I am a paramedic with PTSD. AMA!

Nurse here - are there any paramedics without PTSD at this point?

Last few years have been....wild....

Thank you for being a nurse - such a vital role.

What I've heard from my colleagues over the last few years it has been more challenging. Covid is just one of many issues with our health system. Our hospitals are more frequently at crisis points with lack of beds, which I'm sure you know puts more pressure on emergency ambulance services. Crews are over/worked and under-supported, which is increasing mental health issues in personnel. I haven't asked everyone in the service if they're experiencing PTSD, so can't speak for them, but I do know it’s massively underreported.

Problem is people don't recognize the warning signs and think they don't have PTSD. I am a former army infantry soldier and now paramedic. I've been told by several friends and family members I have PTSD but I feel fine!

Feeling fine is, well, fine. What if you could feel good, or even great? I've heard that people in medicine (please let me know if there's a better blanket term) often have a blind eye to their own health.

I can only imagine all the people you've helped, the times you could have given up but decided to keep going, the passion you feel for helping people in their worst moments. Your contribution to society is beautiful in a way, and I'm so grateful that people like you exist. The role you play is so, so important.

But, if I may, your role isn't more important than taking care of yourself, and neither is your contribution to society. If you reach your breaking point, and you will if you don't address this, the destruction and heartache won't be confined to you, it will spread to those around you.

Please listen to what your family and friends have to say. Ask them why they think you have PTSD. Google the symptoms and think honestly about if you feel them. Treat yourself like a patient and assess objectively. You could even go to one psych appointment if for nothing but to allay the suspicions of your loved ones.

Please take care of your mind, you can't help anyone if you're burned out. Sorry for the rant

Amazing answer. I don't know if I can value-add much more!

I lied to myself, or was in denial, or was afraid of the stigma surrounding ptsd for a long time. It takes courage to admit you're struggling, particularly in a career you love so much.

Also a nurse here, I've begun wondering if I have ptsd...

Just from your comment, I can tell you're self-aware and willing to question what's going on... It's hard to hear a diagnosis of PTSD, but you're worth seeking help. I cannot stress enough how important it is to reach out, get professional a assessment, and start the healing process as early as feasible for you. I wish you the absolute best :)

Hello! I had considered studying paramedics at uni (ACU, I ended up going with midwifery) and I echo the comments of everything applauding you for how hard you + others ambos work/have worked.

One for me I guess from someone who deals with emergency scenarios often (obviously at a DRASTICALLY different level to what you would have experienced) I want to know if you found your coping mechanisms kind of.. subconsciously and slowly broke down? Idk if that makes sense, but some of my co workers comment on the pragmatic way I deal with death and trauma by completely removing myself emotionally, and I am worried that as the demands in health care just continue to ramp up w/ short staffing, shit pay, expectations beyond our means etc. if I will begin to slowly lose these coping mechanisms, or if the past trauma of what I have seen will one day hit me in the face.

Obviously that is totally unanswerable, but I would love to hear your perspective on coping in traumatic situations when it’s your 9-5 (or… 0700-1900 ha)

:)

Thank for your roll in midwifery :) I understand exactly what you mean with your question, because this is what it was like for me - it snuck up on me until my first ever panic attack. Earlier in my career I kept up my social circles and exercised to maintain my mental health. But over time I became exhausted and stopped participating in sports etc. It was a symptom that I was struggling but I only see that in hindsight.

It's different for everyone, some people I worked with were very detached and pragmatic, I think it protected them from the emotional toll. But, in my opinion, it made them less empathetic towards their patients. I say that because for me I think I maybe gave too much empathy and that contributed to my burnout. I have heard from long-term paramedics that everyone has a "black box" where they file away the trauma, and that box can only hold so much before it overflows. There are some paramedics who worked in this field for their entire working career, so maybe they had lots of space to file away the trauma. I don't know what I'm trying to say, but maybe you don't have anything to worry about. If you're asking yourself these questions, that's a good thing. Keep asking yourself and assess it regularly so you can make any changes you need to take care of yourself.

Thank you, I admire those that can do this so much. What are you doing to overcome PTSD?

I've been in therapy for my PTSD, but it seems that 10 years of cumulative and insidious trauma takes a lot longer to work through than I realised.

I'm hoping to try EMDR soon to see if this works for me to make healing quicker and more effective. I've tried multiple antidepressant medication but they didn't work for me. Talking about my experiences has been helping me recently to consolidate what I've experienced and give me a different perspective. For example, I've begun to see the silver linings and I now can remember the better times!

That's great, I'm glad things are improving. EMDR helped me. I had flashbacks for years and they immediately stopped after one session, the healing process became easier after that.

Oh wow. I’m sorry you experienced flashbacks - they’re awful. But reading your reply gives me hope heading into a new type of therapy. Thank you :)

They really are, and I was shocked at how suddenly they stopped. I kept expecting them, but they just never came again. That was about 6 years ago after having them every few months for about a decade.

Hypnotherapy also was good for me too. I think a combination of everything is worthwhile, but not many psychologists do it all. I just got really lucky with the one I did - he was actually a psychologist, but I paid extra because he was close to start, then helped so much. I didn't take drugs either, because they never agreed with me.

That’s crazy to hear. Ive got ptsd and am starting trauma therapy soon but I’ve suffered with flashbacks for about 6/7 years and tbh I don’t believe them when they say that it’s possible for them to stop. Just can’t imagine not having them at this point, but seeing your comment is somewhat hopeful. Amazing that they helped you so much, hopefully will work for me to

I really hope EMDR works just as well for you as it did for me. This was about 6 years ago and I still occasionally think about it and even oddly intentionally recall it in my 'trigger zone' (I guess I'm trying to test myself), but a flashback has never come back since. I still find it hard to believe writing it.

I remember exactly that horrible moment, but the strong emotions aren't attached anymore, in fact, there's very little emotion.

I'd suggest to have a lot of trust in your professional and fully lean into it. You need to vividly recall that awful time to be released of it. Don't be scared of it, because you're already living it over already and what's one more time that could potentially help?

What do you mean when you say "flashback"?

Flashbacks are sudden and vivid intrusive memories, specifically to something traumatic you've witnessed or experienced. Within a flashback the body responds as if you're back at the event, which can manifest in panic attacks, nightmares etc.

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I figured as much with my uniform - I mostly wanted to hide my face, and if anyone wants to dox me then they can delete their account xD

I wasn’t adequately prepared for the realities, in the stress management sense. And as you would know, reality is much different from theory. Once I connected those dots after being exposed to cases I can absolutely say uni students need more preparation with placements etc than what was available when I did my study. I don’t even recall ptsd being brought up! That’s changed now here, thankfully.

Second part - I didn’t mind being diverted, as my mindset at the time felt more prepared for a high acuity job (I trained interns as well, so that may have played a part).

Thank you as well for your service!

Is it a 4 year degree for paramedic in AUS?

3 years at uni and a 1.5 year internship with a service, when I went through. It is different state to state.

1. What made you want to be a paramedic as opposed to another kind of medical professional?

2. What do you think about the sentiment that while one person may be having the worst day of their lives, emergency responders have to deal with people having the worst days of their lives every day?

1. I grew up in a home that supported and helped less fortunate members of the community. So for me it was a natural progression to continue helping others. As for paramedics over another medical profession - I was always interested in biology and the human body, but I really enjoy variety in my work, so thought paramedics would be even more suitable for me over emergency medicine in a hospital.
2. Oof - difficult one to answer, but the most simplistic way I can explain how I feel about it is that I signed up for anything and everything, to be there for people in their emergencies, but you’re never fully prepared to see as much as we do. If you know, you know!

Have you ever arrived on a scene and looked at the patient and thought, "This person is definitely dead," then worked on them and they weren't?

No, and I'll briefly explain why because it’s quite complex! If a patient has a sudden cardiac arrest with no obvious known cause there are still some signs of life for a period of time. For example, complexion can tell you a lot about their oxygen levels and blood circulation eg pink and warm would tell us it was recent, or there was bystander CPR, which has a higher chance of a successful resuscitation. In contrast, same scenario, if they’re cyanotic (blue/grey) they haven’t had as much blood perfusion to their vital organs and therefore have worse outcomes. The obvious deaths would have signs such as rigour mortis, lividity, or a visual cause (think more gruesome).

I could see these signs of life and know that this person can potentially be saved. So for me even if a patient has no heart beat, I wouldn't necessary say "they're definitely dead".

Hope that answers your question! Gosh, so many more things I could say!

Thank you for sharing. I am sorry about your friend. I can't imagine how that felt.

I am wondering if PTSD in your field is caused more by what happens to people (accidents, OD) or what people do to each other (rape, murder, torture). In other words, is the trauma due to witnessing suffering regardless of cause, or the fear of what humans are capable of.

Any thoughts?

Both are traumatic experiences, I don't think the two can be compared by which is "more" traumatic. Without going into too much detail (for privacy reasons), I have seen accidents and ODs, as well as horrific violence perpetrated by one human to another (including threats and attempts of violence towards myself), and both "types" are difficult to process in their own way. I really don't want to compare traumas because in my healing I have learned that any perceived traumatic experience is valid full stop. It's something I advocate when talking to other survivors of traumas - if it's traumatic to you then it's valid regardless of what someone else has experienced or how trivial it may seem to someone else.

Sorry if this isn't the answer you were hoping for, but it's an important point to make in the bigger picture of the individual experience of PTSD.

Do you have kids?

How do you deal with the possibility that you're gonna wake up and possibly have to see dead or seriously injured kids.

Its been one thing that made me unsure I could ever work in these fields, I mean, a car crash happens everyday.

Firstly, I love your username - can relate!

No, I don’t have kids. I have nieces and nephews, and the personal connection there is definitely a more frightening thing to think about, if I were to be called out to them. Seriously injured or dead children I found the most confronting, but the disconnection of emotion (if that makes sense) I could create with a child I didn’t know made it easier to “do the job” than if it were someone I knew.

I did get call-outs to people I knew, but we were always told we could stand ourselves down from attending them if need be. I never did, and those cases stuck in my mind a lot longer.

I have two cousins doing the work right now. They said they have infinite debrief/emergency psychiatric hours they can pull on at any time.

One of them had an incident out of uniform, they were required to go through debrief before they could be reactivated. The uniform partly sets a shield, knowing things will happens while in uniform.

How are Australia doing on that part? Can/Could you talk to a professional?

Massive props to your cousins for their service. I’m very happy to hear they have such a high level of support. It was available to an extent - peer support would msg or call after a flagged job. But a lot would slip through the net. And the psych support would be up to the para to organise, and it pissed me off when I went once and the DH said I should’ve come earlier. So that system was flawed during my time. As for proper debriefs, I found them inadequate and rare. I recall many times being paged while still at hospital handing over patients and/or restocking our kits after a hectic job and I reached a point where I’d say over the radio for them to give us some effing time! One time we got paged we were still cleaning blood of the floor and walls of the ambulance.

So, in essence, there are a lot of changes/improvements needed in that regard.

Did you get PTSD from the job? If so, how can you continue to work in the field if you'll be exposed to more of the same?

I did get PTSD from the job, I've included more details in another comment. I haven't worked on the road in 7 years - since my diagnosis. I don't know if I'll ever be able to return to that type of work, for now I'm keeping my options open as I work through the traumas of the past.

Do you have any advice on getting through the intern year? The pressure is immense.

Oh I remember my first shift as an intern being very daunting! It’s perfectly normal to feel this way. I would suggest finding a mentor(s) you really click with, can offer you extra time, and help you figure out your own practice. It’s also important to try and work with many different paras to see how they operate etc. Ask a lot of questions - there are no stupid questions. I tried to do as many scenarios, off-duty, with my mentors to improve my clinical knowledge and skill set. I would be constantly doing extra research, right up until my last shift, because I hated the thought of turning up to a scene without being on the ball. That said, everyone gets out of their depth at times, and call for extra/higher levels of clinical support as soon as you can. Take every case and talk about it in detail, or do your own audits (on top of the mandatory audits) and you’ll continue to become an amazing paramedic!

Ultimately, you’ll be learning and growing your entire career, and so is everyone else. You’re not alone in this.

I used to be an EMT. I'll be honest and say I never saw anything too traumatic, but there was one call. I don't experience nightmares, or even unintentionally recall it, but my anxiety and emotional regulation derailed shortly after, and I still get panic attacks when I hear a pager go off. I'm on meds now, but it was a multi-year process.

Is it at all possible I experienced/am experiencing some kind of mild PTSD? Or is it more likely I had underlying anxiety/ADHD issues that came to light after?

All it can take is that one call-out. Your symptomology fits in with PTSD, but I can only give you my opinion over the web. It isn't black and white - it's a spectrum. The same with ADHD - there are crossover symptoms with one another, as well as other psychiatric disorders. I suggest finding a psychiatrist who specialises in this, even if you've already been to one and even if you're already taking meds. I found some doctors gave out anxiety meds like tic-tacs and didn't really want to address the root cause. So don't stop seeking the help you need until you find the right doc/therapist for you.

Proud of you for wanting to figure out your diagnosis and get adequate treatment. :)

Hope you're doing okay, and take care of you.

Hi, thanks for everything that you are doing. We need more people like you.

What's your best feel-good anecdote?

Thank you for your kind words. :)

Saving lives and reducing suffering always made me feel good, but I look back fondly on my career at the pranks me and my colleagues played.

A couple of examples, which immediately come to mind are: - Filling another crew’s ambulance with balloons on their birthday. - I dared my partner to use a Scottish accent whilst talking with a patient, and needed to continue with the accent all the way through to handover at hospital so the patient didn’t realise it was a dare.

Another joy I recall was blowing up a glove and drawing a face on it to cheer up sick children.

Best stories you have to share?

Am I right to assume by best you mean you mean best outcomes? It's very hard to choose because every case is so different and can't be compared in that way. But cases with children really stand out. Saving a sick child and seeing the relief and gratitude on the parents faces really makes you feel good in a job where you're exposed to so much suffering.

What was the best experience you had with a patient on the job?

The first one that comes to mind is a heroin overdose. They weren’t breathing on arrival, so we bag-masked them and gave the patient the reversal agent, Naloxone, which works quite rapidly. On the way to hospital the patient was awake and alert enough to talk with me. I explained what had happened, that they had an overdose and would have died if paramedics didn't show up. This patient really internalized everything I said. I found out months later that they had gotten clean from their addiction after that experience. I was so proud of that patient, and proud of myself for knowing I gave them another chance at life.

Even though I only spend a brief moment with patients it's enough to make a meaningful connection and change lives.

Do you think if more paramedics existed that some kind of rotation program to reduce repeated exposure to high stress and traumatic calls was available it would have helped? Or are some of the calls so impactful that once you've done one you're traumatized?

I have a long and multi-faceted response so I’ll try to summarise (good questions btw). From experience, when we’ve had more paramedic crews, it does have the potential to lower exposure and increase time/opportunity for breaks. But not always.

Some shifts multiple crews are dropped because they can’t cover sick leave, for example. These shifts would be relentless, exhausting, and also unfair/unsafe on the community due to slower response times.

Further to this, there are paramedics who are sent to traumatic cases more frequently. We would call them “shit magnets” - I was one of those!

More paras would and will help in many ways, however I feel like the accumulation of trauma for me was inevitable and the fuse would’ve still burned out eventually.

I hope that answered your question well enough!

How does the PTSD affect your relationships with other people in your life that might not relate to what you've been through?

Also thank you so much for the amazing work you've done as a paramedic, I have so much appreciation for what you all do from a public health and patient perspective!

Thank you for your kind words :)

PTSD definitely has an impact on my relationships. The healing process is messy at times and I've tried to shield my loved ones from that. I don't see friends or family as often as I'd like to and it has put a strain on those relationships. I've encouraged people close to me to read more about PTSD so they're more understanding of how my disorder makes it incredibly difficult to engage in "normal" life.

It can be hard for people who haven't experienced PTSD to understand that the changes I have gone through are completely normal.

is it like the movie "bringing out the dead"?

I haven’t - had to Google it, but now I want to watch it because the tagline sounds very bloody similar. What did you think of it?

Have you considered MDMA therapy for PTSD?

I have indeed considered it. I’ve researched it a bit and if it were legal here I would jump onboard. I have positive thoughts about this - it’s an exciting new area for PTSD treatment.

There are quite a lot of underground practitioners in aus who work with this, have seen it super good - good luck bro

Thanks mate :)

Thank you for doing this ama. I hope i don't sound insensitive for asking this but, in which movie or tv show do you think PTSD is best shown?

You’re welcome :)

You don’t sound insensitive - it’s a good question!

The first movie I thought of is American Sniper, particularly the scene portraying hypervigilance, which I suffer severely.

TV shows: Peaky Blinders, Cillian Murphy’s character Tommy Homeland also portrays panic attacks, anxiety, depression - all symptomology of PTSD - very well.

You say hypervigilance - ff/paramedic here- is this why I can’t go to the beach anymore? Everywhere I look is the potential for someone or a kid to drown or some tourist crap out from a heart attack- who lays on a towel with their protocols open in their phone “just in case?”

Mine feels like there's constant danger, everywhere, all the time - a constant panic state. For sure, yours is an important example - it feels like you never truly take your uniform off. I avoid a LOT of places because of it, and can't even walk out my front door without feeling these 'threats". It's debilitating. I hope you're doing okay, and can make it to the beach again soon!

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For me, I can’t pinpoint a singular cause of my PTSD - it was a breadcrumbs series of cumulative stress and trauma.

With my symptoms, I have flashbacks to many horrific scenes. But the last straw (also the last case I went to) was a death of a friend. I broke-down after that and got diagnosis.

Sorry I can’t give you a simple answer to this - there’s lots of research coming out now about accumulative trauma and complex PTSD. I really hope the field of psychology continues this research, improves treatment, and reduces the stigma surrounding it.

Questions (with a comment)

1. Do you or have you gone into therapy yet to address this extensively, and if so, are there techniques, such as mindfulness techniques to deal with the symptoms of PTSD while on the job and in a triggering scenario?
2. I was wondering what if any techniques or advise you have to maintain the level of focus you need for the job while managing your PTSD?
3. Do you have any reading suggestions or other readily available links or reading resources that have worked for you specifically?

Kudos to you man. That is a rough job, and you are often thrown into impossible situations, terrifying situations, witness things that would shock and rattle an average person, and expected to keep calm and focused the entire time. The stress level of each and every one takes its toll over time, from PTSD to complex PTSD (which has been identified for some time but still not studied well enough). For those of those that do not know what complex PTSD is, it is the development of PTSD from a series of events, not a singular one.

Thank you for your kind words and understanding.

1. Yes - I started regular therapy after my first panic attack 1 year before the job which broke me. I managed to get through that year medicated (beta-blocker). I didn’t use any new techniques, definitely more sick leave/mental health days. I had already built an innate ability to switch into “job mode” at an emergency. I do recall feeling much more exhausted after shifts and on days off.

I would try guided meditation a lot, but it was a short relief for me at the time. Any relief was welcome, but difficult to attain for me.

1. I would suggest extended time off and seek therapy to find techniques which work best for you.

2. “The Brain that Changes Itself” by Norman Doidge. I can’t recall others at the moment but may update this if I do.

What were (/are?) your foremost symptoms that caused you to seek help for the condition?

I had a panic attack at work, during a routine handover - I was diagnosed with generalised anxiety disorder. I went to a case a year later which broke me - I was sobbing on the floor in my kitchen with my partner saying repeatedly "I can't do this anymore." Very soon after, I began having floods of panic attacks, flashbacks and nightmares of cases I'd been to - these are the major symptoms led to seeking more help.

Is there anything that would surprise the general population about working as a paramedic? Like, do you know how to get seen to quickly by a triage nurse?! Or do you find more time is spent doing x rather than y? Anything really.

Oh. What about salary? Not specifics cos I know that isn't really relevant to a global audience but where does it sit in terms of other jobs? Does it top out quite quickly or are there a number of salary steps?

There's a lot to talk about here, so I'll talk about the triage question. There's a misconception that people who arrive to hospital in ambulances get attended to faster. It's the same triage system as any other person arriving at hospital.

Salaries vary state to state and clinical level, but we get paid well. There are a number of salary steps as well as penalty rates, allowances, and other entitlements.

I’d love to hear some of that dark humor (uplifting humor is great too). Any funny stories you’d like to share?

Hi, LatentBloomer. :)

Here's a couple I can recall...

Called out in the early hours of the morning to a sports field for an "unconscious male". We arrived, he was responsive to pain stimuli but he was intoxicated and had walked across the grass section, tripped and hit his head on the concrete. He was combative mainly about not being able to recall his own name. So I decided to use a random name (let's just say 'Billy Bob') in an attempt to calm him down. This worked so well I continued using it all the way to hospital.

I was handing over to the triage nurse and mentioned we didn't know his real name, he had zero ID, and he overheard this and yelled out "I'm Billy Bob!" maybe a dozen times.

A staff-member recognised him so they were able to call family members, who'd arrived by the time we returned with another patient... He'd spent enough time yelling his new name to family that they were already using it! xD

I'm not a medical professional right now, but a lot of my PTSD comes from [redacted] so a good amount of it does come from medical stuff, so maybe you have some input.

I just woke up from the worst nightmare of my life. I'm on medication for it (prazosin) and I've been in therapy for many years. Do you have advice for nightmares? I genuinely can't live this way forever. they are very bad and very frequent.

I feel your pain, my friend. I still get panic wakeups from nightmares and they're awful! I go immediately into Child's Pose, focus on my breathing and try to ground myself. I then visualise the dream and finish it in a way that makes me feel I've taken control of the narrative, and finish it in a much more comforting place than what I woke up to. I also put rain sounds on and take slow-release melatonin before sleep. Have you found prazosin helps at all, and does your GP regularly assess this (the nightmares and medication efficacy)?

I'm glad you have a good therapist, and I'm sure you've spoken with them about many options available to you... And it's okay to see what you're currently doing with your therapist isn't working.

You're already doing the work by reaching out, which is amazing and courageous!

Me, too.

How do you deal with burnout?

I make sure I keep regular GP and psych appointments, spend a lot of time doing stress-free things (even if it's just sitting out in my backyard in the sun for hours listening to music), and reach out to talk with people who are either personally close or who understand.

I hope you're okay.

Thanks for doing this ama. And thanks for your sacrifices for this work. Do you have any advice on how to comfort the dying? Is there anything universal that you see in the process of dying that can be comforting? Thanks ❤️

Gosh, this brings up many memories immediately! I'll speak about a specific memory, but first - you're welcome, and thank you for your kind words. :)

Comforting someone who's dying is hard but so important, and also their loved ones. I remember a paediatric patient (14yo from memory) who had a terminal illness. We were called because he was deteriorating rapidly. His parents would usually opt for a hospital admission, but after assessment we realised these were his last hours. I stayed with him initially, holding his hand and speaking quietly while my partner spoke with his parents and decided they wanted him to pass away at home rather than hospital. He had already verbalised on another day that's what he wanted.

Usually we wouldn't be able to spend this much time on scene, but we spoke with our duty manager and told them the parents' request for us to stay. My partner and I took turns sitting with him, and comforting his parents, until they were ready to say their goodbyes. He passed away soon after surrounded by love.

We remained there for as long as his parents needed, which wasn't long (other family turned up).

Sorry - that was a bit of a vent!

The main lessons I learned from this and every other dying person were - help them feel less alone, keep as much normality for them as possible, speak softly to them even if they can't respond, hold their hand or light touch... those are the types of comfort I noticed were most appreciated. (I've also exhausted my brain with the story, so I'll have to leave it there - I hope any of this helps!)

How do you feel about the sensitisation people go through?

My last First Aid course was done with an ex-paramedic, who basically said that if you need to give someone CPR, their chances of survival are at best 1 in 3. That's a lot of deaths to see in a career, which the non-medical us don't see.

It's a shock to the system initially, which does help with building up the reactivity needed in emergency situations. The more deaths and traumatic cases we attend, the more we become desensitised and compartmentalise in order to continue onto the next call-out. This is where the issues such as vicarious traumas can build up.

Hey there. First of all thank you for everything you do. My dad used to ride in the back of ambulances.

My questions for you are: what roadblocks do you routinely face that make it difficult to do your job? what could the industry be doigg to incentivise people to become paramedics?

Hey there! I hope you're well. :)

1. Every region, state, country is different, but one of the current roadblocks locally is ramping. Metro hospitals are often full and ambulances wait on the "ramp" for a space to handover their patient, sometimes up to several hours (we sit in the back and continue treatment etc). We're frustrated we can't respond to the community as we should be, and as a result response times are often disgustingly slow.
2. The new state government has promised a huge investment in healthcare to mitigate these issues, including offering more intern positions, increasing hospital capacities, and more crews. The union has played the most pivotal role in pushing for this and more. The service's management have nothing to brag about - we're just numbers to them.

Did you get professional help, if so why did you do it and at what point did you feel like you needed it?

Yes, I did seek professional help, and still go to therapy regularly. I had my first panic attack, on shift, during a routine handover at hospital. I didn't feel it coming, so it hit like a bad surprise. Afterwards I never wanted to experience it again. I was afraid by how sudden it was and afraid it may happen on a job, so I sought professional help. This was a year before my final shift, which involved a case that was the last straw, and I broke down.

Thank you for this AMA. I have a question and I understand if you don’t want to answer it.

Have you experienced an intense situation with a patient and then run into them afterwords? If so, how did you handle it?

I am asking bc I was a patient once, and I later ran into the person who helped me. Unfortunately it turned into a situation that was … not good.

Great question. Yes - multiple times. I’ll answer properly when I can, about to start working through earlier Qs.

Why don’t you get over it?

This is a great example of the humour we use, and someone who understands it, because some people ask it genuinely. I’m about to reply to the dark humour questions, so impeccable timing. Benefit of the doubt!