This information is for anyone working in the ambulance service, whether you manage a team, help people by responding to calls, work from home or in an office, or are a paramedic.
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We know the pandemic isn’t over. But parts of society are starting to return to the way they were before.
As a responder in the ambulance service, you might notice that some things at work, or in your home life, aren’t going back to the way they were before.
There might be new rules during your shift, or more jobs to respond to than before the pandemic. You might feel differently about your role to how you did previously. And for some things, you might not want them to go back to the way they were before.
This information might help you to make sense of what you’ve seen and experienced during coronavirus (covid-19). It’s not a replacement for mental health treatment and support. But it may give you some tools to help you understand how you’re feeling, and some tips on how to cope with these feelings.
We experience many different feelings every day. Feelings can help guide us in how to respond to the situations we find ourselves in. But often, we can’t give a name to every feeling we’re having, when we have it.
During the pandemic, you might have dealt with lots of things you found difficult, and not had the time to think about them properly. You might be having feelings now, as a result of something that happened a while ago.
Identifying some of the feelings you’re having now might help you to understand what could have caused them. And once you know the causes, you might feel better prepared for how to deal with these feelings.
Recognising how you’re feeling might help you to understand why you reacted the way you did to certain situations in the past. For example, you might have had a sleepless night, and not associated it with the stressful calls you’d taken that day. Maybe you had an argument with someone you care about, without really knowing why.
Putting your feelings into words could help you to understand the emotions you’re having. There are different ways you can do this, and everyone’s preferences will be different. Here are some suggestions:
“You try and compartmentalise everything you do – you go to nasty jobs and you try and leave it behind. But you've got your own stresses on top of that, your own mental health – it makes the job extremely hard.” – David, paramedic
Below are some of the things members of the ambulance service have told us they’ve been feeling throughout the pandemic. You might be experiencing some of these, and may also be having feelings which aren’t listed here.
When we say things like "this is stressful" or "I'm stressed", we might mean:
If you’re experiencing stress, you might feel:
“When taking 999 calls it can often be similar to this: ‘COVID’, ‘Mental health’, ‘COVID’, ‘Mental health’, ‘COVID’.” – Ben, emergency dispatcher
Anxiety is what we feel when we are worried, tense or afraid, particularly about things that are about to happen, or which we think could happen in the future.
Anxiety can affect:
Moral injury describes a set of feelings you might have if you’ve had to do things, or see things, which go against your values and beliefs.
During the pandemic, you might have been forced to make some difficult decisions around supporting patients. For example, you might have had to care for one patient, while knowing there were other patients who also needed your help. This might make you feel conflicted, or like you could have done more.
If you’re experiencing moral injury, you might feel:
“I’d often find myself just sat there, not really doing anything but thinking about the job, and thinking about whether there was anything else I could have done.” – Dan, ambulance service
When you’re repeatedly looking after people in distressing or difficult circumstances, this can leave you feeling physically and mentally exhausted. You can end up feeling like you don’t care about people as much as you used to. This is sometimes known as compassion fatigue.
Compassion fatigue might make you feel:
Going through very stressful, frightening or distressing events is sometimes called trauma. Everyone has a different reaction to trauma. You might notice the effects quickly. Or you might not notice them until a long time afterwards.
A traumatic event might make you feel:
“It is very difficult to predict what will come on the line when you hear the beep, and during a block of three days I was unfortunate to have a slew of traumatic calls.” – Daniel, emergency medical dispatcher
Fatigue and burnout are more than feelings of being tired. Burnout can happen if you’re constantly under lots of pressure from work. It can make you feel:
“You bury your feelings deep, and sometimes you have to do that to deal with the job. You just carry on regardless, and it reaches a critical point where your brain and your body say "no more". Something has to give, and it's always the person, it's never the job.”
Lots of people in the ambulance service have been under extra pressure during the pandemic. If you’re struggling and feel like you need a break, it’s important to speak up.
But you might be feeling guilty about asking for extra support, especially when you know so many of your colleagues are struggling too. You might also feel worried about letting down the public. Try to remember that your wellbeing is just as important as the people you support. We have more information about where to get support.
You might have found yourself feeling angrier during the pandemic. For example, you might have felt angry with people who’ve broken lockdown rules, when you’ve been working so hard. You might have felt angry with loved ones or the general public, if they’ve denied that coronavirus exists.
This may have felt even harder when you’ve had to treat patients who haven’t followed the rules. It might have left you feeling demotivated, or like you’re enjoying your work less.
Some people find it hard identify how they’re feeling, especially if they’ve been through something traumatic. This is sometimes known as disassociation.
If you dissociate, you may feel disconnected from yourself and the world around you. For example, you may feel detached from your body or feel as though the world around you is unreal. Dissociation is one way the mind copes with too much stress, such as during a traumatic event.
We have more information on disassociation, including tips on how to take care of yourself when you disassociate.
Once you understand what it is you’re feeling, you can start to think about what could have caused some of these feelings. This might make you feel better prepared for how to deal with them.
Some of the things in this list might be contributing to how you’re feeling now. You might also have had experiences which aren’t included here.
See our information on bereavement.
“At work, we are making life changing decisions in more difficult situations than ever before. These decisions are ones we are taking home with us.” – Ben, emergency dispatcher
For many of us, the pandemic meant that things we hoped would happen, or looked forward to, suddenly felt less likely. And things we feared would happen might have felt closer to coming true. For example:
You don’t have to feel motivated all of the time, and many of us have days where we feel less motivated at work and at home. But if you feel like coronavirus has taken away some of the love and enjoyment you once had for your job, you might find these tips helpful.
We have more tips for taking care of yourself when going into work during coronavirus.
The NHS has more information about how to deal with change and uncertainty during coronavirus.
“The most important thing is to look after yourself as well as others, and to have someone you can talk to about how you are feeling if you need it.” – Amanda, peer supporter in the ambulance service
We have more information on staying mentally healthy at work, including tips on how to cope with stress.
“Sometimes, when my head has too much going on, music doesn’t work for me. I have to lay on my bed and ask Alexa to play some mediation music. Just focusing on your breathing with your eyes closed can really help.” – Ben, emergency dispatcher
It’s very uncommon to feel positive all of the time, and most of us will have periods where we feel better or worse. But working during the pandemic may have left you feeling worse about yourself, your job, or society in general. The following things might help you to regain some positivity.
“If I'm feeling overwhelmed then I take a step back. It helps me refocus and recharge my batteries. I try not to be too hard on myself if I have a bad day, or if I feel I haven't coped as well as I should have.”
We don’t know what might happen in the future. At work, some things might be returning to how they were before. If you were working from home, you might be returning to your regular workplace, and seeing colleagues again. If you work with patients, you might be seeing fewer patients with coronavirus.
And there may be some things which still feel different. You might still have strict hygiene measures in place. Your caseload might not be back to pre-pandemic levels.
You might find it helpful to have some strategies in place for how you’ll cope with the future, and any feelings of uncertainty or worry you might have. The following things might be helpful:
“Talking to my peers has also been a massive help. It helps me realise that what I’m going through is normal, and that many people experience things like this from time to time.” – Dan, ambulance service
You may have experienced lots of big changes to your life during the pandemic. You may have lost loved ones, or missed out on important events. And when the anniversaries of these moments come around, you might find it brings up some difficult feelings.
It can be helpful to take a moment to think about the events that have had a big impact on your life. If you want to, you could plan something on the date of the event’s anniversary. You could meet up with other people who were affected. Or, you might prefer to spend some time reflecting on your own. You might find these pages helpful:
Ask your supervisor, line manager or colleagues if you can access specialist support. Some of the following things may be helpful:
If you are a student paramedic you might be able to access extra support through your course provider. Our student mental health hub has more tips and resources for anyone who is studying.
We know it can be difficult to reach out for help at work, especially when so much of your job is spent helping others. It can feel like there’s a stigma in the ambulance service, where you feel you have to put on a brave face and not admit that you’re struggling.
It’s always OK to ask for help. Reaching out could help you to get the support you need to feel better. And if you don’t feel comfortable speaking to someone at work, there are other organisations which might be able to help.
If you’re a line manager, think about how you could encourage your team members to come to you if they need to talk. You might find it helpful to read our resources on taking care of your staff. This includes information on how to support your team members, and how to create a mentally healthy workplace.
“In the ambulance service, we like to have this feeling that we’re bulletproof, and sometimes you can feel a bit ashamed to admit that there’s something wrong with you. But we’re humans, not robots.”
“Talking to my colleague probably saved my life. Having the chance to open up to someone was the beginning of a process that ended with me being correctly diagnosed and treated for the mental health problem I was living with.” – Neil, ambulance service
This information was published in October 2021. We will revise it in 2022.
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