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medicnow911

Can't deal with suicidals

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There are a lot of good points here. Most of my college work before EMS was in counseling and I've completed several internships in Psychiatric/counseling inpatient facilities. I have also completed several internships with Juvenile Detention facilities. I've personally dealt with the suicidal death of two individuals, one very close to me, as well as many many cries for help over the years, mostly from teenage kids. I am currently, this very minute, dealing with a situation very personal to me of the same nature.

I used to get angry also. I used to think those individuals were cowards. I used to think the whole act was a very selfish one, at best. In some ways, it is...but to those suffering, they can't see the rationale. Most of the time, it is never their intention to hurt anyone. They are just so desperate for the pain from their own personal hell to end that they will do anything. Sometimes, as mentioned here already, they don't mean to be successful, but they are.

This has become my "specialty" in EMS. For some reason, I have the gift of ability to walk into one of these situations, and to sit and talk to the individual, and by the time we talk, and get to a facility, they are crying, hugging me, saying they don't really want to die, but the pain of (insert event or problem here ) is too much to bear. I've had patients (one just 2 weeks ago) tell me recently that if I hadn't talked to them at that time, they are almost certain they wouldn't be alive now. Sadly, I also lost one a week before that. It was too far "in progress" by the time I arrived.

These situations now bring a whole new form of anger for me. No longer anger because I don't want to help, but anger when I can't make a connection, which thankfully rarely happens to me. There are so many problems causing suicidal thoughts...medications that need adjusting, clinical depression, bipolar disorders, etc... Some are so very correctable, if someone has that someone to lean on just for that moment, someone they can trust to get some help. It would be so so easy for all of us to write these individuals off as "nutbags" or "freaks" or "psychos"...however, like Rid said, and he said it well....our job is to help people. These people have an "illness" just like a diabetic, or someone with a nosebleed, or the flu, or a heart condition. Either way, there is treatment available. Someone just has to be willing to help.

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I stand by my point that those with suicidal tendencies and history of unstable mental health should stay away from this profession. That is why many EMS services require psychological evaluation before employment. I wished there was a mental health check as well a regular physical examination. Maybe we could detect problems before they had escalated before an incidence.

The nature and demeanor of our business can cause some major stress on even the stable ones. In the event of a crisis or emergency is not the time for an occurrence to occur to the medic performing care. This is true even with high stress level in physicians as well.. again, that is why some physician groups also require psyhc. testing as well.

I worked with a great physician and a professor of emergency medicine that turned out to be manic-depressive. We did not know that he was until a very stressful event that caused a major disturbance. Since for some reason his med level had decreased, he acted & performed wrong which could had caused permanent damage to a patient if a nurse had not intervened.

This is the hard part of mental illness, there are no physical signs usually. No I do not mean to "stigma" by any means, but there our some professions that are better suited and definitely less stressful.

PTSD is a common aliment to our profession. JUst like having chronic back problems limit employment, and inability to lift as well, so I consder this a medical ailment as well.

Be safe,

R/R 911

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I really don't know where to start on this one. Everyone is entitled to their own opinion.

The part that is getting me the most are those that say anyone with an "unstable mental past" should avoid this profession like the plague. What caused that person to be "unstable" earlier will be a completely different scenario than what they are dealing with in their work. So yes, perhaps they became depressed maybe even suicidal over the death of a close family member or friend or were stuck in a spot in life where they just didn't know where to turn. If they are recovered why should they not be in EMS? How is dealing with death in the field or making a bad call on a medical situation going to lead them directly to suicide? Personally I think they are two totally seperate issues. These are not the issues that they were suicidal about in the past.

You also mention that this job can lead some of the best EMS to suicide, so it's not for the weak at heart. SO, if someone so great can suddenly go wrong, why can't someone who was so lost become clear again?

As for how to deal with these patients in your car, yes the girl with the webcam should have had it shoved down her throat,it's people like her that create the stereotype. But those who are seriously in a state of apparently unreturnable depression, NEED YOUR HELP. Yes, suicide is a selfish act, but not in the way we know selfish. Depression leads you to a seriously horrible place where the illness takes over and all you can see is the bad. It would be wonderful if they were able to see how it'd affect their family and friends, and they know their act is not likely to result in a party. However, these people can't stand life anymore-if not for themselves, then of course not for others! Suicidal Depression is a totally encompassing illness, you are a horse with the blinders on and all you see is darkness, there is no hope. Of course those of us outside know there is hope, that's why we have to deal with these people as human beings in pain who need a helping hand and someone to care. Once they are suicidal, they can't help themselves, as EMS we are there to help people, these are people who need help, just like everyone else.

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I have been there and understand how you feel. My mother committed suicide on 11/12/03, she had progressive MS and Colon CA, she was bad off and thought she was a burden, of course she wasn't. I was angry for a LONG time, how could she leave me, how could she do this to my dad, my daughter, my sister, etc....BUT this is a phase of death acceptance and it will get better I promise, a part of you will always be a little mad I think but the sheer anger fades as you realize things must have been so bad, things we probably will never know about, I am so sorry you are going through this!

Jenn

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I guess what some people don't realize is that in a lot of suicides there was some major mental problems. For example, My grandfather committed suicide years ago. He was a paranoid schitzo (SP) and thought these strange men we're coming to take his children away from him. it was very odd and he ended up killing himself. He didn't do it because life sucked and he just wanted permanent solution to a temporary problem. he didn't want to die at all. Some people just don't realize that suicide isn't all just cracked up to be "well my life sucks and i cant pay the bills, my husband left me so im going to OD on some pills" some cases are like that, some aren't. when your presented with a suicidal patient, just do your job, talk to them a bit because sometimes thats what they need. They're people just like us and shouldn't be judged either. Its not our job to try and figure out why they wanted to do it. its our job to lend a helping hand and be there through one of their darkest times in their life.

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I used to see those suicidal attempt patients as "attention seekers" as well. I wouldn't treat them any differently but my respect level for them would be a lot more different than most other patients.

Those patients are usually the ones who require the most help compared to your "typical" 911 call that does not usually require an ambulance in the first place. Over time I also have personally gone thru certain experiences where I have learned and now have a much better understanding as to what brings someone to such thoughts and actions. Something that could happen to any of us. Those patients (maybe using the wrong method) seek that help that those of us would never admit to needing as well. Who is stronger in the end?

As it has been said, some people become into that "frame of mind" because of uncontrollable events. They have gone down a path that they didnt realise they went down and require that little boost we can provide as caregivers. Others are having difficulties because of a mental illness which is sometimes not something they have control over at all.

No matter where you've come from do your job the best way you know how and have been trained and care for that patient without being judgemental. You will never know what brought this individual to where they are now.

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If you had a patient who was injured in a gun fight with police, for example, how would you treat him or her? Surely that's worse, but the fact remains that we are here to treat patients, not to judge them or correct their behaviour.
Exactly what I was going to say. If it's bothering you, detach from him as a patient you're trying to help and see it as meaningless motions you have to go through...it's kind of cold, but it lets you feel better about your job, have a better day, and be able to help more people.

And like other said, there's often mental illness involved. Even if not apparent to you on scene, there could be real detachment from reality on some levels.

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Something that could happen to any of us. Those patients (maybe using the wrong method) seek that help that those of us would never admit to needing as well. Who is stronger in the end? ...... You will never know what brought this individual to where they are now.

Ain't that the truth. I was also told that suicidals were just attention seekers. As I grow older, I keep hearing about more people taking their lives...one was a mentor of mine whom I thought was a good person.

Something I might one day want to do is work as a negotiator or at least prevention hotline. I'm not ready for it now, though, because I know one line would stop me and I wouldn't have anything good to say back. "You don't know what I'm going through." And they're right, I have no idea how much pain they're feeling...it could be emotional pain 10x worse than the physical pain of having an extremity sliced off...we don't know the psych/neuro illnesses causing their degree of pain.

BTW, don't know if it's the proper technique, but after having a number of friends go suicidal on me (I'm always the non-judging listener in the groups, so I think they come to me more), I just guilt trip the hell out of them...makes it easier to reach a resolution so much faster.

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The thing that i dont get with the way people accept and view suicide, are those people that will say "Suicide is so selfish, how could they be so selfish to kill themselves blah blah blah blah blah" and THEN at the same time will go "What about me? what about my feelings? Why didn't they think about me? they must not care about me?......so who's actually selfish here?

Think abou it.....

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