Alan Rudnicki, an Ambulance Emergency Assistant (AEA) at ER24 West Metro, describes how medics maintain their mental health under pressure in a high-stress environment.​​
Alan Rudnicki, Ambulance Emergency Assistant, ER24 West Metro

We cope with stress, we cope on empty stomachs, we cope because we do. The path we have chosen isn’t easy; it isn’t always pleasant, it isn’t the best paid job, but we don’t care because at the end of the day we can go home and say, “I saved that person’s

life”, a feeling that cannot be described to anyone who hasn’t experienced it. You need to have a passion for working in emergency medical services. It’s one of those jobs where you know from day one if you’re able to do it.

ER24 paramedics put their patients first under any circumstances.

On the scene

On a scene we can’t show emotion, we focus on one thing – our patient; knowing full well they might not make it. From experience you gain confidence. In the moment, you go into medic mode, focusing on whatever treatment needs to be given. You’re constantly aware of your surroundings. It’s not normal for a human being to be exposed to daily sadness but somehow, we manage.

We may seem emotionless at a scene of carnage, smiling despite being in the presence of tragedy, but it’s who we are. Appearing stoic is a much-used coping mechanism. We aren’t heartless, we do care – we care a lot. Our main concern is the wellbeing of that stranger trapped in a car or that homeless person lying in the wet streets on a freezing night after collapsing from hunger. We care for anyone, come rain or shine.

Once you get the patient to the hospital and the adrenaline rush starts subsiding – then you stop and think “oh wow”. That’s when many of us do a debrief where we chat about the call. Everyone can give their input into how it went, the positives and negatives – you always learn something and it helps to manage potential burnout.

We are human after all, not robots, and sometimes we just need that cry or chat.

How we cope

We all have our coping mechanisms. When I was much younger, I preferred to deal with challenges alone, but I let them eat me up inside. I remember going home thinking about a horrible call and having nightmares. If you don’t deal with an issue, it’s always going to stay with you. That applies to any job. You run the risk of mental health problems like anxiety or depression if you keep quiet. In the past 20 years or so it’s been much easier for me to speak to someone. We need to talk about it.

The idea that “cowboys don’t cry” has slowly faded over years. There was a time when it was “normal” not to show your emotions on a scene or around people who’ve just lost a loved one. We are human after all, not robots, and just sometimes we need that cry or chat.

Sometimes we find it easier to talk to our colleagues than our loved ones. At ER24, there are also counsellors on call 24/7 who you can speak to if a call really gets to you, or if something happens. Our shift seniors and branch managers are always approachable – and will give you time off if you need it, which helps to manage burnout. I speak to all of these people, and I encourage colleagues to talk to me too – I’m very approachable.

Having an escape from the work environment, whether it’s a hobby or meeting friends, also boosts mental health. I do amateur photography. After a cycle of shifts, I sit in Cape Town’s famous Kirstenbosch Botanical Gardens and take photos, go for a walk on the beach, or simply listen to the waves for 10 minutes.

Ultimately, it doesn’t matter where you work – just talk to someone. Don’t keep it quiet, don’t be scared to open up. Ask for help.

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