For Amina Naser, working in emergency care is a high-stress environment that sometimes includes being assaulted by patients. (Photo: Cheryl Hwang)

911 : Paramedic Pressure

Working in emergency care is a high-stress environment that sometimes includes being assaulted by patients.

Paramedics have rewarding jobs, but by the end of a long day, their tired eyes have seen the worst moments in someone else’s life.
Working 12-hour shifts on a rotating schedule of seven days in a two-week period can be grueling physically, but it’s the profession’s mental toll that is of particular interest to Amina Naser.

The 23-year-old is two years into an occupation that’s both stimulating and rarely boring, yet she has learned the payoff for being first on the scene to provide emergency treatment often comes with a big downside. Post traumatic stress (PTSD) has pushed her to get help from therapists.
Ten to 15 percent of paramedics or Emergency Medical Service (EMS) professionals are medically diagnosed with PTSD, and many hide their suffering out of fear of losing their jobs, according to Naser and others.

The pressure and tension come from many aspects of the job. She starts her shift by driving 45 minutes to her station in Dolton, Illinois. Unlike other well funded ambulance services, her station does not have designated areas to park the ambulance until a call, so she and her partner wait on street corners and hospital parking lots.

An entry-level paramedic is paid about $13 an hour, and Naser is paid $13.50. Even with little pay, Naser keeps the job because she says it immediately connects her to the people she helps.

Her duty is to safely transport a patient to a medical facility after an emergency phone call and to provide necessary medical care along the way. When she gets called cases range from a nosebleed to a trauma case. After returning to the station, she fills out a pile of paperwork.

Many of her patients appear to be dealing with a mental health issue such as schizophrenia, depression or anxiety, according to Naser.
She says EMTs also encounter physical abuse from patients, adding that she doesn’t think there is enough training on de-escalation techniques.

“I can’t count how many times I’ve been pushed and shoved,” Naser says. “We are told, ‘Don’t let them hit you, if they push, push back.’ But how do you push back against someone who is sick, when you can rationalize it’s not their fault?”

Other training consists of a 4-hour lecture, a demonstration and a 10-question quiz. Naser says these may not be enough to help EMTs deal with the mental health issues they confront when treating patients.

The pressures Naser experiences at her job are in stark contrast to her home life. Asked about how she balances the two, Naser looks out the window next to her couch, eyes glassy, her voice slightly trembling and says, “I make a point to not leave dishes in the sink. I get this feeling like if something happens to me, I don’t want my mom to have to do the dishes and also worry about me. So I’ll do the dishes. I put on a necklace she gives me and drive to work.”

To effectively get through traumatic events, talking through the incidents helps. However, Naser finds it difficult to share her experiences with her family.
“I can’t talk to them about it, because they don’t know what it’s like to be on an ambulance. I had four trauma cases in one day and a suicide patient who brought a gun. We had police everywhere,” she says. “How do I explain this movie that happened in one day?”

At first, she had a hard time talking to therapists, because some would regard her job as entertainment value. Many people like to ask Naser about the craziest thing she’s seen.

“They want to know, have you seen somebody’s guts open? Have you seen somebody who took every single drug in the world?” Naser says. But she thinks about the saddest thing she ever saw three to four times in a day. “If I told you, you would end up crying,” she says.

One benefit of Naser’s job is the amount of extra time she spends with her coworkers, primarily at monthly dinners where they discuss job-related issues.

Naser also makes sure to check on her partners, who are often male and seemingly emotionless, to make sure they are all right on the drive back from a trauma case.

Naser has thought about her decision to go into emergency care. But after some back and forth, she decided she is happy with where she is.
“I love what I do. I love who I am and where this job has taken me,” she says. “But if I were to do it all over again, I don’t know if I could.”

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