To be a first responder is to participate in some of the most rewarding work possible. You make a difference in the lives of others — and may, in fact, save lives, as well as property. 

But that doesn’t mean there aren’t significant challenges. You may face hazards that can threaten your own life. You may find yourself working long, exhausting hours. And in the midst of all this, you may face burnout and high levels of stress that can impact both you and your loved ones. 

Burnout is not uncommon. Utah State University reports that nearly 70% of first responders feel they need more time to recover between traumatic events than they have. As many as 37% of fire and Emergency Medical Services (EMS) first responders have considered suicide, which is 10 times higher than the national average. 

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How Does The Pandemic Continue To Impact The First Responder Community? 

COVID-19 has made life harder for first responders. “Covid has significantly impacted work for first responders, especially EMS personnel,” says therapist and former Emergency Medical Technician (EMT) Kelly Lynch, LCSW, owner of Turning Point Wellness. “From poor access to appropriate PPE (personal protective equipment) to feeling betrayed by management through lack of support, little to no time off, and a significant and ongoing increase in acuity of call volume and severity. Burnout rates have skyrocketed.”

First responders working in healthcare are particularly at risk, reporting significant rates of emotional exhaustion and burnout. A study reported in the Annals of Emergency Medicine found nearly 20% of emergency room personnel screening positive for Post Traumatic Stress Disorder (PTSD) risk. 

But healthcare is not the only industry impacted by the pandemic. A study done at the University of Texas at Dallas indicated that firefighters face stress from unexpected sources. Writing at www.firehouse.com, study author and risk management expert Steven Haynes said, “as a result of lower fire academy numbers, decreasing funding sources, and challenging political climates, many departments are forced to increase mandatory overtime requirements on their members. Coupled with the already stressful nature of the job, these conditions are leading to higher burnout rates and turnover intentions.”

Haynes and his colleagues believe that the outcome of administrative difficulties, such as increased overtime, more complex rules and procedures, and more, will have a lasting impact on the lives of first responders. Inconsistent practices cause conflict, which leads to both internal and external signs of stress.

What Is First Responder Burnout? 

According to the CDC (Centers for Disease Control), the stress felt by first responders has two primary outcomes:

  • Burnout: This is the feeling of overwhelming exhaustion and the sense that you cannot handle all the tasks you are facing.
  • Secondary traumatic stress: In this case is a result of being exposed to the trauma that other individuals are facing, rather than your direct trauma. 

These two outcomes are closely related, and experiencing secondary traumatic stress may bring on burnout. Other causes, according to Joseph Hunter writing at www.armorupnow.org, include:

  • Long shifts (that may include overtime)
  • The stress of each call
  • Too many shifts in too short a time
  • Too few first responders at a call
  • Handling difficult patients or other people
  • The sense that first responders need to seem invincible
  • Increased number of calls (especially true of EMTs during the pandemic)

The impact on first responders can vary, with an increased risk for a broad range of negative behavioral health outcomes, including:

  • Personal distress, both on and off the job
  • Periods of intense worry
  • Disturbed or broken sleep
  • Inability to concentrate
  • Difficulties in dealing with a spouse, children, or other family and friends
  • Substance abuse, whether of alcohol or drugs
  • Depression

Sleep Disorders That Impact First Responders 

Several sleep disorders are common among first responders, both before COVID-19 and now. Nonetheless, after a year of pandemic, the incidence rate increased. 

Insomnia 

Insomnia is characterized by persistent difficulty in falling asleep, as well as low-quality sleep and disrupted sleep. It can be chronic with first responders. 

Fatigue or excessive sleepiness

This is another common problem with first responders. Fatigue or excessive sleepiness may be related to the nature of shift work, which is so pronounced among first responders that there’s a name for it: shift work disorder. 

Sleep apnea 

With this disorder, your breathing stops and starts again erratically during the night. According to the American Sleep Apnea Association, first responders have a high rate of sleep apnea

Restless leg syndrome  (RLS)

People with restless leg syndrome get an intense urge to move their legs when lying in bed or sitting for long periods. It can cause daytime sleepiness and problems with concentration. Severe RLS may interfere with day-to-day life and require treatment by a sleep expert.

It’s not hard to understand why first responders are so prone to sleep disorders. Firefighters, police officers, and EMTs often work long shifts of up to 24 hours or more, followed by a shorter rest period. When they are on duty, their work is intense and concentrated. There may be times when first responders fear for their safety. Even a quiet night at the firehouse, for example, will have the firefighters anticipating a call-out — and thus unable to relax and get some shut-eye.

What Are The Best Ways To Respond To YOUR Needs? 

If you are experiencing stress or sleep disturbance as a first responder, the first thing you need to know is that you’re not alone. Shalini Paruthi, M.D., writing on the American Academy of Sleep Medicine website, reported that a study of nearly 7,000 firefighters indicated that 37% screened positive for sleep disorders. 

So what are the best ways for first responders to build resilience and maintain their equilibrium in sometimes less-than-ideal circumstances? Here are seven possible techniques from therapist Kelly Lynch that you can use to minimize health issues while being the best you can be at your job.

1. Take care of your body

“When [first responders] move their bodies on a regular basis, hydrate well, eat well and practice good sleep habits, they are taking good care of their bodies,” says Lynch. Maintain a good diet and get regular exercise, and if possible, drink adequate water even when you’re on a call.

2. Excercise your brain too

Lynch suggests keeping a journal or making reading a habit. Do you enjoy crossword puzzles or other mental challenges? Make them a regular part of your routine.

3. Make meaningful connections

First responders report experiencing less intense rates of burnout if they feel supported by a community of people they feel are trustworthy, and they can be vulnerable with because they feel safe with that particular community,” says Lynch.

4. Practice good sleep behaviors whenever possible

Try to eat at least two hours before you go to bed, keep room temps low and lights off as much as possible, and avoid using computers or other devices at least an hour before shut-eye. Weighted blankets are also an option for relieving stress.

5. Recharge when and how you can 

What sparks joy in your life? If you can answer this question, you have a good lead on what you might do to counter the stress of your work life. Even if you are working in a disaster situation, it’s not wrong to ask for some personal time to recharge and rest.

6. Be proactive in seeking support resources 

Lynch recommends podcasts such as That Peer Support Couple, Code4Counseling, and books like Hold the Line and Emotional Survival for Law Enforcement. Lynch herself posts live videos weekly to her Facebook page

7. Keep it simple

“I emphasize to all my clients that simple is better,” says Lynch. That means that it’s probably best not to try to implement a handful of changes at once. Try one thing: say, putting away your cell phone an hour before bedtime, and see how that goes. A week later, add something else to de-stress.


To see a zoomed in version of our recommendations, please click here.

Thoughts From First Responders Around The U.S 

Every first responder will have their unique take on the topic of burnout. Writing for fireengineering.com, John M. Buckman, chief of the German Township (In) Volunteer Fire Department, suggested a few possible tips for firefighters facing stress. “Don’t take the fire department too personally,” he said. “The department operated before you arrived, and it will operate after you leave. If you think you are indispensable, this attitude will increase your risk of burnout.”

Buckman also suggested regular exercise workouts and leaving fire department problems at the department, rather than taking them with you when you go. “Give the fire department your complete attention while you are on duty or at the department, but leave it there when you go home,” he wrote.

Firehouse.com quotes Chief Sam DiGiovanna of the Verdugo Fire Academy in California, speaking about stress. “As first responders, we see a lot of trauma while dealing with many types of personalities—both good and bad. It’s hard to become completely proficient with all that is required of us nowadays.” Chief DiGiovanna recommends mindfulness techniques for first responders to help keep the stress at bay. 

What is the toll that stress takes on first responders? Nothing we can say will have the impact that firefighter-technician Tyree Kable of Loudoun County (VA) County Fire and Rescue has with his story of dealing with PTSD in the following video.

  • Tyree Kable’s Story


Resources For Coping and Staying Resilient

As we said before, if you are struggling to deal with stress or burnout, you are not alone. Nor do you have to find a way to heal on your own. Here are a few of the resources available to help first responders and all those coping with burnout.

ResourceWhat it offers
National Center for PTSDThis website, run by the U.S. Department of Veterans Affairs, is an education and research center on traumatic stress. Learn more about what it means to have PTSD, how to manage symptoms, and care centers near you.
Resilience Resources for Emergency ResponseLook here to find assistance if you are a federal or federalized employee involved in first responder work following a disaster or catastrophic incident. 
Surviving the Job: Emotional Self Care for First RespondersThis one-hour webinar, sponsored by the International Fire Chiefs Association, outlines concrete steps that responders can take to protect themselves and their families. 
YOU/ResponderStrong websiteA confidential space for first responders, their family members, and caregivers, this site features resources and tools to help responders stay strong for themselves and others.
The All Clear FoundationA nonprofit, nonpartisan foundation focused on collecting resources to aid the wellbeing of first responders and their families. 
Mindful Responder: The First Responders Field Guide to Improved Resilience, Fulfillment, Presence, & Fitness — On and Off the JobMindfulness and meditation have been shown to improve our response to trauma and stress. This book is focused on helping first responders use these techniques to maintain health and resilience. 
Fire/EMS HelplineCalling 1-888-731-FIRE will connect you with a counselor trained and experienced in firefighter and EMS culture, sponsored by the National Volunteer Fire Council as part of the Share the Load Program
National Suicide Prevention LifelineCall 1-800-273-8255 or go to the website to chat with someone on this free and confidential support resource for people in distress.

Final Thoughts 

It’s not hyperbole to say that first responders have a noble calling: they are in the business of saving lives, after all, and it’s not far-fetched to call them heroes. For all the rewards of this challenging work, though, there are many reasons why they might struggle with stress, burnout, and depression.  But they don’t need to suffer alone, and there are numerous resources to help them maintain their resiliency and continue with their work even when it’s not easy. In addition to those resources, we can’t stress enough the benefits of getting a good night’s sleep, one of the most basic ways in which you can face a new day with energy and vigor.