r/Paramedics • u/Anonymous_Chipmunk Critical Care Paramedic • 11d ago
Rescuer Guilt
I've been a paramedic for almost 15 years. I'm fortunate not to be burnt out, love my job, have good work:life balance, and have good mental health. But in June, on my birthday, I ran a call that would change me.
We were paged to a road where it crossed a creek (a common place for people to recreate) for a drowning. When we arrived a first responder was doing CPR on a 10 year old girl. She had been walking along the road when she slipped, fell into the upstream side and was sucked into a metal culvert under the road where she became entrapped for 5-10 minutes.
We resuscitated her on scene, did excellent patient care, and everyone executed flawlessly. I was truly proud of how our team performed that day. We obtained ROSC and transported her to a nearby LZ for a 25 minute flight to the nearest hospital.
She has since been transferred to a children's hospital where she stayed for over a month before moving to a rehab. She is currently vented with a trach, has minimal conscious activity, but does apparently have sleep and wake cycles, and some movement.
I struggled with this call for a while. This isn't my first pediatric call, they all suck, but this one was different. I live in a very small community and, unbeknownst to me, this family was very prominent. Everyone knows them. Everyone. The story was all over the Internet. Not just locally, but regionally. I couldn't escape coverage of it. Even now a few months later it's still everywhere. Signs, tshirts, gatherings, fundraisers, etc. I'm okay with all of that, but it does mean there's no "ignoring it."
For several weeks, maybe a month, things were hard. I struggled a lot. One day I was overcome with guilt. It was so hard to explain. It felt like survivors guilt, but I called it "rescuers guilt." I felt guilty to her parents. Not only did we not save your daughter, but she didn't get to die. She, and you, are left hanging in the middle. I understand rationally the chance of survival and the practicality of the situation. But I felt so guilty. I cried a lot that day. That was also the day I decided to use our EAP and get help.
I'm doing much better now. My therapist has helped my process my emotions and the trauma, but it's still a work in progress. I just wanted to post this because it would help me process, but also don't want anyone else burying themself in guilt for doing a great job against immovable odds. No matter what you're feeling, it's justified. Don't be afraid to seek help and talk it out. You're out there doing amazing things every day, don't hang your hat just on the big ones.
PS: I had a set back yesterday. I got dispatched to a drowning at the exact same crossing. It was an adult this time. Importantly for me, I handled it well. I was shook for a few minutes while we were responding, but I had managed it before we got there and again, our team did great. He will survive.
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u/CaptAsshat_Savvy FP-C 11d ago
I understand on a personal level. We fly some messed up people and I think to much. I also, have guilt, more so, I feel guilty that we are prolonging this persons suffering, what's the quality of life? is a positive outcome even realist, what else could I have known to impact a better outcome etc.
I also have worked hard to get that out of my head. I found it helpful to try and look at it from a different perspective and perhaps this could help.
I did not cause this event to occur. I have no control over any part of what happened. I only have control of what happens when I have this patient in the time that I have. While my actions have impact down the road, what's important is now. I'm hopefully making time. Time for loved ones to say goodbye. Time for life. That little bit is beautiful and I hold onto that small piece of beautiful to rationalize the madness.
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u/NinjaJake86 8d ago
This just reminded me of something we got taught on our course (I’m a CFR btw, not a paramedic) but we got told that while we may do great CPR, often the patient doesn’t make a full recovery like you would want, but us doing CPR can mean the difference between someone getting a call to tell them there loved one is dying and they need to come and say goodbye, to instead getting a call to tell them they have passed away
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u/rads2riches 10d ago
Honestly after clinical mistakes my biggest fear is saving someone only for them and their caregivers to have years/decades of misery. Saving/hero shit has a dark downside if you are an emotional intune person. Death sometimes is the most generous path.
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u/MaricLee 10d ago
I'm sorry you've had to go through that. I had a call where a baby had stopped breathing. I resuscitated successfully but I think it was too late to save her brain. Remains my worst call to date and I don't think I've ever properly dealt with that...
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u/SelfTechnical6771 10d ago
As hard as it can be,sometimes it can be so hard to recognize that the pt is no longer ours when they leave our hands. You did what you were trained to do. So you're agony and hers seem perpetual, please understand that you're hard work and diligence fully save somebody's life next time. You only know what you know and all the things you know, you don't know the future. I wish you peace soon.
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u/unorthodoxfun 10d ago
I’m sorry this happened, although I’m certain everything was done as well as possible based on the factors present on scene.
I’ve been doing this 32 years myself, and I believe that Fire and prehospital EMS is one of the most difficult jobs around. For reasons like this.
I know it’s hard, sounds like you did great, and don’t forget all the ones you’ve provided full saves for in the past 👍
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u/Pure_Cry6583 8d ago
Rescuer guilt is real. We saved them, but at what cost?
I had a fall a few years back that I ended up flying out. Patient was uninsured and ended up trach’ed and with a craniectomy. Hundreds of thousands in debt. I saved them, and I buried them.
But at the end of the day, it’s not my fault. I did what was right for a human life. I provided the best care I could, and gave them the compassion they deserved. The moment that helicopter took off, it was out of my hands. I cannot play god any more than I already do, nor can I control the state of the world. If I don’t let go of that, it will eat me alive.
As good old Olaf says, we’re call this controlling what you can when things feel out of control.
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u/traumasiren NRP 10d ago
Been experiencing something like this myself after a peds arrest this summer. Our kid’s outcome was nothing short of miraculous after a AAA with dissection. Cried to my partner just yesterday about how helpless I feel in this job sometimes, even when my help makes a huge difference for a patient and their family.
I have no advice for you. But you’re not alone. Stay strong, friend, and keep leaning on that support when you need it.
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u/forksknivesandspoons 8d ago
Sorry to say this but it’s not your fault. You can’t change some things or the outcome. Sometimes biology will do whatever it wants despite doing all the right things well. You have to almost not care. Do your job, be professional, do the right things but at the end of the day, you didn’t cause the problem and it’s not your fault. You and your crew only do what’s expected and what you are trained to do. Rinse and repeat.
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u/Sad_Faithlessness585 7d ago
Im going to go out on a limb here and say this is far more common than you think. Personally, guilt has been one of the huge factors in my PTSD which mainly stems from a successful resus of an 11 month old. Now, by the books, clinically, we smashed it. Good ROSC, excellent care, right team, right meds, right children's hospital. And this is what we go to work for, right? So I really really grappled, and still do, about why I've never felt proud of it.
This kid is now severely disabled, life-long complex medical needs, but he's home.
And I feel guilty for that, I'm almost ashamed to admit the amount of times I've wondered if he and his family would be better off if we hadn't been successful (in no way am I suggesting I would ever not try my hardest) but those thoughts are there.
Rather tragically, we live in the same community and I live in fear of bumping in to the family and being confronted with what I've done- and yes I'm in therapy and I know I didn't cause this, but they're called irrational thoughts for a reason I guess...
However, a colleague of mine went back to him not too long ago, and he's so loved, and cared for and the family are so grateful that they have him. He's their boy and they bend over backwards to keep him safe and comfortable.
I think, we have to be kind to ourselves. We have to do the best we can, and you've done a good thing. You've saved a life. Its a horrible thing to witness and its so important that we reach out when we need support. Just remember that you're not alone with it.
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u/onyxmal 11d ago
Are you religious?
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u/Slight_Can5120 10d ago
While it’s been said that “there are no atheists in foxholes”, in my time in 911 EMS, I found most medics who’d been at it for several years were agnostic or atheist.
Having faith when you see what we see is a challenge.
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u/pairoflytics 11d ago
Perhaps taking up the torch of improving safety barriers at that culvert/creek would be something actionable you can do to help work out the remaining trauma.
Good on you for seeking help. I’m sorry to hear about the girl.