Over 240 million calls are made to 911 in the U.S. each year. For the Emergency Medical Dispatchers (EMD) that must answer these calls, there are some serious mental and physical consequences. Dispatchers spend their entire shifts dealing with people in the most panicked moments of their lives, and those people’s lives are dependent on how quickly and efficiently the dispatcher reacts. EMDs dispatch help in the form of fire, paramedic or police first responders, and stay on the line with the caller until help arrives. And, as a result of the many hardships of the job, there is a national shortage of EMDs across Canada and the US.

Why It’s Hard

Being an Emergency Dispatcher is difficult for a multitude of reasons. Firstly, the job is incredibly intense and stressful; at any moment you could answer the phone to a panicked caller and alter the course of their lives depending on your actions. To top it all off, this is done at a lower salary level compared to other first responders.
Those that quit during dispatcher training cite not being able to handle the “rapid pace of the job and the responsibility of having someone’s lives in their hands.” The hours are long, and there is mandatory overtime; working during emergencies and on holidays is often required as dispatchers are needed 365 days out of the year, 24 hours a day. In small towns, dispatchers must often take calls from people that they know.
To make matters worse, dispatchers do not find out what the outcome of their calls are. They can walk someone through performing CPR, and once the first responders show up, that is the end of their involvement. They usually don’t get the same recognition as first responders, and they don’t get closure. There is no resolution, they just pick up the phone and move onto the next call.
Emergency dispatchers are taught to control their emotions when taking a call, which can be psychologically draining. And, even though the dispatcher may not physically be on the spot of the incident does not mean that they are not affected or experience trauma. For the first responders who spoke to a person for the last few minutes of their life before they decided to the pull the trigger, the trauma is very real.
As well, dispatchers work individually while other first responders work as teams. After a traumatic incident, two partners might grab a coffee, decompress and talk out what just happened. The emergency dispatcher, on the other hand, can take maybe ten minutes to cry in the hall, before needing to get back on the phone lines and do it all over again.

The Effects of the Job

While not previously recognized, the effects of being an emergency dispatcher are becoming more and more clear. In 2013, being an EMD was named the 13th most stressful job in America. The job is highly demanding – dispatchers are dealing with constant bursts of adrenaline as they receive panicked calls for up to 12 hours a day.

Post-Traumatic Stress Disorder (PTSD)

The risk of post-traumatic stress disorder (PTSD) is high in the profession. Psychology Today wrote an article describing how a dispatcher named Gail was diagnosed with PTSD after she took a call from a family that had just witnessed their three-year old child plummet to his death from a 17th story apartment. Gail had to listen to the family scream and cry in horror, and as per her job guidelines, she had to instruct them to attempt to save the boy, even though she could tell from their description that the child was dead. Gail may not have been at the scene of that call, but that does not mean it doesn’t haunt her to this day.

Vicarious Trauma

Another common side effect of the emergency dispatcher job is experiencing vicarious trauma. One of the effects of vicarious trauma is becoming pessimistic and cynical. A study of EMDs concluded that EMDs felt they are exposed to “a ‘darker side’ of life…  calls surrounding assault, substance abuse, murder and mental health problems. One first responder reported starting to become suspicious of everyone:

Burnout

Perhaps the most prevalent of all is the reports is burnout. Burnout is a special kind of job strain that results from prolonged stress. It leads to physical, emotional and/or mental exhaustion and often leads the individual to feel “low-job satisfaction, powerlessness and the feeling of being overwhelmed.” And, in the work environment of an emergency dispatcher this cocktail of scenarios easily emerges.
  • Powerlessness: Often dispatchers can only help to a certain degree. If the emergency responders do not arrive in time, the dispatcher must hear the caller succumb to their injuries/attacker/situation.
  • Low Job Satisfaction: Even if the dispatcher was able to keep the caller calm, and get assistance out to them on time, they usually do not hear if the caller was saved. Once responders are on the scene, the caller gets off the phone. They do not get the thank-you from the saved ones or the closure to find out that that close-call they were on the phone for 20 minutes with, didn’t make it.
  • Feeling of Being Overwhelmed: Between the long shifts, mandatory overtime and the back-to-back calls, it is easy to feel overwhelmed in the job. To put down the phone after hearing someone have a heart attack and answer the next call of someone screaming that they can’t find their child, there can be no time for recovery.
Any, and all, of these conditions can follow a dispatcher and begin to shape their personal lives.It is important that dispatchers know how to fight against these conditions so that they know how to take care of themselves.

How to Recognize Burnout

It is not all hopeless, and there are steps that can be taken by dispatchers to battle dispatch fatigue. The first and most important step is being able to identify when you are experiencing burnout, PTSD or vicarious trauma. By recognizing the indicators of these conditions in yourself, or your coworkers, you can take early steps to reverse the effects.
  • Chronic fatigue
  • Insomnia
  • Physical symptoms such as chest pain, headaches, shortness of breath
  • Loss of appetite
  • Anxiety
  • Depression
  • Increased anger and/or irritability
  • Loss of enjoyment
  • Pessimism
  • Isolation
  • Detachment
  • Feelings of hopelessness
  • Lack of productivity and poor performance

Preventing Dispatcher Burnout

Dispatch centers can take preventative measures before even hiring a recruit for a dispatcher position. Most dispatch centers screen applications with a psychological assessment to ensure that the individuals can handle the complexities of the job. However, an argument has been made that these assessments should continue after the individual is hired, as regular check-ins. For example, the RCMP reassess its dispatchers every two years to ensure that nothing has changed for the individual’s mental health.
Recognize that you are experiencing stress before it turns into something else. Ignoring stress can leave it to compound and develop into burnout. Some dispatch centers in Canada are teaching new recruits “to recognize signs of stress, whether the symptoms are physical, emotional or behavioral. Through role-playing scenarios, trainees learn about personal triggers and are encouraged to discuss their emotional reactions.”

Practice Self Care

If a dispatcher has identified that they are overly stressed, the best preventative practice would then be self-care. Eating healthy, exercising, relaxing in any form, yoga and meditation are proven methods to relax and take care of yourself, significantly decreasing your stress levels.
Getting enough sleep is also a priority. Getting 7-8 hours of sleep most nights will allow your mind and body to recover and protects your health.

Limit Caffeine Consumption

It is recommended that caffeine intake should be limited in the afternoons, as one cup of coffee can disrupt your eight hours of sleep later. While this is easy to suggest, and harder to implement due to the 12 hour shifts where dispatchers need to be on constant alert, it is a vital to cut down on caffeine. The simple fact of the matter is that dispatchers already have enough adrenaline pumping through them throughout the day due to the high-pressure stakes of many calls.  Caffeine can cause “nervousness, sleeplessness and irritability” so it is best to avoid it when possible.

The Combat Technique

Dave Larton, an associate editor for 9-1-1Magazine.com, who has 35 years of emergency service experience, teaches “trainees to use combat breathing” (also known as tactical breathing), during a call if they are feeling overwhelmed or anxious. This breathing technique is described as “four counts to breathe in, four counts holding that breathe, four counts to breathe out.” Larton believes that this will help them get through the call, at which point, they can take a few moments to recover.

Focus on Positive Outcomes

Most importantly, dispatchers need to learn how to focus on the positive – on the calls where they made a real difference. Where they helped a parent calm down and locate their child in the neighbor’s backyard, or where they walked someone through performing CPR on someone in need, or where they advised someone how to lock themselves into a bathroom until help came. These moments are the reasons they became a dispatcher in the first place – to help those in need. And they are saving countless lives with the work that they do every day.

The Future: Removing Misconceptions

Change is on the way, with a lot more attention on the psychological effects that dispatchers experience due to their job. Previously, PTSD was never associated with the job as dispatchers were not on the scene, but this has changed. Programs are being implemented so dispatchers can get the help that they need, when they need it. And they are being given tools themselves to fight against these conditions. “The National Emergency Number Association said the field has begun to appreciate ‘the long lasting and severe physical and psychological effects’ of the 911 jobs.”
Dispatchers continue to be heroes that help the population access the emergency services it needs. It is important to remember that dispatchers help people who are having the worst day of their lives, over and over again.