Who rescues the rescuer?: Why self care in EMS is life or death - - PDF document

Who rescues the rescuer?: Why self care in EMS is life or death

Kristen M. Cline BSN RN CEN CPEN TCRN CFRN CTRN CCRN- Solheim Enterprises

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Adverse Childhood Experiences Study (ACE)

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• Abuse
• Emotional
• Physical
• Sexual

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• Household challenges
• Mother treated violently
• Substance abuse in the household
• Mental illness in the household
• Parental separation or divorce
• Incarcerated household member

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• Neglect
• Emotional

neglect

• Physical neglect

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Study findings of note- prevalence

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ACEs and health implications

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ACEs and health implications

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ACEs and health implications

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Generational trauma

• Epigenetic changes d/t trauma are now believed to be inherited
• Children of survivors suffer mortality effects of traumatic events even if they

didn’t personally experience them

• Documented in civil war soldiers
• Holocaust survivors
• Somalian refugees
• Native Americans
• African Americans

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Generational trauma

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Trauma informed care

• Trauma is common, multifactorial, and affects ALL patients
• Patients are vulnerable: power discrepancy may trigger a trauma

response

• Reactions of anger may be manifestations of fear/anxiety related

to trauma

• Many chronic illnesses can be traced back to trauma
• Caregivers have their own complex history of trauma that

may affect the care provided to patients in acute crisis

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Secondary traumatic stress

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Vicarious traumatization

• Exposure to the traumatic

experiences of other people

• An inevitable occupational

challenge for the field of victim services

• Effects are insidious and

cumulative

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Secondary Traumatic Stress

• Sometimes known as ‘compassion fatigue’
• Definition- ‘the natural consequent

behaviors resulting from knowledge about a traumatizing event experienced by another. It is the stress resulting from helping or wanting to help a traumatized or suffering person’

• Can be exacerbated by the caregiver’s own

personal traumatic experiences

• Burnout- results from long term non-supportive

work environments, exposure to other people’s trauma is not the precipitating factor

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Symptoms of STS

• 70% of care providers experienced at

least one symptom in past week

• Fatigue, illness, cynicism, irritability,

reduced productivity, feelings of hopelessness, anger, despair, sadness, nightmares, anxiety, avoidance of people or activities, persistent anger/sadness

• Effects at work- increased sick leave, low

morale, less effective workers

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• Loss of pleasure that your role had previously

brought

• Inability to maintain balance of empathy and
• bjectivity (becoming over-involved with

patients)

• Increased irritability and blaming of others

(including patients)

• Diminished sense of personal

accomplishment

• Overly high expectations of self or others
• Decreased ability to feel joy

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• Feeling ineffectual and less capable
• Feelings of hopelessness
• Chronic lateness
• Ineffective and/or self-destructive

coping strategies (working even harder, drinking, etc)

• Lowered functioning in non-

professional situations (less socially competent, less interested and engaged in normally pleasurable activities)

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Self care

• Access Employee Assistance Program
• Online counseling services
• Better Help
• Talk Space
• Start small- choose one self care activity to

commit yourself to

• Learn to say ‘no’ (including OT)
• Support each other, reach out if someone seems

to be struggling

• Regular check ins with staff and colleagues,

debriefings

• Use your PTO!
• Listen to your body- sleep and rest if you need to

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@traumainformednurse

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Take care of each other! traumainformednurse@gmail.com

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