Delaware’s emergency responders coping with stress

By Craig Anderson

DOVER — Unfortunately, the work life of an emergency responder doesn’t always involve saving one.

And working through such severe medical conditions can rattle the soul.

Kent County paramedic Greg Schulties learned that early in his career, which he began full time with the Camden-Wyoming Fire Co. in 2006.

“I said when I started that there’s three different calls that I never want to go on,” he said. “I want to never go on a pediatric cardiac arrest. I never want to see a bad accident where I know the individuals, and I don’t want to go on a call that involves my family.”

The reality: “Within the first year, I went on my first pediatric drowning. Within the first year, we had a triple-fatal accident. I knew the three people who died and the fourth who was involved, as well.”

Later, Mr. Schulties rushed home from his job as a seasonal park ranger at Killens Pond State Park in Felton to assist EMTs and paramedics with treating his mother, who was suffering from multiple seizures.

Responses to similar serious incidents have continued for 17 years or so.

“I’ve been in a lot of stressful situations, seen a lot of accidents where people have died,” Mr. Schulties said. “I’ve seen bodies burned, to individuals that were walking along the highway, possibly intoxicated and ... hit by a tractor-trailer, so the body was in multiple pieces.

“Those are the ones that stick with you for a while.”

A recent spike in fatal vehicular crashes in Kent and Sussex counties has put many paramedics, firefighters and anyone else involved into emotionally jarring circumstances.

As of Thursday, there had been seven fatal traffic collisions in the two counties combined since Jan. 14, leaving nine dead.

Two occurred in Laurel, and there was one each in Rehoboth Beach, Smyrna, Seaford, Harrington and Frankford. Two crashes involved bicycles.

Additionally, there was a deadly crash Jan. 7, also in Harrington.

Those numbers followed 2022, when 165 road-related fatalities statewide tied a record set in 1988, according to the Delaware Office of Highway Safety.

And that’s not all that first responders have to deal with, said Kent County director of public safety Colin Faulkner, a paramedic for 45 years.

“It’s not just the fatal accidents we see,” said Mr. Faulkner, who directs the county paramedic program. “It’s all the other things, such as suicides, drug overdoses, to small-child fatalities. Sometimes, people get into bad predicaments, and it’s always tough to see.”

For an emergency responder, “a critical incident can affect you physically, cognitively, emotionally and behaviorally and mentally, all at various points and at different velocities,” he said.

“And some of (the reactions) are unseen. You don’t see them, and sometimes, they may manifest as some behavioral issues.”

Paramedics are hardly alone when it comes to stress on top of stress.

“We’re not the only first responders out there,” Mr. Faulkner said. “We have EMTs, police officers and emergency department nurses and doctors, fire personnel — they’ve experienced the same thing. I think that, if everybody was honest with you, they would indicate that, ‘Yeah, we’re pretty sure we’ve got varying degrees (of) post-traumatic stress syndrome.’

“It’s a treatable thing, but you have to get treatment for it.”

Group effort

To that end, the Kent Critical Incident Stress Management team has never been more important. Mr. Schulties coordinates the 16-member group, which formed in fall 2021 to reach out to anyone who may have responded to an especially gruesome incident.

Besides contacting those involved in the immediate aftermath of an occurrence, team members are trained to look for signs that the angst has continued to grow later on.

“There’s different signs, different symptoms that show we need to speak (to) this individual,” Mr. Schulties said. “Being in a consistent bad mood can be an indicator. ... Having that negative outlook is something that we look for.”

It is fortunate that there are many options for the extremely stressed to express themselves.

“Whether they want to speak to us or speak to somebody else, there’s opportunity to do that as part of our system team here at Kent County,” Mr. Schulties said. “We have two medical doctors and mental health professionals as part of our team.”

Further, the way he sees it, “the biggest thing is being able to speak about it, to be able to get those emotions, those thoughts, those feelings out, rather than just tucking them away and compartmentalizing them.”

At the same time, Mr. Faulkner knows the Critical Incident Stress Management team isn’t for everyone.

“I think some folks still have sort of a stigma against participating in that type of thing and think, ‘I’m a tough guy. I can take it. It’s all good.’ But I can tell you that, over the years — and I speak for myself, as well as the paramedics who may not say it over the years — when you see so much, it eventually changes you,” he said.

“You don’t see it happen, but it eventually changes you in a number of different ways.”

The Delaware Volunteer Firefighter’s Association follows the same plan, with one incident response team in each county.

The Rev. Charles Arnold, a Lewes Fire Department member and its chaplain, coordinates the Sussex team, which activates when asked.

“If you’ve talked to any firefighter, they’ll tell you that they absolutely remember their first worst call,” he said. “And no matter how long they’ve been in the fire service, the things that we see and we hear and smell don’t ever go away.

“We learn to cope with them and file them away, but sometimes, things cross a personal line, and then, it becomes intrusive into our lives. We tell them, if it lasts more than 30 days, then reach out, and we can put them in touch with a professional counselor.”

Such assistance is rendered confidentially, he added.

“We don’t say where we’re going, and we don’t take notes,” he said. “To adequately help someone, we keep it completely confidential because, if you don’t keep that confidence, then people aren’t going to tell you what’s really going on and why a certain call may have crossed that personal line and given them trouble.”

However, attention to managing stress as a group effort hasn’t always existed.

When he started with the city of Dover in 1978, Mr. Faulkner said a common response to experiencing a critical incident was “being told to suck it up, basically.”

“I was fortunate to have my wife, who was an ER and trauma nurse, and we, kind of, speak the same language. Others were not so lucky,” he said.

One recent example of a true team effort occurred following that fatal crash in Harrington on Jan. 7, which killed a 1-year-old. Kent Critical Incident Stress Management joined the Delaware Volunteer Firefighter’s Association unit for a debriefing involving fire companies, EMTs and paramedics.

‘Trigger point’

Cases involving young children are especially jarring to emergency medical services, said 27-year paramedic Matthew Donnelly, who added that he’s twice been pulled off shifts because of “the visuals” of incidents to which he responded.

The stress of working serious cases can build up to a point where a responder may “crack,” Mr. Donnelly said.

“Pediatric ... cases are the ones that hit home the closest, but it can be anything that’s a trigger point,” he said. “I had a partner of mine that, years ago, (told) me it’s not the call. It’s a combination of all the calls that are the trigger point, everything.”

In the midst of potentially saving the life of someone in distress, Mr. Donnelly said there’s a hyperfocus on doing that alone.

“We’re an alpha, dominant, driven profession,” he said. “We come in. We take authority. That’s what we do. We take care of patients, and we’re there for the worst of times, when people are at their worst, when they’ve had an emergency.”

For Mr. Donnelly, 51, there has to be a level of personal connection with these individuals.

“Empathy is a wonderful tool to use,” he said. “We all live off of life experiences. I was raised that, in order to get respect, you have to give respect. Well, you have to respect patients, and when you’re treating them, you can’t be disconnected that way.

“I’m not saying you have to be (holding their hand) the entire time and be personally tied to them, but you have to have a little bit of a personal touch to what’s going on. Otherwise, it looks like you’re not connected at all. You’re not a robot. You’re a person, and in the time of a person’s need, you need to treat them appropriately and how you feel you would want to be treated.”

He went on to say, while he’s seen his “fair share of nasty things,” the approach to handling the individuals challenges afterward has evolved over the years.

“I come from a time when we were expected to just put something behind you and go home,” he said. “There was no debriefing or anything else. The thought was, ‘This is your job, so get past it.’”

During those times, “dealing with it” was standard operating procedure, he added.

But he believes there’s an extreme difference between “dealing” with a situation and “coping” with it.

“Dealing with it is when you start having problems because the way you deal with it is by taking anger out on people. You start doing things that are outside your personality,” he said. “You turn to other things as an outlet that may be harmful, whether it’s ... drugs or alcohol or whatever.

“It could reach the point of taking ... one’s life, which is a permanent solution to a temporary problem.”

These days, though, Mr. Donnelly is grateful for ample encouragement.

“Thankfully, I have a wonderful support system, not just (at work) but at home. But (at work) in particular, we have the support system. We have the system team we activate. We have coping mechanisms, briefings and the support of the people we work with.”