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I think of a person. A crusty, bitchy, unhappy person or someone who may have been this way and is now making an excuse for his or her departure from the profession: “I used to be in EMS, but I got ‘burned out’ doing it.”
Our individual senses of duty and the resulting expectations for what our daily professional lives will be like can be the kindling for “burnout.” We fail to ask ourselves often enough, “Why am I here?” outside of the context of the 3:00AM call from a mother who can’t get her baby to stop crying, or the guy who has had toe pain for a week. Why are we here? If we think we are here to care only for the sickest and most critically injured patients and that anything else is beneath us, we are most certainly going to be disappointed.
How do EMS professionals arrive at these expectations? Many of them come from the sensationalism about EMS in the media, some come from EMS folklore about the profession and some come from denial—a protective response to the threat the mundane presents to our perceptions of the importance of what we do. Whatever the source of these expectations, they attract people to our profession and also push them out the door. I believe that the majority of us have pure and altruistic motives for entering EMS. I will concede, however, that some go into it to drive fast, to be authority figures and to be recognized as heroes. One can often spot these folks sporting their agency-identifying apparel while grocery shopping or going to the movies off-duty, to which I usually shake my head and mumble under my breath, “Dork.”
So how do we go from “I want to help” to “I’m burned out?” It is akin to what killed the dinosaurs; they failed to adapt. Many of us start out thinking we are going to preserve life and limb all of the time, on every call. We, the ones fortunate enough to learn to accept that this is not the case, adapt our views and press on. We learn that we can expect a heaping helping of sub-acute, social work-esque responsibility in our daily professional lives and that we may be occasionally blessed with a righteous shooting or a tube. This adaptation allows us to maintain our sense of duty and to remember that we are here because the person in front of us has exhausted his or her ability to deal with the current problem. It also gives us a modicum of predictability in our daily work lives because we resign ourselves to the fact that most of the calls will be what they are, rather than what we want them to be.
The walnut-size-brained dinosaurs who fail to make this professional adaptation are the ones who get “burned out.” Rather than accept the reality of what the job has to offer, they are perpetually disappointed by their unreasonable expectations. They fight to make reality conform to their skewed beliefs about what their professional lives should be like by treating patients who don’t meet their expectations as a bother. And as if incessant bitching will change the world, they become the EMS curmudgeons, poisoning their colleagues and their agencies with venomous speech and unbecoming behavior. At the extreme, this can lead to mistreatment of patients and co-workers and to “flame-out” as a result of “burnout.”
Life in EMS is not always easy, but it can be very rewarding. We’re a family and we have to look out for each other and ourselves. The Skeptic’s advice, take it or leave it, to all of the EMS family is, if you need help, get help. It’s best for you and for your family at home. If you’re “burned out,” get a new job. It’s best for the rest of us and for our patients.
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EMS Skeptic 