Burnout...The Other Silent Killer

Burnout is a terrible thing that we all learn about in paramedic school.  It's usually discussed in the first couple of chapters of the paramedic book, but never again, really.  Burnout sucks.  When you get to the point that showing up at work makes you cringe and you start developing creative excuses for calling out or going home early, you're getting there.  When you lose focus and forget about why we do what we do, and allow that to change the way you do things, speak to people and think, you've probably gotten there.

Recently, I hit what others have told me was my "first burnout".  A burnout that, thankfully, is easy to overcome.  I've been asked by other paramedics, many of them newer than me, how I stay focused, appear calm, and always try to do what is best for my patients...basically, how am I not burned out.  My answer is usually that appearances are deceiving.  I've learned over the year to develop the paramedic version of a poker face.  That is, I don't show my emotion.  I don't allow my patients, their family members or my crew to see the stress in my head.  I keep it in my head.

As to how I strive to deliver par or above par patient care, the answer is simple.  Our patients, whether homeless, smelly, mean, nice, poor, wealthy, or what have you, are someone's family member.  They are a brother, sister, father, mother, aunt, uncle, cousin to someone.  They are someone to someone.  And we have been put on this earth, for at least this moment, to care for them.  So how do I stay focused, appear calm and attempt to do what is best for my patient?  I put myself in their shoes, or, better yet, I put a friend, or my parents, siblings, cousins, family members, in their shoes and remember that I have to respect my patients the exact same way I'd expect...and demand...a paramedic treat my family member.

But, I also explain that it is our responsibility to do what is best of the patient because that is our job.  We were not hired, nor did we attend school and ultimately get licensed to practice as paramedics and EMTs to sit on our asses and do nothing while our patients writhe in pain, wretch from nausea, cry due to depression, clutch their chests because of chest pain, or struggle to breath as a result of COPD; we got hired to act upon our callings to save lives and treat people in their time of need.  We come to work every day (for many of us, just three days a week...THREE out of seven), to be compassionate, to speak to our patients, to listen to our patients when they speak to us, and to treat our patients when they need us.

The practice of medicine is taking an interesting turn.  We've seen medicine all over the place (especially in the United States) move away from patient-focused medicine to finance-focused medicine.  Medicine has shifted away from a practice to a field in which we can be sued for making human errors.  From a field where good judgment, clinical gut, hands-on-diagnostics to a field where every test must be employed to cover ourselves from legal liability.  Ultimately, however, medicine is still and always will be about the patient.  If we fail to focus on our patients, on what they tell us, on their signs and symptoms, the minutia we find, what they feel like, sound like, smell like or look like, we will fail at providing patient-focused medicine. 

Again, we went to school to learn how to interact with other humans, to be humans who are capable of helping other humans when the need arises.  We went to school to do this, so, why not do this?  Why not give it your all, for three days a week?  Why become bothered and frustrated when someone makes you have a bad day.  For all intents and purposes, they called 911, so by definition, they're having a bad day!  That's why they made your day worse; why they're being rude or short with you.  They're sick!

So how do I try to continue to treat patients to the best of my ability even if I don't feel like it?  Because not feeling like it is not a legitimate excuse; it is an excuse that simply represents laziness, the inability to convey compassion.