When many first responders close their eyes they can hear the sound of a radio crackling, see the bright lights of the truck, and even imagine the high pitched wail of the siren. For many, these sights and sounds are a routine part of the job, while for others, it can be a psychological trigger causing a harmful emotional reaction. This trauma and accompanying emotions may result in members taking time away from workplace.
“What happens to a staff member who goes off work and how do they come back?”  This was a question posed to Kevin Jerebic (now the Manager of the Reintegration Program for Alberta Health Services Emergency Medical Services (AHS EMS)) by a friend and colleague. This conversation sparked a greater idea to build a program to better support EMS members who are injured and away from work, all the way through to their recovery and successful return to the workplace. In the summer of 2014, Jerebic brought the ‘Reintegration Program’ proposal to the Senior Leadership Team (SLT) at AHS EMS for potential trial and implementation. The program came to fruition in February 2015, when the first ‘reintegration session’ was carried out in Edmonton, Alberta.
What is a Reintegration Program?
AHS EMS’ Reintegration Program is a return-to-work platform facilitated by specially trained peers that assist members to return to work in a safe and healthy manner. The program aims to support members throughout their psychological injury journey.
There is no set timeframe for how long a member can or should participate in the program. The time is loosely determined in conjunction with the member, their treatment provider, and the Reintegration team. It should be mentioned that any member (who is off work for psychological injury) must be referred to the Reintegration program by their treatment provider.
Once referred to the program, a meeting takes place (with all stakeholders) to determine the needs of the individual and the focus of the sessions. After goals are identified by the individual and their treatment team, the session is then facilitated by a Reintegration team member. The exposure sessions can be based around locations, equipment, facilities, or other areas that may be a trigger to the member.
Training to become a facilitator includes 10 days of education surrounding topics such as prolonged exposure therapy (PET) and relationship building. Facilitators also spend time with psychologists and occupational therapists to review techniques and literature surrounding different treatment modalities and the facilitation of PET.
Jaclyn L. – Former AHS EMS Employee
Jaclyn is a former AHS EMS member who went through the program in 2018. An ACP with over 15 years of experience in EMS, Jaclyn participated in approximately 25 sessions with a facilitator over a year.
Her reintegration journey began over coffee with Randy M, a facilitator. The following sessions, which spanned anywhere from 2 to 5 hours included activities like visiting the station, donning a uniform, riding in a response SUV, and shadowing calls. Jaclyn said  one of the most memorable and challenging moments was when Randy was helping her with a controlled desensitization exposure in a retail store. He turned on the handheld radio and Jaclyn remembered the anxiety it caused her in that moment (despite it being a planned event) and how she had to remove herself from the situation. With the help of Randy and through repeated, safe exposure to the radio, Jaclyn was able to work through the distress and end the session confidently. This exercise helped her realize she could work through her triggers.
After participating in several sessions, Jaclyn self-identified that she was not thriving in the EMS environment anymore and she made the choice to resign from EMS. When asked if she would recommend the Reintegration Program to her peers she quickly replied, “Yes, 100%” . The program “allowed me to be honest with myself” . She explained that she went through many different emotions throughout her journey but always felt safe and supported during her time in the program. Jaclyn now works in the Audiology department where she does newborn hearing screening. She says she is forever grateful to the Reintegration team for helping her feel empowered, confident and at peace with her decision.
Shauna P. – AHS EMS Employee
Shauna is a current AHS EMS staff member who participated in the Reintegration Program in January 2020. She is a Primary Care Paramedic (PCP) who has worked in both a suburban and now urban setting for 7 years. Shauna participated in approximately 15 sessions with a Reintegration facilitator.
Shauna’s first session began with meeting a facilitator at one of the EMS stations in Edmonton where she started with getting used to wearing her uniform in the public eye. Her sessions progressed from there to include driving to the location where her trauma occurred and eventually walking the steps she took that day of injury (footprint exposure). By the end of her program, Shauna was able to attend calls with the facilitator in a controlled environment at a pace she was comfortable with.
Shauna shared  her greatest achievement was being able to fully recover and return to her job, however there was a time during her program that stood out in her mind. This event began with Shauna being asked by one of the facilitators to visit a gun range for an exposure session. When mentioning it to her psychologist that she was nervous about visiting the range she began to remember a call that she had been a part of as a student years prior where she encountered the impact of what a gun can do to a patient. The next session with her facilitator, Shauna relived and explained the call details from 8 years ago vividly. She became emotional. She stated “I finally felt safe enough through the reintegration process and that I had all the resources I needed. My body and my mind found the perfect time to unearth this memory I had suppressed for 8 years” .
Shauna now recommends the program to her peers and colleagues. “They have the ability to connect with so many other agencies in order to personalize everyone’s journey to healing. You are in total control of every session to make sure you feel comfortable” . Shauna continued on to say how important it is to ask our peers and ourselves the hard question of ‘are you ok?. This impactful question has a variety of answers; the important piece is knowing that there are supports in place to access no matter the reply.
Randy M. – Reintegration Facilitator
Randy is an Advanced Care Paramedic (ACP) with AHS EMS and is one of the Reintegration facilitators. Randy is in his 38th year with EMS and has a diverse background including time spent with Mobile Integrated Health, metro/suburban-rural ground ambulance, STROKE ambulance, STARS air ambulance, and the Peer Support program. He is the founder of the Tactical Emergency Medical Support Program (TEMS) in Alberta and has training in cognition therapy. Randy joined the Reintegration Program in 2017.
Randy has worked with over 100 staff members helping to facilitate reintegration sessions. He recalls many challenges and highlights over the years but always comes back to how rewarding it is helping a member to heal. In Randy’s experience, being a facilitator is a “wonderful way to give back to colleagues and provide them inspiration and trajectory in their career”. He concluded with saying how much he has learned from each member he was able to support, and what a positive impact this program has had on staff.
Our Path: Then & Now
Since 2015, over 2000 sessions have been facilitated by the Reintegration team (2 of which are full-time positions). These one-of-a-kind sessions have allowed for countless members to be able to return to the workplace, armed with a resiliency toolkit. It has also allowed members to successfully heal and come to the realization that they do not want to return to the workplace, which is supported as well.
The goal for the program, for all who are involved, is for it to continue to grow the capacity to help AHS members. The program is seeing an increase in demand for services and anticipates that this will continue into the future as EMS members are reducing mental health stigma and seeking psychological supports. As the positive word spreads throughout the EMS community, it is the hope that this program can be a support to as many staff as possible and set an example for first responder organizations across Canada. For more information about the AHS EMS’ Reintegration Program, please email EMS.Reintegration@albertahealthservices.ca.