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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As a member of the ambulance service, you deal with a lot. And the things you experience on a daily basis can have an enormous impact on your mental health.
The pandemic may have made your job even harder. And even though a lot of society has gone back to the way it was before, you might still be dealing with feelings and experiences you had during coronavirus (covid-19).
This information might help you to make sense of the things you see and experience in the ambulance service. 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.
Because of the job you do, you might have been dealing with lots of things you’ve found difficult, and not had the time to think about them properly. This might be especially true of things which happened during coronavirus. 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 through in their roles. 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:
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 have made 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:
Post-traumatic stress disorder (PTSD) is a mental health problem you may develop after experiencing traumatic events. Emergency services staff and volunteers are routinely exposed to distressing and traumatic incidents, as well as having demanding workload pressures. As a result, they’re more at risk of developing PTSD than the general population.
We have more information on PTSD, including the causes, some of the symptoms you might experience, and the support you could get.
“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 were under extra pressure during the pandemic, and many still are now. 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 find yourself feeling angrier during coronavirus. For example, you might have felt angry with people who broke lockdown rules, when you were working so hard. You might have felt angry with loved ones or the general public, if they denied that coronavirus exists.
This may have felt even harder when you had to treat patients who didn't follow the rules. It might have left you feeling demotivated, or like you were 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 dissociation.
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 dissociation, including tips on how to take care of yourself when you dissociate.
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.
“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
Losing someone important to us can be emotionally devastating, and bereavement can have a huge impact on our mental health.
During the pandemic, you may have lost loved ones to coronavirus or other illnesses. You may not have been able to be there for them in the way you would have wanted. You may also have missed out on funerals, or not been able to hold a funeral in the way you imagined.
We have more information on bereavement, including places where you can get support.
You might have felt like during the pandemic, you were missing out on the rewarding or enjoyable parts of your job. Or, like you weren’t getting the ambulance service experience you were expecting. You might still feel like this, and you might feel like you’ve lost the love you once had for the job.
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’re feeling like you’ve lost some of the love and enjoyment you once had for your job, you might find these tips helpful.
“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.
Try to be kind to yourself. Notice when you’re thinking negative things about yourself. If you had a difficult shift, are you telling yourself that you should have done better, or that it was your fault when things went wrong? Try to challenge these negative thoughts. Think about the things you did well instead.
You could also take a break from news and social media. During the pandemic especially, it may have felt like all you heard was bad news. Even though coronavirus isn’t in the news as much anymore, watching a lot of news or being on social media a lot can still feel overwhelming. You don’t have to cut them out completely, but you could limit how much time you spend reading them each day.
You could also try to think of some positive things which are happening in your life, or things you feel grateful for. This could be a good news story you heard, a positive conversation you had with a colleague, or a time you laughed recently. You could write down your positive things and reread them when you’re feeling low.
“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 the pandemic. And there may be some things, like hygiene measures and caseloads, which are still different.
Having some strategies for how you’ll cope with things now we’ve moved out of the pandemic might help with any feelings of uncertainty or worry you might have:
“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:
Seeking help for a mental health problem can be a really important step towards getting and staying well, but it can be hard to know how to start or where to turn to. There are many resources, services and organisations which offer mental health support for people in the ambulance service.
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. Some people have told us they feel like they’ve ‘failed’ when they admit how much their work has affected their mental health.
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.
There isn’t a specific time for when you’re supposed to get mental health support. It's always OK to seek help, even if you're not sure you’re experiencing a specific mental health problem.
You might choose to seek help because:
Read our information on how to seek help for a mental health problem.
“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.”
Ask your supervisor, line manager or colleagues if you can access specialist support. Some of the following things may be helpful:
If you're 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.
“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 May 2022. We will revise it in 2025.
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