression that he/she is just another body on the gurney.
posted by Kevtaro at 9:00 PM on August 16, 2012 [3 favorites]

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