Paramedics often work long shifts in high-stress environments. Due to the physically and psychologically demanding nature of the job, they frequently burn out.
Jason Hernandez, a paramedic from Texas who was awarded the American Ambulance Association's Star of Life award for his dedication to his work, told The Atlantic it takes a lot of thought.
"It's different every time; there's no monotony to it," he said. You can have two patients with almost identical symptoms but completely different problems. But typically, "the most frequent calls are a toss-up between psychiatric or chest pain."
"For psychiatric calls, you never know what’s going on. It could be anything from somebody calling for a medication refill—where they just want to go to the hospital to get their medication—to a schizophrenic episode," Hernandez said.
"For chest pain, which is another really frequent one, those are harder to diagnose. It could just be acid reflux, or a heart attack, or an asthma attack, or a blood clot in the lungs. There's no sure way of fully diagnosing it in the field. You’ve got to use all of your knowledge to figure out as best you can what they've got going on."
There are plenty of things that paramedics need to worry about at any given time, from violent people to safety on the road. Uncertainty is a frequent partner as well.
"As far as not being sure what's wrong with a patient, we will pick the worst thing that we can possibly treat if we're not 100 percent certain," Hernandez said.
"A heart attack is typically going to be the worst thing that we can treat. The medications that we give for it are relatively benign: aspirin to prevent the blood clot from getting any larger and nitroglycerin, which dilates the blood vessels to allow blood flow back to the heart. If I am in doubt, I run every test that I can. If it still could be a heart attack, I'll go ahead and treat for that because it's not going to hurt them to get aspirin and nitroglycerin—but it could save their life," the paramedic explained.
As for the pressure, everybody's got their own way of dealing with it.
For Hernandez, it's talking to friends and family about what he's seen that day. "We lighten the situation with jokes. Primarily, my wife is the one who gets to hear about it," he said.
"When I get home from work, I'll tell her about how my day went. If there was a particularly stressful call, I'll tell her about that one. There have been times when I've had to go see a therapist just to talk about it."
Hernandez explained that, for the most part, his life has to bend around his job. When he's working, it means 12-hour shifts, and he usually can't do much else unless he sacrifices sleep.
To him, EMS feels like half of his life—more time is spent sitting in an ambulance than with his spouse. “It's almost like having a second marriage," he joked, adding that it's become one of their running jokes.
