It was a bad call; no question. The supervisor on duty had pulled the crew out of service for a couple of hours so they could talk, get something to eat, and restock the ambulance. Plans were underway to hold a formal debriefing of the incident for those who were present on scene. I contacted the paramedics who had responded to the call, with a message of concern and support.
After working in EMS for more than 15 years, I know the response to my outreach to crews involved in high-stress calls can vary considerably. Sometimes, we make plans to meet for coffee; sometimes, I schedule some ride along time with the crew members. And sometimes – quite often – the reply comes back, “thanks for your message. That incident was hard, but I have what I need; I talked it over with my partner and my supervisor, and I have a couple of days off coming up. But I really appreciate your support. It means a lot.”
The role of the leader is to be a witness. The image of the EMS leader or chaplain as witness comes from a legal context and describes one who has knowledge of something by recollection or experience, and who can tell about it accurately. Psychotherapist Kristi Pikiewicz writes that, “Bearing witness is a term that, used in psychology, refers to sharing our experiences with others, most notably in the communication to others of traumatic experiences.” This applies in particular to those in leadership and support roles – managers, supervisors, field training officers, chaplains – who bear witness to the experiences of the EMS provider, affirming that the event really happened, corroborating the story.
Bearing witness does not assume any pathology; there is nothing wrong with someone who experiences trauma, and there is nothing to fix. Rather, the role of the witness is to provide a safe place to process the activities that occur in the normal course of the job, which sometimes carry a significant amount of emotional weight. It consists of giving and receiving empathy and support, lightening the emotional load, and may be verbal or unspoken, a ministry of presence.
In his book, “The Gap: A Paramedic’s Summer on the Edge,” Paramedic Benjamin Gilmour writes, “Of course I’m pleased to have a recognition from my employer, recognition for the hundreds of days and nights spent rushing round the city and country towns I’ve worked in, helping those in need. I don’t want to be ungrateful, but this is not the type of recognition that sustains me; what does is the appreciation I get from patients and their families. Even simple words of encouragement from a colleague or manager mean more to me than a medal.”
Recognition and appreciation
Saying “thank you” is a simple act, but it means the world to the dispatcher who responded calmly to an urgent request for care, the ambulance crew who just finished a seemingly endless shift of interfacility transfers, and the critical care team who provided advanced care to a patient in need. Those two words are shorthand for, “I recognize and appreciate the skill and compassion you bring to this job every day.” Every crew would benefit from hearing those two words at the end of every shift. Rather than going home, thinking about the challenges of the work they do, a word of support and thanks lightens the load.
The sage wisdom of the poet Maya Angelou sums it up – “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
