Deacon Michael talked about trauma and what to do with it last week, and as well as taking care of your body he suggested sharing our traumatic experiences with others, and also that is helpful to share anything other than that traumatic experience with others. He hit on something that seems to be a core human need: social connection.

I expect we can all think of times with others when we felt really connected – when we shared laughter or tears, or those important moments in our lives. Something we might have been missing recently, during lockdown, is the day-to-day connection with others that is important as well – both physically and mentally. There really are strong connections between social isolation and loneliness with cardiovascular, autoimmune, neurocognitive health – not just our mental health.

I wonder what this magic is that makes our connections with other humans so helpful to us? Perhaps it is about being in the here and now, right in the present. When we are with another person, we are forced into the present and into that moment we share together – even if it’s a quick conversation in a queue with a stranger. Alone, we might find ourselves going over past events, worrying about the future, and we might struggle to place ourselves right in the present.

There are so many clichés about how great it is to live in the present: ‘Yesterday is history, tomorrow’s a mystery. But today is a gift, that’s why they call it the present,’ and great thinkers remind us that ‘Nothing is more precious that being in the present moment. Fully alive, fully aware,’ (Thich Nhat Hanh). I’m not sure that abandoning the past and the future is entirely right – we often need to process past events, make sense of them and put them away, and we also benefit from imagining our possible futures and planning for what might lie ahead. But sharing a moment right now with a friend or relative, or just passing the time of day with a stranger, might give us a gift of the present.

I suppose all that above is something we mostly know to be true – speaking to people is good, having close relationships is healthy - but like a lot of things, it isn’t always easy to go out and find these connections.

I wonder how many of us would say we are always confident to talk to other people, always happy to take that first step and make contact. I know for me I would normally rather not! I suppose this is a mixture of lack of confidence, a fear of rejection and a feeling of not wanting to interrupt or intrude. It’s easy to give myself excuses to not make contact and to avoid taking that risk. But a part of me also knows that I need social connection and wants to just go for it – to feel the fear and do it anyway.

To be able to make that first move, I remind myself of all the clichés and memos I have seen that remind me how important social connection is – that a smile from a stranger really can make someone’s day, a call from a friend can remind us that we are loved and remembered and an honest conversation with a colleague can build stronger relationships at work. I remind myself that the person I am going to talk to is an adult who can take responsibility for themselves, and if I am interrupting or intruding, they can manage this. I remind myself of all the times I’ve made the connection and it has gone well, and of all the times someone else has connected with me, and I’ve enjoyed it. I remind myself that I can build deep connections with people, and I remember to be brave: “Courage starts with showing up and letting ourselves be seen.” (Brené Brown)

Some days these reminders come easier than others – some days no matter how much of a stern talking to I give myself, I’m not going to be able to start a conversation. On those days, I also remember to be kind to myself, and show myself the care and compassion I can show others. It’s ok to not be able to do everything every day.

But on a day when I can make a connection, maybe I feel like I can say something to a stranger, or call a friend, or start a conversation with a colleague, I take a few deep breaths, I reassure myself that it will be ok, and then I jump in.

So now you’ve read all this, I’d like to offer you an invitation to have a think about yourself and how you manage your social connections. Are you someone who can take that first step? How does it feel when you do? Can you give yourself kindness when you can’t do it? Once you’re in there, can you be open and vulnerable? How does it feel when you are?

Some of the things that come up for you might feel scary and risky – you might like to remind yourself that you are not alone in feeling like this. Remember that kindness you can so easily show to others? Be kind to yourself.

Places that might be helpful:

https://brenebrown.com/

https://www.psychologytoday.com/us/blog/mindful-anger/201703/how-make-friends-adult

https://www.helpguide.org/articles/relationships-communication/making-good-friends.htm

 

Jessica Tett

We are now in day 58 of lockdown.

Let that sink in.

I'm going to say something that some may see as controversial. But, please indulge me and let me explain my rationale behind my thoughts.

I am pleased the likes of McDonalds, KFC, Burger King, Costa, Starbucks etc are all opening back up. There, I said it.

There are many schools of thought which are not happy that these businesses have re-opened. Mainly down to the incredible demand that they've seen through their drive thru lanes. I totally get that, and understand why people might get a little irked to see someone queue for ages in their car just to get a burger. Just how essential can a cheeseburger be?

But, these things are an important part of normality for many. As we move further into a period of uncertainty, the fact that these little things can be available to us are a step into trying to make life seem that little bit more normal. Life's going to be incredibly difficult for a long time, with the things that we used to be able to do freely becoming a bit more of a challenge. At least until the picture of how we deal with Covid19 becomes clearer.

 But, the point I have in this blog is this.

 Throughout all this, for us emergency service workers, NHS staff, keyworkers, day to day life has not changed, but in some ways it has changed dramatically. We have continued to go to work. We have had to try and hold on to a sense of normality doing the jobs we did before this and that we'll do after this.

 The bit that many will have found tough is the fact that the things that we would do to try and maintain a normal life and to relax or decompress after a stressful time at work; shopping, eating out, visiting friends and family etc have all been taken away from us.

 This can have a massive effect on our mental health. As simple and trivial as it may seem, the fact that these little things become available allow us to try and maintain a sense of normality for us and our families.

 Everyone who is working through these challenging times deserve a chance to do the simple things that keep them happy.  If that's a cheeseburger, or a fancy coffee, so be it. 

 Go get your cheeseburger without judgement.

 I'm not downplaying how hard it is for people who are stuck at home too. Simple pleasures can go a long way to helping some of the mental effects of being stuck at home. Especially so for some of our children who might not be able to understand exactly what is going on.

But for us, who have been carrying on regardless, it's especially important to have the little things.  Something as simple as picking up a quick meal on the way home can do wonders for your mental health. It can help you relax. It can help you maintain normality, in a time when a sense of normality can be hard to find.

 The fact that it's harder to even just jump into a shop quickly on the way home has a huge effect on your mental wellbeing. The fact that life has had to become meticulously pre-planned to ensure you have time to do the things that would have taken minutes before is undoubtedly one of the toughest things that we have come up against. Especially for us who have been at work, and find ourselves in the position that in the limited downtime we do have, we have to plan more and more how to make effective use of it for not only relaxing but trying to do "normal life". Yes many places have given accommodations for keyworkers, but who really wants to be up on the super early restricted times on a day off? That in itself can have a detrimental effect on our mental well-being.

 So lets not underestimate how something as simple as a fancy coffee, or a burger can help someone.

 How busy these places have been are testament to how much that as a world we need these little things to maintain a sense of normality. Like everything, the initial rush to experience something "new" will always happen, but I have faith that eventually that things will settle as the "new normal" becomes just that, at least until things become clearer.

So, I say to all you key workers, to my colleagues in the ambulance service and throughout the NHS. Go get your cheeseburger without judgement. Go get your Starbucks frappe. Get your KFC bargain bucket for your family. These are all key in helping you maintain a healthy mental state. ANYTHING that can allow you to hold on to a sense of normality in these incredibly difficult times is hugely important, no matter how trivial some may see it as.

And to those stuck at home, the same goes for you too. These little things are wonderful and should not be underestimated how they may make you feel better mentally.

 As long as we continue to do it in a safe, socially distanced manner for now, I see no problem with it. Be safe. Be happy. Be sensible.

 
Darren Miller
 

 

 

The other day, I was vacantly watching television (a behaviour that risks becoming a habit during COVID 19) and I heard a brief interview with a Junior Doctor. She looked weary, was still dressed in scrubs and appeared to be engaging in the interview in a Hospital corridor. I was struck by something she said. She commented that things had been really tough for weeks, but that the situation was beginning to ease. That was both a good thing and a bad thing, she observed. It was a good thing in that the actual work was becoming more manageable but having more time available was leading her into difficult reflections. Had she done the right thing for each patient? Had she made mistakes? Were there things she should have done differently?

 

Listening to this young Doctor made me think about trauma and the far-reaching effects of traumatic experiences. Common sense would tell us, and research supports this fact, that dealing with trauma while the trauma is on-going is unhelpful. It’s when the trauma is passed that the healing (if any is required) needs to happen.

 

I suspect that many of our SAS colleagues have been exposed to very difficult situations over the pandemic. In addition to the usual stresses of the job, there will have been added stresses tackling an unknown and unseen virus, coping with the fears of clients, and the fears of colleagues and families, not to mention fears experienced by the staff themselves. If trauma is defined as ‘an overwhelming amount of stress that exceeds the ability to cope”, the last months have certainly been traumatic and coping with that, as things improve in whatever form that will take, might take some consideration.

 

As the pandemic eases, it will be natural for staff on the front-line to feel a bit dazed and shocked, perhaps even a bit ‘cut off’ or slightly numbed to usual feelings. Initially, a coping mechanism may be to deny the extent of those feelings. Feelings are rarely rational and can encompass all kinds of sensations. Fear may be part of that range of experiences, as will feelings of helplessness, and even feelings of anger and guilt. Sadness may be present and there may even be feelings of shame. All of these feelings may be part of a very normal reaction process following intense exposure to traumatic events.

 

There may be other physiological responses experienced, including difficulties with sleep, exhaustion, nightmares, poor concentration and memory difficulties. Again, all of these responses are to be expected in the days following trauma.

 

So, what might be some helpful strategies to deal with this post-traumatic experience? Research seems to indicate that it is important to give yourself time, to recognise that what you’re feeling is part of a natural response, and to accept your feelings as part of that response. Discussing your experiences with other members of your Team can also be really helpful. Spending time with people who have had the same experience that you’ve had, and sharing that experience, can be useful. Taking time for yourself and beginning to re-engage in hobbies/pastimes that you previously enjoyed is also a good idea. Sticking to usual routines regarding meal-times, for example, even when you don’t feel especially hungry, can help to ensure that you maintain a balanced diet and is an important part of looking after yourself. In addition to talking to colleagues, it might also be useful to spend time with friends and family who have not had your experience and with whom you talk about anything but your recent work!

 

It is important to ensure that you don’t ‘bottle’ your feelings up. Talking about things is always a great way to put things in perspective. It will be crucial to ensure that you give yourself some time to recover. Don’t burden yourself with a lot of unnecessary things to do. Watch your alcohol intake and ensure that you are drinking within safe limits.

 

In very general terms, responses to traumatic events tend to ease within a month or so. If things seem to continuing beyond that point, and your family and friends may begin to notice some changes in you, it might be helpful to seek professional support. There is no shame in needing some extra help and it is important for you to seek that help if required.

 

You may feel defeated by your experiences, close relationships may come increasingly under strain, work may begin to suffer, you may be relying on alcohol more than is helpful. If any of these things are happening, consult your GP, who may refer you to support services, including Clinical Psychology. You can also consult Occupational Health. Remember, there are services out there aiming to help the helpers!    

 

Rev Dr Michael Killoran Ross

Chaplain - SAS

 

It’s eight weeks now since lockdown began and it’s got to the point where social distancing has become the accepted norm in day to day life. For me, the weeks are starting to merge into one with little difference between the weekdays and weekends. That said, this week has been a little different, there has been a lot of commotion as politicians try to work out when it is best for the country to move away from the current restriction measures we are in. Whatever path we eventually follow out of lockdown, it appears that life as we knew it will still be a long way off. With that in mind I decided to try and work out a few points I have learned over the last eight weeks;

 

Teaching children at home is not my strong point - in fact it’s incredibly hard.

1. Running out of toilet paper never posed a threat to humankind.
2. Family and friends are so important, and I miss them.
3.  I now understand the true value and meaning of freedom.
4. The staff of the NHS are amazing, and I am so proud to be part of that team.
5. An appreciation of the great outdoors and the fact I now live in a beautiful country (Scotland).

The last point brings me onto the wellbeing theme that the Scottish Ambulance Service and NHS Scotland are promoting this week, which is ‘Physical Activity’.

 

Truthfully, when I am at home, I have always been the kind of guy who likes to put his feet up with Netflix and relax. That was until November 2017 when I found myself talking about mental health in the emergency services to the Royal Family (Prince William, Princess Kate and Harry). They were launching the Heads Together Programme alongside the London Marathon. At that time, I didn’t really understand how physical health and mental health went together, but I went with it. After the event, I got to meet the Royals which was incredible. Harry was a genuinely nice guy and indisputably wanted to raise the profile of mental health and wellbeing. After our little chat, he challenged me to run the London Marathon and before I could answer, I had a poster in my hand saying, ‘you’re in’, with pictures being taken by the press – I think Harry secretly found this challenge quite amusing.

 The challenge was set, I had 6 months to go from couch to 26.2 miles – prior to this the only place I had ran was between pubs in the rain. I started my training almost immediately. the night after my first run (a mere half a mile) I slept the best I had slept in years. I followed my training plan and eventually found myself able to run further and further. I found myself becoming happier and a generally more relaxed as a person. If I had a bad day, I was able to return back from a run a new person – I was finally able to blow of some steam and enjoy the great outdoors. It eventually got to marathon day and I only went and finished; I’m not going to lie it was one of the hardest things I have ever done, but the sense of achievement in being able to reach my goal still stays with me.

So, I guess that’s the link between mental health and physical health, I felt a new person after my first run. But not everyone needs to run a marathon, or even choose running as their physical activity, its important you get active your way. I tend to cycle or just go for walks nowadays, but it’s the doing something that feels great and it means I have earned my rightful place on the sofa that evening.

 You can find out more about physical activity and some ideas on how to get going here:

https://www.nhs.uk/live-well/exercise/get-active-your-way/

 If your already physically active…great! Share the benefits of this with your friends and colleagues, and once the lockdown and social distancing is over, encourage them to join you on your next outing.

I have recently transferred into SAS as a Paramedic from another service where I have worked for 15 years. The plan was to move up and start a new chapter in life, this was quickly changed by the covid-19 pandemic as I am in Scotland and the kids are still back in England. Thankfully, the wonders of FaceTime and Skype have helped us to keep in touch, more recently as the children’s mum is now classed as an essential worker, I have had to start traveling back to take care of the kids whilst she works. I’m not alone in this I know a lot of us are making sacrifices at the moment – which can be tough on us as individuals.

A number of years ago I attended an incident which changed my life, it was a call to a child that had significant injuries, who sadly died. Following the incident, I felt withdrawn, alone and didn’t know where to turn. Mental health was a taboo subject and the term health and wellbeing hadn’t even been conceived. When I tried to seek help, I was asked to consider if this job was really for me. I am pleased to say I didn’t even consider it – throwing in the towel was not an option. After a rocky road of getting into a deeper and darker place I eventually received support via my own GP who put me in touch with an amazing counsellor. The day I met my counsellor I instantly felt supported and that the weight of the world had been lifted off my shoulders. After a number of months, I started to feel like a new person, I was diagnosed with Post Traumatic Stress disorder, I still live with elements of it today – but in a much more controlled way.

Following my PTSD diagnosis, I knew things had to change. I have been lucky enough to work with the Royal Family on the Heads Together mental health programme and won the NHS Heroes Award on ITV for my support to colleagues as a Mental Health Champion. As you would imagine I have a huge passion and interest in how we as colleagues and the organisation support each other not just on a day to day basis but when things get tough.

Over the last week I have had many interesting conversations with members of the senior management team within SAS, offering my support and help in supporting colleagues and with our services approach to health and wellbeing. Despite the obstacles that recent times have imposed on all of us, the team are working as hard as they can to roll out new and exciting programmes to support us all.

Now, I must admit I am often very critical about how services support us and question whether its just an answer to a tick box exercise – from what I can see this far, I’m pleased to report it doesn’t feel like that, it’s a genuine attempt to support us. The best thing is that we are all invited to play a part in designing what we want as frontline staff, whether that be in an Ambulance, in the Control Room, Workshops or Finance department – we are all welcomed and encouraged to get involved and make suggestions. Visit http://www.formwize.com/run/survey3.cfm?idx=505d04080b0b0100

There are long term and short-term issues that need to addressed, but mid pandemic the team are looking to support the here and now. In the future they want this to grow into bigger and better things. Over the next few weeks the team are working on different themes, this week’s theme being Resilience.

So, what is resilience, is it another corporate term? Well when I was diagnosed with PTSD eventually, I learnt to see the time I was low as a positive experience. I even started to call my diagnosis post traumatic resilience, because the whole experience has made me a stronger person, more aware of mine and my colleagues mental health and ultimately it made me a stronger person. That is RESILIENCE.

But the good news is we don’t all have to go through a really bad time to improve our resilience, there are lots of techniques we can do on a day to day basis. In the past I have presented to groups discussing resilience, one of my first questions is ‘what are the qualities of your closest friends, that make you cherish them’? Often there are varying answers but every time the some of the same answers come through, these are: Accepting, Non-Judgemental, Loyal and Respectful – to name but a few. I then ask the group when was the last time you showed these qualities to yourself? It’s normally at this point when the penny drops amongst the group, that we are often too hard on ourselves, we wouldn’t be this critical with friends, we would support them. Understanding this principle is the first step to resilience, there are many more things we can do to increase our resilience, some of which are being uploaded to the @SAS intranet site. However, some other top tips include:

• Be kind to yourself. Take care of your body and mind through things like good nutrition, exercise and practices such as mindfulness and keep active; talk about the things that are bothering you and take regular breaks to disconnect and recharge.
• Secondly, consciously notice your thoughts and feelings and don’t try to suppress the uncomfortable ones – recognise that they’re all equally part of being human, alongside the good ones! Aim to keep things in perspective and cultivate a habit of seeing positives and learning from your experiences; and
• Finally, social support is critical for resilience so stay connected to friends, family and colleagues and know that you are never on your own.

But one thing we must realise is that despite working for an emergency service, we are all human, the uniform is not a suit of armour. We may be fine mentally or we may not – but working for the Scottish Ambulance Service is like being part of a large family, look out for yourself and each other.

 

Remember - there is always someone to talk to, its ok not to be ok.