1) BE SAFE
STOP. Are you physically and mentally able to continue your shift? If not or you are in doubt, contact your supervisor immediately and tap out, if necessary, even if it's just for a brief time or a quick rest. There is no shame in admitting your limits, and it helps no one if you become an additional victim.
2) Put yourself back together
Take things one step at a time and get yourself presentable again. Pull out the SHTF bag (see below). Wash up or shower. Change your uniform. Clean your boots. Whether you clean the rig beforehand or not will depend on the situation and the policies of your service, but go through whatever motions you need to get yourself back to your normal physical baseline.
A side note: sometimes the greatest act of service one crew can do for another is to clean a truck and get it functional again so the affected crew can focus on themselves. I have watched with admiration as a supervisor told her crew to go get cleaned up and took the mop herself to clean the rig. THAT is true leadership.
3) Rehydrate and refuel
Drink a big glass of water. Stress is dehydrating, and hydration helps you cope with stress. Don't forget to get a solid meal as soon as you can as well. If you have trouble eating under stress like I do, then make sure there are people who help monitor that you take that next bite.
4) Don't procrastinate
I know it's tempting to try forgeting the events of the call, but that report isn't going away and those details are going to fade quickly—all the moreso because you want to forget. As soon as you are able, get your narrative written and all the boxes checked. Sometimes that can even help you process what happened. Then move quickly to the next step...
5) Activate your support system
Notice I didn't say build—I said activate. That means you already know who you are going to call to support you. Find someone to talk to without reservations and spill it all.
--your partner (caution: she/he may be having difficulty coping)
--coworkers
--your significant other
--close friends
--an EMS dinosaur
--the leader of your circle of faith/or the on-call Chaplain
--your service's mental health providers
6) Be a good partner
It's important to respect others' coping mechanisms, but it's also important to be there for your coworkers. Check up on those around you. Talk to them. ASK how they are doing after the call, on the next shift, a week later, a month later. Get through things together and have each others' backs. Sometimes more peace can be found over beer and tacos than in any conference room.
7) Recognize if you need further help
Anyone can get beat down working in EMS, but if your difficulties (sadness, insomnia, chronic health problems, flashbacks/dissociation, depression, sexual difficulties) last more than two weeks, interfere with your daily life, and/or you are having thoughts of suicide, contact a professional or your service's EAP. If someone you trust recommends you get help, LISTEN.
There are also resources that can help:
Safe Call Now
206-459-3020
Code Green Campaign
SHTF Bag
--Spare uniform
Make sure the uniform in your bag is decent (no old, faded BDUs) and check occasionally to make sure it still fits. Include another belt (the webbed ones can be difficult to clean quickly) and include an extra set of pins, should you need them.
--Nice, comfortable (pretty) unmentionables
Just because this bag isn't accessed often doesn't mean you have to put the old, worn out clothes in it. When you pull this bag from your locker or vehicle, you need pampering. Go for the high end stuff that's comfortable and builds confidence.
--Good socks
Just do it. In fact, never don't do this.
--Boot cleaning tools or extra boots
Brushes, picks, whatever you use. You don't want to get stuck using an old paintbrush handle from the engine bay to dig clay from the treads. Trust me on that one. It sucks. Also, remember an extra set of boot laces. A broken lace can put you out of service.
--Trash bag for dirty uniform/boots
Some things you can wash at the station. Some things you can't. But you don't want contaminants in your bag or in your car. Plan for containment. Remember also that sometimes a uniform is not redeemable. If that happens, cut your loses and request another.
--Laundry detergent/fabric softener
Washing clothes at the station is great, but it can be mildly uncomfortable when your clothes smell strange. Use your home detergent to add more normalcy.
--Shampoo/conditioner/toiletries--your favorite or a special smell
When you're covered in mud or someone else's blood or worse, it's not a time for the bargain shampoo. Get a travel bottle (or small refillable bottle) of the good stuff or your normal faire. Don't forget a bath poufy and/or razor.
--Hair dryer/Make up
Throw in a clippy or scrunchy in case you don't have time to dry your hair. Makeup may not be essential, but it contributes toward confidence, inner strength, and normalcy. Don't underestimate it. Even your favorite lip gloss can go a long way.
--Tea/Coffee/Money for soda
Whatever your pleasure is. Mine is Celestial Seasoning Peach Tea with a little box of apple juice thrown in for sweetness. You may need to commandeer the station coffee maker with beans from the local coffee shop or hit up the soda machine for a name brand soda instead of the knock-off you normally drink to save money.
--Special treat/Gift card/Money for a snack
Chocolate. Full stop.
Or if you're like me and keep your bag in the car (melted goo anyone?) then some other special snack. What's your favorite candy bar? Favorite milkshake? Special munchie? If you can't keep it in your bag, try a gift card--you'll be less likely to worry about your budget if it's already been allocated and purchased for just such an occasion.
--Book/video game/MP3 player
You've dealt with your physical and emotional sides, but if you catch the chance to give your mind a break, TAKE IT. Escape for a while into a good book, a new game, or some great music. Some services are not set up to accommodate this, but if you are lucky enough to have downtime, use it to your advantage and be intentional in your rest.
