DENVER — First responders, such as paramedic and EMS director Leah Buff, save lives for a living, often at a cost to their own personal wellbeing.
"Those of us that do the job, we have the utmost passion for it," said Buff. "It is unlike anything you will ever experience in life, but it is only for a select few."
Even those select few can experience fallout from extraordinary stress and pressure, resulting in what's now known as "moral distress."
"I"ve had plenty of circumstances where this has happened," said Buff. "Whether it's working children that you want them to have a good outcome, and unfortunately, they don't have a good outcome. Or it's even something as simple as grandma that passed away, and the entire family's there on Christmas Day, and you have to be the person to break the news on a day that should be happy."
In a Volunteers of America (VOA) first responder panel this week, police, fire and medical providers discussed solutions to moral distress, beginning with the idea that it is not a disorder but a normal human response to something terrible.
"Probably the biggest thing that we're trying to do to combat that is we're trying to normalize this idea that we need to talk about things that we're exposed to," said Vail Fire Chief Mark Novak. "There's not one thing that's going to be effective for every single person. Some people may want to talk with a peer. Some people may want to talk with somebody who's been formally trained. So we have to really be adaptive and meet people where they're at."
Hollie Seeley, president and CEO of North Suburban Medical Center, said she gives people "time out" after tough calls to cope, and she stopped asking, "How are you doing?"
"Now, instead of asking people, 'How are you doing? Are you okay?' after a big event, I say, 'Let's talk.' And if they don't want to talk about the event, we can talk about something else. It usually will lead to where it needs for healing," said Seeley.
VOA recently launched VOA|ReST 4 First Responders, a national campaign and peer support service to help first responders, including fire, police, EMT personnel, and hospital emergency staff, process experiences of moral distress and burnout. The goal is to help them build resilience and remain committed to their work.
“I think for people during the pandemic, a lot of moral distress kept accumulating. Or you can have something really, pretty catastrophic, an incident happen that wrecks your sense of who you are as a good person. And that's moral injury, moral injuries when you finally break,” said Dr. Rita Nakashima Brock, director of the VOA Shay Moral Injury Center. “Stigma around mental health support and lack of confidentiality prevent many first responders from getting the support they need. That’s where ReST comes in — we are providing an opportunity to build connection and resilience through our peer-to-peer support sessions.”
The HCA Healthcare Foundation supports the program through a $600,000 grant. The initiative offers free, daily online meetings as a resource for First Responders looking for an alternative type of support. Sessions are confidential and facilitated by trained peer specialists.
VOA began addressing moral distress and injury with war veterans, but now offers services for a variety of professions, including first responders. Fatigue, isolation, sorrow, frustration, guilt, anxiety, burnout and a sense of inadequacy or failure can be signs of moral dilemma, uncertainty, or distress.
In a post-program survey, VOA reports that 82% of VOA ReST participants feel calmer and more peaceful after group sessions.
"The best medicine is your peers. You get back in the ambulance. You talk about it. You cry about it. You get angry about it. You express all the emotions," said Buff. "And it's honestly how I found my love for triathlons. And that is what helped me get through the day-to-day stressors. I found a hobby outside of work that I could put all my energy in, in whatever fashion it came through — anger, sadness, depression, whatever it may be. I was able to release it and find something very healthy on the outside of work to get through it. "
For more information on the VOA Rest 4 Responders program, click here.