From the frontline: paramedics in the time of COVID-19
Like all of our healthcare workers, paramedics have been hugely impacted by COVID-19. We look at the challenges they’re facing at the frontline.
In the COVID-19 world, the terms “essential worker” and “frontline worker’” have become part of our everyday language. And few groups of people are more essential or frontline than paramedics.
They might be highly skilled professionals who are trained to assist others, often in emergency situations, but that doesn’t make paramedics immune to the impacts of living and working through a pandemic.
“Paramedics have experienced the same pattern of worry and anxiety about coronavirus as the general public,” says Mojca Bizjak-Mikic, General Manager of the Council of Ambulance Authorities (CAA).
“At the same time, paramedics not only know they may be more exposed to COVID-19 than others, but that they’ll be the ones people will depend on when the worst happens. It’s quite a complex combination of pressures to cope with.”
CAA is a not-for-profit peak body representing the statutory ambulance services of Australia, New Zealand and Papua New Guinea.
CAA works to advance the mission of ambulance services to provide excellence in pre-hospital care by pursuing strategic engagement with state, territory and national governments and allied organisations in the health sector.
No such thing as “business as usual”
Mojca says the type of call-outs paramedics are attending haven’t necessarily changed, but the logistics look very different.
“Each call-out takes significantly more time, and the turnaround of ambulances in between jobs is a lot longer due to cleaning requirements.”
Ambulance Victoria’s Loddon Mallee Regional Director Michael Georgiou adds that changes to procedures have also been a source of fatigue and stress.
“Clinical practices that we’ve had drilled into us, often for years, and even things like emergency department set-ups have had to change so we can keep everyone safe. That’s been taxing.”
One of the biggest changes is the everyday use of personal protective equipment (PPE).
“Plastic gowns, masks, goggles, gloves – wearing that all the time, on top of the procedure required to remove it safely, impacts the physical health of paramedics,” he says.
Paramedics are also mindful of how PPE affects patients.
“Being in a situation that requires an ambulance is scary enough, then to see a paramedic arrive in full PPE is confronting. The thought that we might be increasing a patient’s stress levels adds another layer of concern for us.”
Taking it home
At the start of the pandemic, many paramedics were worried about putting their families at increased risk of COVID-19. But months on, they’re confident that PPE and other on-the-job procedures are working.
“That’s given paramedics some peace of mind,” says Mojca. “There’s knowledge that ‘if I follow all the steps, I’ll be okay’.”
Michael agrees: “To date, the small number of confirmed COVID cases among paramedics haven’t been contracted in patient-facing roles. So while adapting to new safety procedures has been physically and mentally exhausting, we also know our PPE is protecting us.”
That doesn’t mean that family life hasn’t been impacted.
“We’re taking other things home,” Michael says, “and the increased anxiety and demands of the job are impacting the family-work-life balance for a lot of us.”
Mojca explains that it’s not uncommon for both parents in a family to be paramedics.
“Children may be worried or anxious about mum or dad – and sometimes both – being paramedics because of what they’ve heard about COVID-19 in the media or playground. We’ve worked hard to help paramedics understand how to talk to their children about their jobs and coronavirus, but it is another thing they have to consider.”
In it for the long haul
Healthcare workers, including paramedics, have never viewed the coronavirus pandemic as short term.
“We’ve always known this would be a marathon,” Mojca says.
“On the plus side, that’s meant we’ve had the opportunity to become better prepared for the second wave.”
“Like everyone in the broader community, the challenge for paramedics the longer this goes on is avoiding complacency and fatigue around continuing to do what they need to do to stay safe.”
Michael adds that the public’s complacency can be a source of continuing frustration.
“As a healthcare professional, you can’t help but feel frustrated. Doing and seeing what we have to deal with every day as paramedics and then seeing people not doing – or even refusing to do – the right thing is exhausting.”
A boost in support
Like other healthcare professionals, Mojca says paramedics aren’t always adept at recognising when they need support – or at reaching out for that support even if they do feel they need it.
“Fortunately, a range of strong, effective support services are available to paramedics, from peer support programs to 24-hour counselling services,” she says.
And many of them are 'reverse engineered'. “Specific call-outs are automatically flagged and support workers immediately dispatched, which means getting support doesn’t always rely on paramedics asking for it.”
Additional support resources have been introduced in response to COVID-19, too.
“Podcasts, tip sheets and online resources are now available, and as always, there’s psychologists available 24 hours for our people their families. We’ve seen a huge uptake in our paramedics accessing these services, which is great,” says Michael.
“It’s all part of destigmatising reaching out for mental health support for healthcare workers, including paramedics,” Mojca says.
Hand-n-Hand provides a free pre-clinical peer support service that matches dedicated, experienced mental health volunteers with healthcare workers who request assistance during the COVID-19 pandemic.