BY KATHLEEN NELSON
For a quarter century, paramedic Mike Paoletto has responded to calls for Stratford Emergency Medical Services in southern Connecticut. Most incidents don't weigh on him, but a few — fatal accidents and wrenching cases of domestic or child abuse, for example — can be tough to shake off.
Mike Paoletto, a paramedic for Stratford Emergency Medical Services in southern Connecticut, says he appreciates that St. Vincent's Medical Center of Bridgeport, Conn., offers chaplain and pastoral services to EMS workers.
"We have to just push through it because we have to get on to the next day," Paoletto said. Yet repeated exposure to the traumatic suffering of others can lead to chronic psychological stress. A study in the World Journal of Emergency Medicine released in 2013 indicated th
at of about 1,000 paramedics surveyed, 22 percent have suffered from post-traumatic stress disorder.
In an effort to help EMS workers cope with job stresses and build resilience, St. Vincent's Medical Center in Bridgeport, Conn., has begun to offer pastoral and chaplain's services tailored to emergency medical technicians and paramedics.
The need for services crystallized in August 2014, when a student at Sacred Heart University in nearby Fairfield, Conn., died at St. Vincent's from injuries she suffered when hit by a car just days before starting her junior year. Her death struck a chord in the community. Local media rushed to the scene of the accident, then covered a candlelight vigil held on campus.
In the aftermath, Dr. Doodnauth Hiraman, chairman of emergency medicine at St. Vincent's, organized a Critical Incident Stress Debriefing, a structured discussion following a traumatic event, which he said is standard procedure in cases with emotional impact. Unlike some debriefings, though, Hiraman invited the attending paramedics because he thought one of them had known the victim, and he asked the pastoral team to sit in, another unusual practice.
The discussion went beyond the standard debriefing in length and impact when the first responders and hospital staff opened up and shared their feelings over the loss of a young life. "It was very healthy for everybody," said Deacon Tim Bolton, supervisor of the hospital's pastoral care department at St. Vincent's, a member of Ascension. "Clinicians don't share openly regularly."
The hospital staff thought the EMS crew had benefited from the debriefing, and that their peers might too. Professional and volunteer emergency medical responders in the area typically don't have access to the variety of counseling resources available to firefighters and police.
Led by Hiraman and the pastoral care team, St. Vincent's set up an outreach program for all EMS workers that includes an email, firstname.lastname@example.org, and a 24-hour phone line answered by a member of the hospital's pastoral care department. The staff includes six full-time and five per-diem pastoral care workers.
The hospital also distributed posters and flyers describing their pastoral care counseling services to the area's EMS and ambulance offices, and they are planning a continuing education program on the benefits of counseling to offer to the area's EMS providers.
"This is a work in progress," Hiraman said. "We're not anywhere near the form we want to take on. But the spirit, the foundation is there to support the folks outside the hospital that may or may not be thanked for everything they do."
Hiraman said he and the pastoral team also consult with Terrance Sheehan, St. Vincent's EMS coordinator. Sheehan said he observes EMS workers when he hears a critical call come in, then monitors the run sheets, which detail each EMS call, searching for red flags that could show signs of someone who could need an attentive ear or extra prayer.
Deacon Tim Bolton, left, supervisor of pastoral care at St. Vincent's Medical Center in Bridgeport, Conn.; Dr. Doodnauth Hiraman, center, chairman of emergency medicine at St. Vincent's; and Terrance Sheehan, St. Vincent's EMS coordinator, set up pastoral care services for EMS workers who bring patients to the hospital.
Sheehan flags the report and talks with Hiraman, Deacon Bolton and the pastoral staff about reaching out. The chaplains, Sheehan and Hiraman now routinely invite EMS workers to the formal debriefing and follow up casually one-on-one.
It's a soft-sell approach, Deacon Bolton said.
In the year since St. Vincent phased in the program, about a half-dozen EMS workers have used the outreach services. The team wishes the number was larger but knows the barriers it must overcome, particularly Sheehan, who worked as a paramedic for more than a decade before joining St. Vincent's.
"Unfortunately there is still that stigma that if you have to reach out for help that you're not strong," Sheehan said. The old-form clinical debriefings could be a little too regimented and cold, he said. "The pastoral approach reaches out to the more personal side of the provider and their mental well-being. This is definitely the appropriate way to do it."
Hiraman, Sheehan and the pastoral care team are content to let the program grow organically, but they continue to quietly search for opportunities to build relationships. One example: Members of the pastoral care team visited the American Medical Response offices in the spring, after one of its paramedics passed away suddenly at the age of 32.
"Within two days (of the visit), one of the (emergency department) docs stopped me and said, 'I heard you went out to support AMR. That's awesome. Thanks for doing it,'" Deacon Bolton related. "That E.D. doc heard about it from some place. My guess is that it's from the AMR staff." Deacon Bolton saw that as confirmation that their vision had an impact.
Paoletto has not used St. Vincent's program but he witnessed another example of trust building when a member of St. Vincent's pastoral care staff attended a memorial service for one of the volunteers with Stratford EMS this fall. "He offered assistance for anybody who wanted to talk," he said. "He gave a wonderful speech and talked to the family. Other forms of assistance are general. This is very personal, since he knows us.
"Saint V's has given us at the front line level an extra resource, which we really, really appreciate. Whether you need it or not, it's really reassuring to know that they are there for us."
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