British Columbia

'We're starving for it': Paramedics get new resiliency training due to overdose crisis

First responders are learning new techniques to handle stress on the job, as the overdose crisis in British Columbia shows no signs of letting up.

First responders are learning new techniques to handle stress amid unprecedented demand

Paramedics in Vancouver attend to an overdose patient after three doses of Narcan fail to revive him. (CBC)

First responders in Vancouver are getting new support to deal with the overwhelming increase in stressful calls during the ongoing fentanyl overdose crisis.

Last week, Vancouver Fire and Rescue hired a new health and wellness coordinator to focus full time on those issues.

And for the first time, B.C. Emergency Health Services is offering paramedics and dispatchers a specially-designed one-day course in resiliency that began this spring, starting with teams in Vancouver and Surrey.

It's been so well-received, the employer plans to roll it out in other areas of the province, said BCEHS in a statement.

The union said it's been asking for this kind of education for three years.

"We're starving for it," said Bob Parkinson of the union representing the Ambulance Paramedics of B.C.

Stress and trauma on these jobs is nothing new, but with British Columbia leading the country last year in reported suicides by first responders, and the overdose crisis showing no signs of ending, there is a new focus and money to help.

The overdose crisis in B.C. claimed an unprecedented 922 lives last year and continues to kill an average of four people in the province each day. (Rafferty Baker/CBC)

'It doesn't have to be that way'

The overdose crisis that takes an average of four lives each day in B.C. is also causing unprecedented strain on the people called on to help.

"It's non stop," said Parkinson. "As soon as you clear a call, there's another one waiting."

Sometimes when you go home, you kind of kick the dog and yell at the kids ... and it doesn't have to be that way- Acting captain Steve Fraser , Vancouver Fire & Rescue Services

That relentlessness leads to burnout and compassion fatigue, which are crucial to recognize before they go on too long, said acting captain Steve Fraser, the new health and wellness co-ordinator for Vancouver firefighters.

Both the paramedics and firefighters are learning to identify those signs in themselves and others and seek help.

"Sometimes when you go home, you kind of kick the dog and yell at the kids, and there's a reason behind that," said Fraser, who previously designed a mental health awareness course for firefighters.

"It doesn't have to be that way."

Last year, 206 paramedics and dispatchers were referred to counselling after critical incidents on their job, according to B.C. Emergency Health Services.

Parkinson says talking about it isn't easy.

"People still don't want to admit weakness," he said. "It's always been about the patient. The people we deal with have these issues, not us."

Workplace stress and trauma can be difficult to talk about, said Parkinson, because first responders are used to being the helpers, not the ones who need help. (Gian Paolo Mendoza/CBC)

Turning off in 'micro-moments'

The growing demand to help these front-line workers has led to programs outside the workplace too, including Langara College's Strategic Resilience for First Responders, which is now being licensed by colleges in Nova Scotia and the University of New Brunswick.

Since the Langara program started last year, about two dozen first responders have taken the 104-hour course, some of whom are already suffering from post-traumatic stress disorder.

Program coordinator Ruth Lamb, herself a former critical care nurse, said PTSD is a perfectly normal response to trauma after trauma after trauma.

"We [look] really effective, but the primitive brain is in acute adrenaline surge mode: protect me. Don't let me die. Let me save people," said Lamb.

"This is fine, as long as it turns off," she said. "We need to help it turn off."

The amygdala, highlighted in orange in this illustration of the human brain, plays a key role in processing emotions. When it senses danger, it sends a distress signal that triggers our 'fight or flight' response. (Shutterstock)

Students in the program learn strategies for the end of their shift and days off, but also for what Lamb calls "micro-moments" within the workday, to get a break from the surging stress response.

Even when out on a cardiac arrest call performing CPR, Lamb said it's possible to take a moment when your partner is doing chest compressions on the patient — to breathe.

"Stop and take some normal breaths ... then try to give yourself a couple of really long out-breaths," she said.

That will help start the body's relaxation response, said Lamb and focus the mind.

"We know from Western science ... your breathing will trigger the parasympathetic nervous system," she said. "But the first responders we're working with, nobody has known that yet."

Paramedics and firefighters work to revive an overdose patient with repeated doses of naloxone, the antidote to opiods such as fentanyl. (Frederic Gagnon/CBC)

'We shouldn't be waiting'

Of course, no amount of training will erase the effects of stress in a job that is inherently life or death but talking about it is progress.

Parkinson says it's crucial that mental health injuries be mitigated — just like a warehouse employee lifting boxes all day should get help preventing back injuries.

Given the positive response to the resiliency training, B.C. Emergency Health Services plans expand it to Vancouver Island and Interior cities in the summer and fall — and in more rural and remote areas after more research.

Parkinson says members province-wide need it now.

"We shouldn't be waiting on this."


Listen to the CBC Radio special Keep Calm on the science of business of handling stress, or read more in the series here:

About the Author

Lisa Johnson is a reporter for CBC News in British Columbia, covering news around the province with a specialty in science, nature, and making sense of complicated things. Get in touch at Lisa.Johnson@cbc.ca or through Twitter at @lisasj.

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