Wellbeing
Dealing with distressing situations
The nature of the work of a paramedic means that sometimes, you will go to incidents that are difficult, challenging, and emotionally distressing. With this in mind, it is important to consider, before such events, the nature of calls, events, or appointments if you work in non-emergency care, that you may find difficult, how you have reacted in the past to difficult or distressing situations to understand what might be helpful to you in future events, and who would be on your ‘go to’ list for support when you need to call on someone.
In the first few days and weeks after witnessing a distressing incident, it is completely normal to feel shaken by it, and to experience upset, anxiousness, disrupted sleep, and to have repeated thoughts about it. It is also normal in those first few days to feel detached from it, perhaps as if it didn’t happen.
Nevertheless, these feelings and behaviours in the longer term, particularly after a month or more after the event, or if they greatly impact your everyday life, may mean that you’re experiencing a traumatic stress reaction. In this case, it is wise to consult with your doctor who may refer you for psychotherapeutic supports and/or treatments.
Your employer’s occupational health department will also be able to provide you with access to appropriate psychological health services and can advise on organisational supports that may be helpful.
The Ambulance Staff Charity provide useful information about dealing with the aftermath of distressing incidents.
The Ambulance Staff Charity
TASC is a wellbeing hub for ambulance staff. There is a 24-hour support line for anyone in crisis 0300 373 0898.
For non-urgent assistance, you can contact TASC by phone on 02477987922 or by email: support@theasc.org.uk.
Moral Distress
Moral distress can be described as a form of psychological distress that occurs following behavioural actions or in actions that violate our moral or ethical code. There were many accounts of paramedics experiencing moral distress during the Covid-19 pandemic where, for example, they were asked to adopt new clinical practices, some of which meant that they were required to not transfer patients to hospital for treatment that previously would have been.
This resulted in some paramedics experiencing guilt, shame, anger, and a sense that they were betraying their patients by not providing the care that they felt they needed or were being betrayed by their employing organisations. Some also began to question their purpose as, and what it meant to be a paramedic.
It is possible that as a newly qualified paramedic, you may experience this kind of anguish that feels very conflicting and may lead to strong emotional responses such as those highlighted above. Situations where others have reported feeling the impact of moral distress include being unable to provide the care or treatment that you know your patient needs, but specialist resources are not available (such as a midwife, HEMS, mental health practitioner).
Moral distress is a normal human response to such situations where your moral and ethical code has been challenged. When moral distress becomes prolonged, it can lead to moral injury which is a more intense form of distress. However, neither are classed as mental health conditions. If any of the above resonates with how you’re feeling, one of the best ways to counter this is to talk with others; colleagues, fellow students, your lecturer or manager, or someone you trust. It is also quite appropriate to seek out formal supports such as counselling or psychotherapy, where professionals can provide a confidential space to support you in processing your experiences.