The Psychology of the Shirt by ProQuest

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									                                                                                                               Guest Editorial
By Tracey A. Loscar, MICP



The Psychology of the Shirt
Why you may need to distance yourself from injured colleagues

  As our EMS careers progress, we become accustomed                patient became ghost-white and said, “I’m
to being exposed to images and situations in our everyday          going to pass out.”
working lives that devastate those involved and can deeply           With his injury covered it was hard to process
affect witnesses and caregivers alike. Through this process of     what was going on. I ended up saying, “Come
gradual and continuous exposure, we often become inured to         on now! We can do this, it’s what we do.” As
such situations and incidents, taking the trauma for granted       a unit, the four of us grabbed him and lifted
and letting it wash over us like water off a duck’s back.          him onto the stretcher. As we started to realize
Sometimes we’re accused of being impersonal, distant and           we were dealing with a blast injury, it became
not invested enough, but such mechanisms serve to shield us        clear what our next steps should be. At that
and keep us functional.                                            point, I noticed his shirt, really noticed it. He
  It is when we personally identify with a patient that we risk    was wearing a summer uniform shirt and
losing the cushion of distance that helps protect our psyches      looked just like the rest of us. We were trying
and allows us to perform in high-stress situations. For some       to check his chest and back without removing
providers, calls involving children are especially challenging,    the shirt. I grabbed his shirt, looked at the
for others it might be when responding to victims of a             EMT next to me and said, “We have to cut it.”
particular crime. However, there is one situation that leaves      Doesn’t sound like such a big deal, does it?
providers vulnerable to their emotions—responding to               That’s what we do with trauma patients; we
line-of-duty incidents. When the patient is one of your own,       cut off their clothes. But in our eyes, he wasn’t a patient, he
everything seems to change. Seasoned veterans can lose
their focus, while brand-new providers might find emotional
reserves they didn’t know they had. But why are such calls
                                                                   was one of us. We started to cut off his shirt and the rubber
                                                                   band snapped, just like that. Time returned to normal, we
                                                                   started to talk above him and around him, and things got
                                                                                                                                        “patient
                                                                                                                                       the
                                                                                                                                           When
particularly challenging?                                          done to the best of our ability. In fact, the surgeons reported
  It has to do with identity. Our badges, patches and uniforms     that our initial actions contributed to their ability to save and    is one of
define who we are. They tell the outside world that we will be      rebuild as much of his hand as they could.
calling the shots during the next 30 minutes. Our uniforms           There is no layer of invulnerability sewn into our uniform
           
								
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