Impact of Stress on Paramedics - Essay Example

? Impact of stress on paramedics The paper entailed to seek information regarding paramedic’s occupational stress, which normally renders them to have trauma after a prolonged exposure to its critical conditions. These entailed lives’ loss by the casualties and other terrifying incidents, which mostly encompassed accidents. Post trauma stress encompasses emotional imbalances experienced by individuals who have witnessed psychologically disturbing episodes like accidents while executing their activities. Besides paramedics having undergone meticulous learning meant to impart them with adequate coping strategies while attending to their tasks, this has not aided effectively. Hence, almost all owing to humanity have developed trauma from these critical situations they normally witness. The information regarding this study emanated from contacting interviews on the paramedics, coupled with integrating it with literature from other related studies. Interviews entailed utter secrecy of the participants’ identity and freedom to decline from responding if they so wished. The Research unveiled that, PTSD besides affecting the paramedics individually (especially health); it also had adverse impacts on their families and close people whom they interacted with, daily. Additionally, owing to their unstable condition, their job performances also suffered their share of negative impacts because of tiredness and decreased concentration. Contents Abstract 2 Contents 3 Introduction 4 Method 7 Results 11 Results in vignettes 11 Finding Analysis 13 Discussion 14 Conclusion and Recommendations 15 References 16 Key words Posttraumatic Stress Disorder – PTSD Work-related stress Paramedics Job/work performance Introduction It is irrefutable that paramedics possess adequate and effective know how both in dealing and handling diverse emergencies entailing their patients. This emanates both from experience and learning they normally undertake regarding how to handle varied situations even the relatives of the ailing victims (Regehr, Goldberg & Hughes, 2002, p.). However, owing to the call and humanity that constitutes their being, with time they develop emotional connections with their ailing victims. This is due to their ardent desire to see them recuperate and resume their normal life, which to the lay people this is not quite clear and assume that it is like a job like any other (Regehr, Goldberg & Hughes, 2002). Paramedics while executing their respective roles in ensuring the wellbeing of emergence casualties, normally encounter human suffering and lives’ loss. Regehr, Goldberg and Hughes refer this as an emotional violence perpetrated to the paramedics as they intermingle with the calsualties due to what they see fellow humanity enduring. Besides their profession being a call and have undergone numerous studies in learning how to distant themselves from emotional connection (coping strategies) with victim or one’s relatives, these normally bear long-term adverse impacts in thier life (Regehr, Goldberg & Hughes, 2002, p. 506). For illustration, the ambulance paramedics who normally encounter numerous casualties while ferrying them to the necessary and effective health care institutions. Paramedics’ environment encompasses numerous incidents of both human pain and violence, which are inevitable and extent even to the operation quarters. Hence, all their activities revolve around these incidences, which make them vulnerable despite know how regarding coping strategies. This know how aids in distancing their emotions from those of the victims’ or relatives’ (Clohessy & Ehlers, 1999). Presently, there are no significant studies regarding the extent and prevalence of PTSD among paramedics. The notion of paramedics undergoing coping strategies training probably could have prompted researchers and the public to believe that, any incidences of PTSD are nonexistent (Johsson, Segesten and Mattson, 2003). Hence, lack any justifiable ground for any arguments concerning paramedics ever suffering from post trauma owing to numerous critical incidents that they have encountered and even witnessed. Conversely, the evident few studies regarding PTSD especially among the paramedics confirm adverse effects; mainly mentally and emotional attributed to critical incidents witnessed while working (Clohessy & Ehlers, 1999). Study by Clohessy and Ehlers encompassing 56 ambulance staffs who responded via questionnaires, 21% of the participants met the DSM-III-R criteria meant for PTSD, while 22% met GHQ screening criteria for psychiatric symptoms (Clohessy & Ehlers, 1999). Consequently, confirming significant prevalence evident amid the paramedics to experience PTSD. Owing to the absence of effective attention especially to the paramedics when PTSD shows up, the concerned people usually attribute its causes may be from other incidences. Additionally, Clohessy and Ehlers contend that, the paramedics’ PTSD prevalence ranges amid 10% to 17%, which is very high compared to both the police and fire service (Clohessy & Ehlers, 1999, p. 251). This is because paramedics normally respond to numerous emergence calls compared to the latter two categories and they have to encounter almost daily critical conditions. Hence, depict symptoms of probable psychological distress (Clohessy & Ehlers, 1999). Johsson, Segesten and Mattson (2003) contende the high occurrence of PTSD among the ambulance staffs amid the newly recruited had high statistics compared to the already experienced. However, the old staffs had the share of their adverse effects, which emanated from chronic exposure to the critical tragedies without swopping with other personnel and shift to less violence situations (Johsson, Segesten & Mattson, 2003, p. 505). The chronic exposure entailed combat zone (Mainly those incidents involving life loss and critical human suffering like accidents) staffs that have no option but to endure in their environment, hence exposing themselves to trauma. This triggers traumatic stress disorder where during their tasks they may be unaware of the results until the doctor after a prolonged exposure due to their behavior reveals the utter truth to them or their relatives (Johsson, Segesten & Mattson, 2003, p. 506). Johsson, Segesten & Mattson (2003) also argued occupational/job stress emanating from chronic exposure reported signs, which exceeded PTSD threshold. Bennett, Willims, Page, Hood and Woollard, (2004) study depicted PTSD rate of 22% from a sample of 1029 where 617 people had returned their questionnaires from crisis ambulance staffs. These findings did not vary according to the grade, but men depicted augmented statistics’ percentage contrary to women (concerning depression and anxiety), which were 23% and 15% respectively (Bennett, Willims, Page, Hood & Woollard, 2004, p. 235). Probably, this difference might have emanated from the male’s prowess to tackle numerous cases contrary to the women, but have decreased immune to harness traumatic stress. Blumenfield and Bryne (1997) observe posttraumatic incidents among the practitioners as they undertake their roles especially in the confinements of the health care and accidents’ venue. Primarily, this emanates from the continuous exposure to critical conditions that entail mostly accidents. Studies’ statistics so far presented regarding the crisis staffs imply that, there is a relationship amid the paramedics’ work arrangement and PTSD, anxiety and depression (Blumenfield & Bryne, 1997). The paramedics that are at the combat zone or where the critical conditions are at their severity normally experience intense impacts contrary to those in noncritical situations. For illustration, Clohessy and Ehlers’ study compares the paramedics with the police where the latter handles almost few cases entailing emergences. This is divergent to the paramedics where crisis characterizes their occupation and have specialized in it. Despite the paramedics’ training to distance their emotions and empathy from victims they are rescuing, this has become inevitable. Since, with continual attending of the victims the development of emotional connection normally occurs owing to the paramedics’ ardent desire to relieve the victims their pain. Primarily, this is via offering their services unselfishly coupled with understanding what the patients or their relatives are undergoing. Besides the critical conditions, which constitute their profession yield to an added stress where with prolonged exposure it becomes traumatic. Exposure time varies directly to PTSD, which is evident from the Johsson, Segesten and Mattson (2003) argument. The study contends the new recruits initially after their orientation normally experiences intense trauma or disturbed mind, but after sometime their condition is not worse than that the old staffs. Since their condition due to prolonged exposures and interactions with the victims has worsened their emotions. This is because of cognitive empathy that their coping strategies advocate otherwise, but owing to humanity, this has failed especially for numerous paramedics (Johsson, Segesten & Mattson, 2003). Method The findings attained in this research encompassed random sampling of the existing literature and interviews of the emergency crises personnel. Initially, the respondents have to feel secure and at ease to deliver the intended information, hence there was an assurance of hiding their identity. This aimed at shunning any probable damage either emotional or occupational that might affect them in retelling the findings when disclosed. For illustration, their posts, which they normally hold where, exposing the collected information it may yield to compromising their work. Furthermore, to attain and for the accomplishment of the research, there was a need to inform the respondents the core purpose of the study, which will trigger their willingness to offer the required information, which is adequate and reliable data. Hence, keeping of high ethical standards when collecting information and probing further worse incidents that entail their work and even long-term experiences. Data collection entailed ethnographic where besides relying on the observable traits of the respondents, its reliance also incorporated qualitative means. Since, the respondents’ prolonged exposure to the critical conditions, its effects manifested primarily from the observation of their physical health (Regehr, 2005). The interviews were one-on-one interactions with the respondents, which aids in probing life questions regarding experiences they normally encounter and how they affect them. This is both in the working environment, while they are with their families and universally social interactions with fellow peers. In addition, there were in depth question concerning individual experiences that one might have encountered while under stress and haunted by those critical situations while not working. The interview’s questions meant for the respondents, their framing revolved around the presented data by the literature, which argued stress does not only affect job performance but also a person’s health. To facilitate the effectiveness of the research, the researcher’s position ought to be neutral coupled with non-existent bias that may be evident in the process and shun the effectiveness of the study. There was also the aspect of anonymity on the part of the respondents’ delivered information besides being free to decline answering the framed questions in case one felt not to. Interview questions Universal Framed Interview Questions 1. How does work-related stress impact you during non-working days, during days/times you are with your family or friends, and times you spend for personal matters? This question seeks to ascertain how the impacts of critical conditions normally affect an individual private life. For illustration, when not working and in the company of loved ones, alone or fellow peers. Through reflection, regarding the past endured emotional balance incidents; they realize that they were not normal and stress interfered with their daily tasks. Respondents might report incidents of feeling very low, anxiety or infuriated. 2. How does work-related stress impact you during working days? The question seeks to highlight the impacts of the respondents’ emotional balance on the daily undertakings. Primarily, their responses entail loss of focus, and tiredness feeling. This emanates from sleep disturbances that they normally experience while working where they may start feeling sleepy or dizziness. Sometimes, this may entail sleep alterations where an individual may yield to feeling sleepy during the day early in the morning. Mainly this is the time one has to be working, which bears serious drawbacks on an employee’s job performance. 3. Had there been any minor or major life incident that you went through because of stress? Question ascertains any incident that the interviewee undergone prompted by stress. The response varies across the respondents, owing to varied habits of the individuals, which they adopt when experiencing stress. For illustration, one may be argumentative and seeking to swop shifts at least to have a change that will offer some comfort or rest. Others in the family may opt to vacate or order some changes in the manner they normally do things and devising unreasonable alterations. These normally emanate from the emotional imbalance domino effects one has experienced, which encompass paranoia, detachment etc. 4. Had there been any minor or major health effect you went through because of stress? This refers to the adverse health effects emanating from the emotional imbalance on the respondents. Responses depicted low appetite, insomnia, unexplainable both head and body aches besides low immune mainly characterized by proneness to maladies. In some incidents, due to the absence of mental alertness, respondents reveal varied accidents or injuries. These usually emanate from stumbling on objects and dropping objects fortuitously. 5. Had the impact of work-related stress on you impacted other people in your life? Explain. The question seeks to establish the effects of stress on those people who are close to the paramedics and how they normally handle them. Primarily, these are family members, relatives and colleagues whom the victim(s) usually intermingles(s) with daily. Sometimes, they may entail strangers especially when they happen in the line of the victims’ duties where they yield to roughing them up. Notably, the responses depicted by the interviewees are similar to those evident among the stress victims, which encompass inadequate job performance, poor health and emotional disturbances. Hence, affect close people owing to attitude, and mood alterations. The methods utilized in attaining comprehensive information from the crisis ambulance staffs incorporated their profiles. This featured duration they have served in their respective posts besides their present age. Profile Table for the Participants Name Years of Employment / Experience Age Department / Role Data Collected Zafer 6 31 Operations Interview Khalil 7 34 Ambulance Interview Moussa 5 30 Ambulance Interview Abed 7 32 Operations Interview Results Results in vignettes Findings contend that, stress emanates from emotional imbalance triggered by a past traumatic experience (Sofianopoulos, Williams, Archer, & Thompson, 2011). According to the interviews contacted, it was evident that via the paramedics’ revealing, posttraumatic situations had adverse impacts on their health and social interactions with fellow peers. Primarily, these affected especially their families and fellow peers whom they usually stay and interact. Additionally, they did confess experiencing feelings of annoyance, anxiety, guilt and even sadness owing to the critical situations they did encounter that entailed even lives loss by the victims they assisted. Results supported the hypothesis that, what paramedics were experiencing were not their normal feelings especially those encompassing of inadequacy owing to worry or anxiety (Sofianopoulos, Williams, Archer, & Thompson, 2011). Additionally, paramedics revealed reports entailing accidents mainly by dropping of objects or stumbling upon blocks that were not evident there earlier. Besides, paramedics revealed stress as having adverse impacts on their health. This encompassed altered sleeping patterns or insomnia where some could stay awake almost throughout the night. There were complains of body aches owing to inadequate sleep or sleep debt (Regehr, 2005). This affected their job performance where in their work they kept entertaining worries and trying to accomplish their tasks lastly and in hurry. Since, most of the time they normally spent regaining the energy they require to undertake the intended tasks due to the feelings of tiredness. Owing to the situations they were in, this also affected their families to the extent of some resulting to marital separations, besides financial predicaments (Regehr, 2005). Since the victims normally turn to be argumentative in numerous incidences, and always wanting things to go there way. For illustration, because their isolation behavior, they opt to vacate and dwell with their families in other places. Similarly, this is also evident in their workstations where they inquire the management to swop their shifts or transfer them to places where they will shun individuals who irritate them (Regehr, 2005). Table 1: Post-traumatic stress among Swedish ambulance personnel, Accessed from http://emj.bmj.com/content/20/1/79/T5.expansion.html SOC- Sense Of Coherence Mean SD t Non-traumatic events (n=137) Men (n=109)? 69.90 8.57 ?0.314 Women (n=28)? 70.54 9.72 Traumatic events (n=223) Men (n=175) 65.57 10.30 ?2.062* Women (n=48) 66.30 9.93 *Significant at the 0.05 level Table 2: The exploration of physical fatigue, sleep and depression in paramedics: a pilot study, By Sofianopoulos, S, Williams, B, Archer, F, & Thompson, B 2011 Finding Analysis Discussion Posttraumatic effects amid the paramedics have grievously, adversely and affected their normal lives; where some have adopted queer behaviors, for illustration, isolation. This is due to the stress that emanates from the nature of their work, which induces into them feelings of inadequacy, worry, lowliness etc (Regehr, 2005). Interviews encompassing the responses from Ambulance personnel confirm the ordeal experiences, which they normally undergo and their impacts, which extends even to their private lives. Consequently, affecting their families and close people (fellow peers) adversely. It is irrefutable that, when an individual is undergoing stress, mainly depicts itself via physical manifestations, for illustration, altered sleeping patterns that yield to sleep debt. The effects of sleep debt due to its accumulation normally features in their normal lives especially poor job performance besides decreased weight; emanating from fatigue (Sofianopoulos, Williams, Archer, & Thompson, 2011, p. 4). Besides, respondents complained of aches, which normally emanate from sleep debt because the body has not had adequate rest. These may become chronic, hence resulting serious maladies like Somatoform disorders. Remedy for sleep debt encompasses prolonged rest, which sometimes takes months (Sofianopoulos, Williams, Archer, & Thompson, 2011). Regehr has argued that, owing to the absence of early detection of PTSD, it has yielded to marital break ups and separations. Since, paramedics owing to their frustrations and stress that they are encountering normally transmit them to their spouses or result to conflicts. Primarily, conflicts entail arguing and disagreements where the paramedics yield to be short tempered (Beebe & Myers, 2012). Additionally, paramedics have also revealed low performances in their workstation owing to stress, fatigue, illnesses and injuries emanating from accidents that prompt them to either be absent or slow their working rate (Regehr, 2005). This is evident in Table 2, which depicts the percentage of paramedics’ performance affected by fatigue emanating from occupational stress due to the absence of early detection (Sofianopoulos, Williams, Archer & Thompson, 2011, p. 8). Posttraumatic stress amid the Swedish personnel, its statistics showed that men had a lower mean score contrary to women, which is evident in Table 1 (Johsson, Segesten & Mattson, 2003). In addition, according to the undertaken studies regarding the posttraumatic stress, men showed a high percentage of 23% contrary to women whose statistics entailed 15% (Bennett, Willims, Page, Hood & Woollard, 2004, p. 235). Probably, this emanated from the women’s nature of sharing their predicaments and being honest when they are seeking assistance. This is converse on the men’s side, since they normally tend to hide their true feelings by having a cover ups. The cover-ups may be overindulgence to either a habit or becoming workaholic due to their egocentric conduct. From the studies undertaken regarding stress and its advanced adverse effects, usually their remedy lies to a personal effective management besides early detection especially amid the individuals who may be in denial. The top management in shunning these incidents, ought to have rotational program that will ensure people who are at the combat zone do not overstay their and get affected by the critical situations (Johsson, Segesten & Mattson, 2003). This entails shifting workers who were in the combat zones to at least in mild situations whereas those experiencing posttraumatic stress given adequate time to recuperate prior returning to their normal duties. Conclusion and Recommendations Paramedics owing to their state of working environment that encompass critical conditions like violence and even loss of lives by the victims they are rescuing, has affected them adversely. This is due to posttraumatic stress whose effects extent to personal life besides lowering their job performance. For illustration, this has yielded to marital conflicts and even separations because the paramedics normally carry their frustrations and stress home unintentionally, hence transmitting to their spouses. Additionally, posttraumatic stress is transmittable where the victims may pass it to their fellow family members or peers due to their attitude or temperament where some become paranoid. Studies contend that, stress at its initial stages an individual can manage it effectively through adequate and proven techniques and seeking assistance when one cannot handle them as necessitated. Besides, top management ought to adopt effective and well-organized programs that will ensure certain paramedics do not overstay in their shifts for long especially those at combat zone via rotation. I also recommend that the management needs to institute timely health check ups for the paramedics coupled with mental and tackle the maladies early prior they result to worse situations. References Beebe, R. W. O., & Myers, J. (2012). Trauma care & EMS operations. Clifton Park, New York: Delmar Learning. Bennett, P., Willims, Y., Page, N., Hood, K., and Woollard, M.2004. Levels of mental health problems among UK emergency ambulance workers. Emergency Medicine Journal, 21, 235-236. Blumenfield, M., and Bryne, D.W. 1997. Development of Posttraumatic Stress Disorder in Urban Emergency Medical Service Workers. Medscape Psychiatry and Mental Health eJournal, 2 (5). Clohessy S, Ehlers A. 1999. PTSD symptoms, responses to intrusive memories and coping in ambulance service workers. Br J Clin Psychol , 38:251–65. Johsson, A., Segesten, K., and Mattson, B. 2003. Post-traumatic stress among Swedish ambulance personnel. Emergency Medicine Journal, 20(1): 79-84. Regehr, C 2005, Bringing the Trauma Home: Spouses Of Paramedics, Journal Of Loss & Trauma, 10, 2, pp. 97-114, viewed 4 June 2012. Regehr, C., Goldberg, G., and Hughes, J. 2002. Exposure to human tragedy, empathy, and trauma in ambulance paramedics. American Journal of Orthopsychiatry, 72(4): 505 – 513. Sofianopoulos, S, Williams, B, Archer, F, & Thompson, B 2011, The exploration of physical fatigue, sleep and depression in paramedics: a pilot study, Journal Of Emergency Primary Health Care, 9, 1, pp. 1-33, viewed 4 June 2012. Read More