The adrenaline rush for a paramedic is a stress like no other.
“You have to have an edge,” Lee Brown said. “Every run is an unknown, but we know we can control the unknown (through our training).”
Emergency medical personnel learn the paramedic craft at the Kentucky Emergency Medical Services Academy at Western Kentucky University in Bowling Green.
Brown is director of the program, which started offering a 65-credit-hour associate’s degree through the WKU Department of Allied Health on the fourth floor of the WKU Academic Complex about a year ago.
“People don’t realize how much information is thrown at you in a certain period of time,” said Steve Carpenter, a working paramedic at The Medical Center who serves as a guest instructor for KEMSA. He was a student in one of the early KEMSA classes in the late 1990s and said the program has grown by leaps and bounds since then.
The general public thinks of paramedics and emergency medical technicians as “ambulance drivers,” and people’s perception of the job is what they see on television, Carpenter said. Carpenter and Brown agreed that paramedics are much more than just ambulance drivers.
“We see things that people aren’t supposed to see,” Carpenter said. “You have to have a good support network, family, friends and strong faith to get through it. To be able to sustain this career path, you have to have something inside you that drives you to do it. You have chosen to serve others. I have put my life on the line to help someone else.”
Joe Dennison serves as program specialist for KEMSA, and like Brown and Carpenter has worked the front lines as a paramedic.
“Your reflexes are more keen. You are more aware,” Dennison said about working as a paramedic.
“That’s how we are wired,” Brown said. “That’s what separates us from those who don’t do this.”
While only 5 percent to 7 percent of ambulance runs constitute an emergency, it is during those emergencies when paramedics do their best work, Brown said.
Emergency medical services work is the No. 1 place to make a difference, Brown said. That difference may be made when the paramedic and partner are 40 miles from the nearest hospital and somebody’s life hangs in the balance.
Sometimes the paramedic can bring calm to the situation, and that lowers the stress level during the emergency call, Dennison said.
“I go about my business calmly and the person with the hypertension or hypercardiac symptoms calms down, too,” he said.
Dennison cited as an example going to an ambulance call where a baby had a fever seizure. “Everybody is in panic mode. Mom will literally throw the baby to me, and I will take the baby and pat it several times. Within 60 seconds, the baby is fine,” he said.
Brown said a paramedic can be a consoling force. She remembers a time when a man was shot and she sat in the hospital emergency room waiting area with the victim’s wife while he was administered to by the hospital staff. “She had no one,” Brown said. The man survived the gunshot, and Brown gained a new friend.
“You don’t always know what your role is going to be,” Brown said.
With modern health care, the role of the paramedic varies.
“Health care can be fragmented. We have that time to look after the patient,” Brown said. Just sitting and chatting with the patient can be important in the care approach. “We teach our students to treat people as a person – talk with them, not at them.”
Many times, the paramedic never knows the outcome of an emergency. Because of federal privacy laws, the paramedic can’t find out how a traffic accident victim who was transported by helicopter to Nashville fared once treatment there is concluded.
“It’s hard to get closure,” Brown said.
The idea for KEMSA is an outgrowth of an effort begun in 1994 in Bowling Green to meet the need of providing quality paramedics in Kentucky. Brown came about four years later to head up the program. Both are experienced emergency medical technicians, and new students who haven’t been inside an ambulance are served by KEMSA instructors, said Dennison, who worked as a paramedic for several years at The Medical Center. Class sizes are 12 to 15 students, the instructional approach is very hands-on, and students develop a closeness as they meet every third day. The class schedule helps paramedics who are in shift rotations, Dennison said.
“This (class schedule) allows a working paramedic to attend the class,” Dennison said. “About half of the students are working (EMTs).”
Brown and Dennison agreed it is a challenge to teach veterans and students who have never worked as emergency first responders in the same classroom.
“There are a lot of places where you have to have experience before you can work in an ambulance,” Brown said. “We have to be able to teach it two different ways – to the ones who have the experience and the ones who don’t.”
Brown said the students without working experience develop a bond with the experienced students, and vice versa.
Katie Ross of Clarksville, Tenn., is enrolled in the distance learning program at WKU and is taking the paramedic class one to two days a week on a noncredit basis at the Bowling Green campus. A former medic in the U.S. Army, she drives an hour and 15 minutes one way to get to Bowling Green and WKU.
She likes first-responder work because of the variety and the challenges.
“Every call is different, and every situation is different,” Ross said. “You just roll with it.”
Ross said her military experience in Kosovo, Germany and at Fort Campbell has taught her to adapt to her surroundings and work with what she has, many of the attributes required of a paramedic. She said she wants to help people and use the skills that she has developed over the years.
Rob Hicks of Bowling Green is a former volunteer firefighter in Missouri who is taking the WKU class to become a paramedic and add to his skill set. He already received an associate’s degree in fire safety in Independence, Mo.
“The (paramedic) material is very challenging,” Hicks said. “It’s like a crash course in a medical school.”
Hicks said he’s learned a lot and has been impressed with the level of instruction.
He, too, believes there is a great need for good, quality paramedics in society.
The demands of being a paramedic can also be a crash course in life stresses, Brown said. The first responder battles with the aftermath of the hair-trigger lifestyle. It can affect the paramedic physically.
Research shows that the stress of working as a paramedic can actually result in post-traumatic stress disorder, a medical condition more commonly found in combat veterans. Brown said PTSD stems from that adrenaline rush the paramedic undergoes during the emergency situation. The body will eventually show symptoms from the continual adrenaline rush, Brown said. The symptoms can become permanent, that research shows.
Psychologist Nancy Davis notes in a report online, “Incidents that Traumatize Emergency Service Workers,” that a study in 1999 found 21 percent of U.S. paramedics had PTSD.
Even in idyllic Hawaii, the emergency medical service personnel have not been spared.
“Traumatic exposure and symptoms of post-traumatic disorder” in Hawaii are documented in a U.S. study, reported Obesity, Fitness and Wellness Week magazine in an article on the website www.ems1.com.
Canadian Journal of Psychiatry, in its December 2002 edition, also cited the evidence of PTSD in a survey of 86 paramedics who completed questionnaires in the study. The 2002 article added that the PTSD symptoms can become chronic in nature for the emergency responders, to the point the condition is a “long-term functional disability.”
Brown said there is more awareness of mental health coping strategies to help paramedics deal with the PTSD symptoms.
As the health care delivery system matures in America, Brown said paramedics can play an important role.
The future of paramedicine, medical care practiced by paramedics, could find them in the day-to-day delivery of health care, particularly in rural areas, Brown said.
“We could play a more proactive community health role,” she said, noting that in recent years there has been more of a concentration on preventive health care. “With the skills that we have (as paramedics), we could function in community clinics. Our diagnostic skills have been incredibly honed, similar to the situations a physician’s assistant encounters.”
Brown also said that medics in the U.S. military who return stateside could be used to deliver health care.
“You can’t replace that health care experience,” she said. Placing paramedics and returning military medics in health care service positions, especially in rural areas where the medical experience is not plentiful, could lead to more efficiencies in health care delivery, she said.