Why Is Peer Support Necessary- Flight Medic James Boomhower

Intro 
Hi, everyone, and welcome to this week's episode of Enduring the Badge Podcast. I'm host Jerry Dean Lund and I don't want you to miss an upcoming episode. So please hit that subscribe button. And while your phones out, please do me a favor and give us a review on iTunes or Apple podcasts. It says, Hey, this podcast has a great message and we should send it out to more people. So please take that 30 seconds to a minute to do that review. And just maybe by doing that, it will push this up into someone's podcast feed that really needs this message. 

Jerry D. Lund  
My very special guest today is James Boomhower. James has been an EMS since he's 16. He's currently working back East. As a flight medic for an agency that does rotor and ground transports. James talks about how important it is to build a peer support team, especially in these times with COVID and everyone feeling so fatigued. He talks about who takes care of the caregiver. He also talks about building resiliency and keeping your resiliency charged up and what that looks like in he'll give you a few tips that you can do today to start making an impact in your mental health. Let's jump right into this episode with James. 

How you doing James. 

James Boomhower
I'm well, man, how are you? 

Jerry D. Lund  
Doing good, doing good. We're just chatting about the weather before we got on here. And James is in the eye of the boom cyclone? Is that what they call it these days?

James Boomhower  
Yeah, some some crazy boom cyclone nor'easter combo thing. Yeah.

Jerry D. Lund  
Hopefully by the time this airs will be dug out.

James Boomhower  
But if you don't hear from me, then you know I'm still still buried.

Jerry D. Lund  
Right? You in half of the East Coast. 

James Boomhower  
Right? 

Jerry D. Lund  
Tell the audience a little bit about yourself, James.

James Boomhower  
Thank you very much. My name is James Boomhower. I am a critical care transport specialist paramedic out of Boston, Massachusetts. And I run a mental health and suicide awareness advocacy campaign and social media following called Stay Fit for Duty.

Jerry D. Lund  
Yeah, and James has been in the business for a few years. You got started really young?

James Boomhower  
I did. Yes, sir. Yep, I am. I actually started in high school. I my first a couple shifts in an ambulance were part of a career exploration program. And I just kind of stuck in from there. I had family that were first responders, I had extended relatives that were in medicine, and really, really wanted to help people as soon as I could. So got my certs as early as I could get them and put in just about 18 years now in EMS total 15 years as a paramedic. And yeah, I started when I was when I was a weak kid.

Jerry D. Lund  
Yeah, that's pretty incredible. I wish I would have started that early. And I have a lot more years right in the system. Right?

James Boomhower  
A lot more years in the bank. Right. So the player side, it would have been 20 an hour. But yeah, I did a longer walkthrough.

Jerry D. Lund  
Yeah. So James, what was it when you're young that like said, hey, I want to do this. I know he has a family in this in that is serving as first responders. But what was it on those ambulance rides? That got you interested into becoming a paramedic?

James Boomhower  
That's a great question. I think it was the like immediacy of impact. I mean, you for anybody who's listening to your podcast that doesn't do any type of first response or pre hospital emergency medicine. You're literally one of the first handful of people to come up to someone in an emergency, be it you know, life threatening emergency or something a little bit less severe in the the ability to be the first pair of hands in the first person to not only help but recognize and ensure that as medicine continues to get more convoluted as we go, that the correct pathways get followed kind of in the role that you play was just really powerful. And I really, I really liked the fact that it was so raw, like you were the first person to stop the bleeding the first person to, you know, do CPR, or performing aid or any other much less glamorous task that we asked our firefighters every day. But it wasn't, you know, seven steps removed. It wasn't well, I'm an emergency room doctor and 14 other people have interacted with this patient before me. It was I'm one of the first and I really liked that part. 

Jerry D. Lund  
Yeah, that you do make an impact when you're definitely the first on scene to render some aid. So it went to flight medicine. What Why did you take that jump?

James Boomhower  
It did so so like I said I took a very convoluted route. After three EMS, EMT guard straightaway got my paramedic certificate licensure right after that practice as a paramedic for a little while when in completed my undergraduate degree, thinking that I was going to go to either medical school or a PP school to be either a PA or an NP and throughout the connections that I was making, in undergrad and in the services I was working at in New England. While I was in college, I started to see some programs that really allowed paramedics and nurses to practice at the absolute like peak of their license level, like modalities that nobody else does. But drugs and nobody else can do in the program that I'm fortunate enough to work for now as a combination, rotor aircraft, traditional plane aircraft and ground vehicle transport team. So we're not limited by what we can take, we're not limited by what we can do. We're really fortunate to be one of the teams that is a jack of all trades, and really doesn't have a patient population that we can't serve. And with some really sincere acuity, and that kind of amalgamation, the whole thing was really what I wanted. I mean, I definitely thought flying was cool. But it wasn't my like, I just want to be in the helicopter. It was really, this is a program and agency and institution that allow me to practice care, unlike any care that I'd be able to provide anywhere else. 

Jerry D. Lund  
Yeah, that's pretty cool that you get to do all the different things. I mean, that's pretty rare. I feel like in on the fight medical side of things to be able to fly, you know, both fixed wing and rotor and do Grand Challenge sport, that's seems to be not the case so much here out on the on the West Coast type of thing. But that's with having the ability to do all those things. Which is your favorite?

James Boomhower  
That's a good question. The the smart, healthy comment I was gonna make was it doesn't make for a peaceful night's Right? Like, when you can get to a vision any way shape or form you? Yes. You know, I think that they both they both have pluses and minuses, I tell people that are interested that when I'm in the ambulance, and the critical care ambulance, I'm almost always dealing with a very, very medically sick person. Like these are very, like complicated intensive care unit level cases, or Cath Lab level cases, where there's a lot of real medicine that needs to be done. Where on the aviation side of the coin, my medical intervention, there is time. So be it a traumatic injury or something that really needs, you know, definitive surgical or interventional radiology intervention. So they both have, you know, their own like, do you really want to get bogged down in the medicine and really try to figure out, you know, all this complicated medical stuff? Or do you want it to not really the more down and dirty rabbit the more you know, scoop and grab and yeah, do everything you can while you're kind of in this more high speed, low drag environment. So it's a really cool, cool mix of both.

Jerry D. Lund  
Yeah, I mean, I don't know too many medics out there, that didn't wants to fly. Like, that is such a, I had an opportunity when I was younger, to be a helicopter mechanic. And I loved it. I loved being around helicopters, and they're just so cool, you know, to fly in the feeling and the he get, and I think it'd be awesome to come in to do those scene flights, you know, agencies call you because they need the next metal level of care possibly, or they need to get this patient to the hospital immediately. So you really enjoy those do get flights like that, where you can go to scenes medical scenes are?

James Boomhower  
We do? Yeah, absolutely. I apologize. I think zoomming in. Like, being in New England being that we have so many hospitals so close by, we definitely do a lower percentage of scene than we do inner facility. But they still have absolutely. And that's a really good point. As someone who is who's been in EMS for a long time, like myself, you know, you it's great to be able to like be the person on the other end, right? I remember calling for you know, whatever my air medical transport was, and like I didn't want to upset them I didn't want to look stupid and I hope it in like column you know, you only have like this eight minute long, like crash interaction. Yeah. So it's really cool to be on the other side now and to be able to be gracious and kind and, you know, really provide some help for people that really, really need it. So we certainly don't have you know, the percentage of obscene calls that maybe some of us would like, but that's just because our our paramedics on the ground side of the coin would be sitting there staring in the hospital waiting for the helicopter. Yeah, yeah. So we do a bit more modified and then in a facility stuff as well.

Jerry D. Lund  
Yeah, and it's just very dependent on our geographically where your helicopter is located far as how many I think scene flights you get the more rural area to cover. Of course, the more seen fights you're going to get just because you know, time and distance that you can be saved, you know, flying someone in the helicopter with going through on the all these calls of these very sick patients. How does that affect you?

James Boomhower  
That's a good question. You know, we talk a lot about that on the on the medical side of the coin of kind of what, what a bad call is right? And how bad calls affects everyone differently. Everyone has a different definition of what a bad call is. If we want to get as broad brush as humanly possible when we talk about what what is considered a traumatic call, quote unquote, we look at calls that are, you know, change your worldview, right change how we kind of see the world that are around us, calls where we felt helpless or trapped or weren't able to provide, you know, the necessity of care that we like, we work really hard to have a really robust peer support team at Boston MedFlight. And we work hard to have an a minimum institutions and foundations where clinicians can support one another. I think it's really part of a holistic. Like, it all matters, right? Like, how are you going? Are you rested? Are you hydrated? Is everything else in the world going? Well, because the adage that I often remind people is, you know, the local fire departments worst call of their year, was my Tuesday morning, first run. Yeah, right. We have four other calls that day, and three other shifts that week. And that is certainly no issue of performance diminish the severity of that call? Sure. But you talk about the accumulation of that call on that call on that call on that call. And if you're not careful, I think it really can weigh on you if you're not cognizant of giving yourself the space to take the stress away from that call, and then leaving that call somewhere, processing that call and then going on to the next one,

Jerry D. Lund  
With running call after call like that, how do you find the time to process you know, those bad calls?

James Boomhower  
That's a great question. It's, I think it's very, very individualized. I'll say one of the most like paramedic-ey traits that I have is it takes me like three days to process a bad call. I am a paramedic, right, I have another call to go on. I have you know, other staff, I have to help I have homework I have to do, right. And I just kind of like throw it somewhere like retroperitoneal II until three days later, I can't figure out why I'm upset. So acknowledging that is super helpful. And my close colleagues, my friends, colleagues of mine in the peer support team have a pretty good sense of like, okay, like, I'll check on Boomer right now, like immediately after the call, but he's not going to need anything until you know, the shift is done and everything settles. And that's not how everyone processes, right? Some people need time, like an immediacy. And some people kind of need time in between. But for me, personally, one of my coping strategies, I guess we'll say is, is I can stay pretty well mission focused, probably 90% of the time until the shift is done home, um, showered, I've worked out right after I've done all this stuff. And then you kind of open up that box, and you give it a minute to kind of let out and go from there. 

Jerry D. Lund  
Yeah, get a chance to actually sit down, relax. And I feel like that's, I mean, I could, like you said, right can take days to actually just unwind from a busy shift and feel rested. And in a moment where you can take the time to process those type of things. I want to go back to something you said, you know, like, some things that affect you is like being hydrated your food, your sleep and stuff like that. I mean, I totally agree with you. Like, if you're not kind of in your most prime state, and you're at work, things just seem to be more impactful. 

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Jerry D. Lund  
Do you do find, do you find knowing that about your your peers, you can see the kinds of difference in them when something's bothering them?

James Boomhower  
I think so. I mean, I think a lot of places certainly not specific to metal, they do a really good job of of reinforcing the fundamentals. I mean, even like some of the cam standards that we have to follow as aeromedical programs, you have to have 10 hours of rest between shift one and shift two. Right now we all know that I can't come home, you know, nine hours and 15 minutes. Yeah, but at least some some of the guardrails are there at Medflight. In our daily shift briefing, we ask one another I'll be rested rehydrated. Are we fed? The terminology of uses are you fit for duty? Are you where are you in with a little bit more comfortability, you can look your partner in the eye and be like, I'm 70% today, right? Like I'm Yeah, I need I could use a 20 minute nap. If you don't check in the truck, I'll get a cup of coffee. And in I really think that on top of knowing that foundational component of like what you need to come into work and do work well, to add that second layer of I also don't feel embarrassed or stigmatized to tell my partner, right like my partner's not gonna think less of me if I come in and I'm like, I have no sleep last night. I'm exhausted. Jerry and I tried for 20 minutes to get the Zoom call to work right but never turned on. Right? Everybody's stressed. And now now I'm at work and I'm just like a quarter step from where I need to be. Obviously with with the space that I run in what I try to advocate I beg my partners to tell me that right? I want to know where we all are so we can both help each other. And I'm no stranger of being like, "Hey, if you can get me a cold brew on the way into work, yeah, so tremendously helpful, because I need another little kit to get us started". But but just recognizing that as part of as part of your early training, it is discussed in like early board certification training for flight medics like they do a bunch talking about how flying affects you physiologically and how nutrition and hydration really play a role into that. And we try to play off and say, you know that that's not just a chapter 10 in your exam review, like, it really matters. So we do a good job of making sure that we can we can hammer home those fundamentals, because you're absolutely right, it cause will affect me differently when everything is copacetic versus when everything is off the rails? Yeah, I often think that we we far too frequently, over emphasize really complicated things, at the expense of some of them are straightforward. In really foundational things. Have you gotten any rest? Are you hydrated him anything?

Jerry D. Lund  
Yeah, yeah, that I know, each one of us wants to show up to work. 100% But we have lives outside of, of work that may make us so we don't show up. 100% You know, having young family, you know, or having family issues, or whatever is going on may not let you come to work 100% and I love that communication like, hey, you know, I'm I'm 70% today, you know, and I think as a, as a company officer, I like to know that too. I'm not gonna judge them because they're 70% because, you know, life is happening and stuff, but it's just good to know where their people are at. So you know, what kind of their expectations are and how things may affect them.

James Boomhower  
Absolutely. And you know, on the leadership side of the coin, I'm certainly fortunate to talk to leaders that are like, well, Boomer, what am I going to do when like, you come in and tell me for the fifth shift in a row that you're 20%? Right? Yeah, well, then then we have something that we have to deal with. But if I'm, if I'm in a space, where I'm terrified to tell my company officer that I'm tired, and I'm dragging on a fire call, right around 13 steps behind the eight ball or asleep driving the ambulance, right? I mean, making like catastrophic examples, right? Yeah, you would much rather know where I am. So you can help in any way, shape, or form. And then if it's something that becomes chronic or abused, but we have policies, procedures and platforms in place to fix that. It's certainly not an easy mix. I don't think every human that walks into any any place ever will look at a perfect stranger or somebody they don't super trust and be like, Hey, here's some of my weaknesses and my faults, but I think it really matters. And, and people have to remember to that, you know, with with eight years on a job, you're 80% is probably still really good, right? You're still pretty okay. Conversely, 100% on your probationary year probably still needs a bunch of work, right? Because you're still probationary. So recognizing that, you know, you just have to be able to tell yourself where you are every day. And in a perfect world. What do you need? Right? Right. If I can just get 20 minutes, like, I'll be ready to go. It doesn't happen. It doesn't happen, right? Because that's always when we get a call. It's when I say I just Yeah, yeah, I'm really, just to echo back what I said it really, really can be that simple in the immediacy.

Jerry D. Lund
How do you set up a culture at work? To to let people be so vulnerable about how they're feeling?

James Boomhower  
Um, it's hard. It's hard. I would be lying if I said that every member of where I work is like, Oh, I'll tell everybody everything you know, we're adjust culture we're this for that. Yeah, I think it takes some time. I think it takes some patience. I work really hard to lead by example. All of my, my co-workers that are you know, paying attention to this stuff, listen to the podcasts that I'm on and you know, really hold my feet to the fire of like, "Okay, Mr. Health and Well-being, why did you work overtime shifts, right when you can barely walk in your boots". So I we try to practice what we preach. And we just work really hard to like help one another. I think one of the the beautiful aspects of what disaster we want to call the last two years in first response in medicine is there is no judgment anymore for saying I'm just tapped out. Yeah, I think it's a universal acknowledgement. And kind of a leveling field, in the sense of no one is going to judge you in January of 2022. If you're in healthcare, and you tell me that you're tired. So, so knowing that, I think kind of pulls away some of that barrier, and, and allows people to have that conversation, and you just try to help as genuinely as you can, and you try really hard to not blow smoke up people. You know, I've never tell anyone that I work with that, you know, "I can fix you and come here and we can do this". But I'm the first one to be like, "Here's what I can help. Here's who we can talk to you. And how can we all get through this together?" And for the most part at a crew level, right at at a, you know, provider to provider level that works pretty well.

Jerry D. Lund  
Yeah. Did you, at your work, did you start the Peer Program? Or did they have a peer program set up before you got there?

James Boomhower  
No, I was, I was one of the individuals that helped create it. So we were able to start from the ground up with a ton of growing pains, took a handful years to really get accepted by the leadership. And then it takes a little bit more time to get accepted throughout the institution. You know, we're, we're kind of a trust but verify species at baseline, right? Like, yeah, I don't think anybody's lying to us. But we're also gonna be super, super careful. And we work really hard to make sure that we're not acting as some talking point for our leadership, right? Like, it's not fair if my leadership can just say we have an industry leading peer support team, but then actually not helped me and my, my members of the peer team support the peer team. Right. So So we work really hard to to make sure that that happens. And we've been incredibly fortunate to help a number of our colleagues. And I think what is what is changing now the shift we're starting to see is more and more people saying, Hey, if you need anything like, you know, there's a team, like it's not a big, it's not as much of a hurdle as it used to be, at least in what I'm seeing, which I hope isn't too rose colored because of my position here. What I'm what I'm hearing from my colleagues, what I'm seeing is, you know, there are people here to support you, there are ways that we can help one another and kind of re encouraging this, this development of teamwork at the ground level and going from there.

Jerry D. Lund  
Yeah. How long did it take you to get your peer support team to where they are today? Like, is it like you said, it was kind of a little bit of a painful process and stuff like that? How long did it take you to, like, get the structure setups? Like, if I'm doing a department, I'm looking to set up a peer support team? How's that going to look like? What what kind of time line do I need to like, plan on?

James Boomhower  
Yeah, it um, it really depends on who you talk to. When it started, there were members of, of my agency that tried to get this ball rolling years before I got there. In in, I don't want to say got shut down in a negative light, but it got you know, kind of puts aside and forgotten about then it can reemerged. And we got to dusted off this whole platform and said, "How can we how can we actually make this happen? Do we have the right people in place the right leadership on board", and from that moment, from like, gavel down from the CEO, it took us probably two years to become official, I'd say like from this is the day that there's a deployable peer support team, and we do all this stuff. And then it just evolves, right, we have a network where we'll analyze calls that are dispatched, and we ask our comms back leadership to look at those calls and say, Hey, Jerry and Boomer just went to a dead child, right. So when they're done with that call, we're gonna ask them if they need to peer support team, and we're gonna, you know, offer them whatever resources they need off of that, we've continued and continue to kind of tweak that delivery, and availability of both people and resources, as my coworkers and my colleagues see fit. Because doesn't super matter if it works really well, in a flow sheet that I made, right? If none of my co workers or colleagues want to use it? And example that I can give really quick is it um, we, in our initial iteration, we never give anyone the chance to say they were okay. We said, "Do you need support right now? Or do you need support later? without ever thinking that somebody was just fine?" Yeah. And that actually took a little longer than I care to admit to like, build into the platform and say, no, no, if you don't need us, we're not knocking down your door. Right? This isn't like involuntary, you know, check into that. But that that whole process took, like I said, a couple years, it could definitely be plus minus. We are super willing to share kind of our trials, tribulations with people that are interested, we work with other local agencies that are trying to start peer support teams, we look to other peer support teams to see what they're doing, and what they like. And our medical direction on the mental health professional side of the coin is always super helpful on changing and adapting. So I tell everyone that's interested, it's American. Sprint, you certainly won't start it in two weeks, but it doesn't have to take two years.

Jerry D. Lund  
Yeah, I do. Like one thing that you you said is like, you have a way to analyze the calls that people went on and then figure out they need peer support. That's I think that's very unique. I don't know any other agency that's really maybe analyzing the calls, like hearing the dispatches, and they like, oh, we should think about that. We should think about maybe they'll needs peer support and least just take the second to ask them. Hey, do you guys need your support? gets good. I really liked that. I think that's something that everyone should implement into their, you know, their peer support.

James Boomhower  
That would be awesome. I think for us it was, you know, the one thing we want to do is we want to distract or stress out the provider as little as possible. Right? Like, if you if you've already had a terrible call, the last thing I need you to do is like, well, who's the peer supporter? And who do I have to call? And how do I have to do it? Right? So unfortunately, the trade off there is, we further burden in already tremendously burden a group of communication specialists, right, like I yeah, I worked for years on this thing. And I handed them this list, and they're like, cool, another 10 for each call. So so we are also trying to balance and be really empathetic with the fact that what I hear when my crewmates come back, and what our communications team heard, right are often two very different things. Yeah. Yeah. Right. Like we've gone to stubbed toes that have spontaneously combust and been the most dramatic call of someone's entire career. And we've also gone to, you know, oh, my god, everyone's dead. There's blood everywhere in the cruise. Yeah. No, it was a hangnail. Right. So it's hard to it's hard to really specify that. But it gives us some semblance of a net that says, hey, at least their eyes out. And you and I talked a little bit about culture change one of the next pieces of culture that I'm seeing a bit more, is people more willing to reach out if they weren't paged. Because what what initially happened was, if someone didn't get a page, they assumed that you know, it wasn't that bad. Yeah, need a thing or somebody for God, or you know, and there's all this animosity there, instead of now just being like, Hey, I didn't hear anything. But like, I'd love to talk to someone if you had a minute. And that's really my goal. I personally, don't care how we get the support to people. I just want my crews to know that 24/7 365 There are dedicated people on shifts to make sure you're okay. Yeah, at the crew level, then.

Jerry D. Lund  
Yeah, so how, as a flight medic or a firefighter first responder, how can I build some, like recharge my resiliency, and like build real resiliency?

James Boomhower  
So fundamentals are huge, right? Like making sure that you're in check is really important. I am a big, big fan of very intentional, I'm at work, I'm not at work. I say that as a member of the education team, I say that as one of our newer preceptors. So as I'm like, you know, extending myself more and more into work, but like, I take my boots off at the door, my flight suit comes off. And I'm not a flight paramedic anymore. Right now, right? I'm a boyfriend. I'm a friend. I'm a homeowner, I'm all these things, but I'm not a flight medic. And I think it's important to start by building those boundaries, that email does not need to be checked. Like flight medicine is notorious PCQI that just goes on and on on. You do not have to answer that email right now. You do not have to respond to that phone call right now. Right? You can take very intentional time and give yourself the space and rest you need the fundamentals like you and I talked about earlier. Are you hydrated? Are you rested? And are you fed? What I remind people is, the more stressed you are, the calories count more than the quality of those calories. So if you're at like peak stress level, terrible call, you're really having a hard time. And neither is better than no food. With the caveat that you can't eat Snickers and pizza every day. I'm not gonna be on the government's health anytime soon. Looking at, you know, the Zoom meeting right now. But yeah, um, what I don't want people to do is I don't want people to not eat, you know, because they're trying to find a salad that they left back at base. Once, once you have your your foundation in place. It really is just time to process some one of the newer things we're working on at Medflight is the idea of an end of shift checklist and not operation. Like what went well, what went poorly. What do you need? And how can you get it. And by by putting really well defined start and ends on each of your shifts, is a really good way for you to kind of turn down this warrior mentality of I'm the protector, I have to help all these people and I have to be constant on all the time. And you can kind of turn that down to a dimmer switch of like, I don't need to be that right now. I am not going to be asked to go in a helicopter and intubate some crazy complicated airway. I'm not going to be asked to go to the ICU and start flow land on this occasion. I'm just James, I'm going to be asked to go to dinner with my girlfriend and clean up the house. Right? Like those are my objectives. So those those boundaries are really helpful in turning down that hyper vigilant state that we live in and allowing us to re process which gives us the strength to come back in for the night shift.

Jerry D. Lund  
Yeah, I like the end of shift checklist. I think that's super cool. I think that would be something I think sometimes it's happens informally, but some kind of maybe at the Fire Department levels like enough shifting would be, would it be cool to sit down as a group, see where we're at, and then sit down as individuals, you know, before we head home, so we, so we arrive at home, kind of in the right space. I mean, I live five minutes, 10 minutes from my station. So I don't have a lot of time to decompress and stuff by the time I get home. And if I'm tired, you know, I walk, you walk in the door, and my wife can already see it on my face, you know that I'm tired. And then she knows, try, try not to talk to him too much. Let him go take a nap type of thing. But yeah, having some kind of end of shift routine, I think is very helpful to get you out of that hyper vigilant state. And to try to bring you down as much as possible. I think that's would be great if I didn't have to check my emails and text messages and all that type of stuff on your, on your days off. So you totally could decompress. But I don't really know too many places that are that are like that, you know, especially when you're, for me, when you're working a little bit smaller department, you're always have more than just one job. So you're always, you know, in the mix of some kind of communication about some something going on.

James Boomhower  
Absolutely. And you know, you you had a guest on your show Destiny a couple months back, we talked a lot about, you know, provider relationships. And one of the one of the things you alluded to, you know, what I call the provider safe word, right? It's like, my, thankfully, my girlfriend is in flight medicine. So it's easy, right? That she knows the acronym, she knows the job, she does it. She knows the day was good or bad before I got home. But we're also really transparent of like, I'm just done. So it asked me to do anything. I need this, that and the other thing when I get home, and then I'm going to bed and I love you goodbye. Right? But you can build that in any relationship. It takes practice that takes time. It's not easy. I don't mean to to sure misconstrue that it is but but you can you don't need to be married to someone who's really empathic right? To have them look at you and say, Oh, you can you can create that plan, you can execute that plan. And it can really, really be valuable with the like yourself, you know, I do five, six jobs at work. And I can't always avoid my emails. What I can do is I can choose when I answer them. And I pulled all of my work email notifications off my phone when I'm off duty. Yeah, that way. If I have five minutes, right, I'm, you know, waiting for the laundry to get done or whatever. And I can open an email something I can answer great. But I promise you, and you know this too, and so many of your listeners, if work needs you, they'll get you. Yeah, they do. They will call you they will call out. Yeah. Um, so obviously, you know, don't ignore your boss, right. So Don't ignore your battalion chief, if he's called three times. Yeah, but you might not. We often think that we have to answer these emails, these text messages right away, when we can perhaps leave them sit. Or if I can't, can I give myself a chunk of that day where I don't write like Jerry and I were talking at 11, Eastern, at nine o'clock, my email shut off. Because I want to take a shower, I want to you know, do a couple things before I sit down and talk with you. Yeah, that was not the time to be rummaging through my email five minutes before. So can you put those those boundaries in there to help kind of reinforce that time?

Jerry D. Lund  
Yeah, no, I'm with you. But for the most part, I turn off my notifications, like period on my phone, I hardly get any notifications unless I choose to look at them. Look at them. Although we have like a, it's called I Spy and it just goes off every call that happens in the city. And I'm a fire investigator. And so like, try to monitor you know, the things that are happening and stuff like that if I need to be available and stuff. But lately, I just like I've got to shut that off. Because I just have got to not have constant notifications of what's going on at work and what calls are happening and stuff and just take a step away. And, and breathe I think we really, we really have a hard time like you know, you know, taking your flight suit off and coming home and being a boyfriend or being whatever, you know, we have a hard time leaving that type of stuff behind us. We it becomes our entire identity and we take it into our family and everywhere we go. So like I said I like really like building in routines are things people can do to just decompress by leaving that someplace else.

James Boomhower 
Absolutely. Absolutely. And it's a practice and that's the only thing I tell everybody else is it I did not come to this in a day. Yeah, it's been my my co workers my colleagues for decades, right? They they laugh when I say this stuff like but do you remember when like of course I do man I'm working I'm improving I'm trying to get better every time and if you have a day where you're you're on you know the dispatch ring for the entire day and you know every ounce of flame that is an entire city like that's okay. Just try to get you know know when you can extend that and know when you can. Yeah, the other kind of the last little component of that is this idea of giving yourself some grace, right? Like you, you've been a professional first responder, and you you are trained in practice in being hyper vigilant all the time. You can't just turn it off. It's not that easy. That's why I say it's a dimmer switch, not a light switch, right? Because it just doesn't come out. Right, right. Calculate the intensity. So when you have a day where you're way off the mark, when you have a day where you've done all the things that we just said, you probably shouldn't do. That's okay, grab a glass of water, grab a cup of coffee, and make an effort the next time to do a little bit better, and then a little bit better and go from there. It's not a pass fail. I did or it didn't.

Jerry D. Lund  
Yeah, I like that giving yourself a little bit of grace. I think far too often. We don't do that. And maybe we find ourselves if we're not giving ourselves our own self grace that we're not doing that, you know, when we look at other people, too.

James Boomhower  
Exactly. Exactly. Right. I have far too many of us are notorious for being super kind to other people. Well, really hard on herself. And then we look at that a little bit deeper. And we're like, actually, we're also being pretty hard on another person. As we're going through it.

Jerry D. Lund  
Yeah. What, um, you work several different jobs, and stuff it sounds like, and then how do you have hobbies and stuff that you do? Or how do you like work? Get in this like, a peaceful lifetime? You know, like, a little bit of James time to go do something like how do you squeeze that in with all these different jobs?

James Boomhower  
Yeah, it changes right. I'm, I'm a huge cycling advocate, indoor outdoor, I like to do that. Jerry and I were just talking, I was a little sick a couple weeks ago. So my first time back on the bike was today. And it was awful. It was a metrics that I won't share with anybody. Wheezing and coughing that nobody should hear. I am a new homeowner along with my girlfriends. So that is kind of a new challenge, right? Like, what are we going to do and what's what's going to get done today. Other than that, I look at a whole bunch of ways keep my physical fitness up. Right now, I'm bigger into weightlifting than I've been in quite some time. And I as weird as the sounds, I'm in graduate school, I'm working on a master's in psychology to become a counselor. And that has forced me to pull away from some of the other stuff, it sounds insane to think that homework in any way, shape or form is actually helpful tool. But like you have to sit down, you have to read this, you have to sit down, you have to go through this. And it really reinforces this, like, I'm a provider, I'm a student, and then I have a boyfriend and you know, we're doing sushi, we're doing this, we're doing that. So I just try really hard to make sure that my identity doesn't get marred only in those three things. And make sure that I get some time on the bike and that I you know, spend some time with my friends drink some good coffee, and like go out and see the world sometimes not on one route to a base or hanger.

Jerry D. Lund  
Right, right. What made you take this next step to go into back to school?

James Boomhower  
I really wanted to help more similar to kind of the analogy that I gave with like going to med flight, like I really enjoyed being a paramedic. But I saw that like I could, I could do that at the peak of its level. I love peer support. I love crisis response. I'm a member of the Crisis Text Line, I just really, really enjoy pardon, like the poor metaphor, but like the idea of like a mental health paramedic, right? Like you have a little bit of training in, you know, some psychologic first aid and some really specific aspects of crisis wellness, and you deploy right and you help people when they're in extremis. And you go from there. The idea of a culturally competent clinician who can not only help see patients formerly licensed one on one, but who can also then help guide other peer teams and guide other programs not as the peer supporter, but as the actual mental health professional that needs to be there. That was really, really what what brought me to it and it was the right time, I am fortunate that I have time to go to grad school right now and in the mean, sort of grad school. So it was kind of the if I don't do it now, it's never gonna happen. So that's that's the plan. The plan is to become a mental health professional alongside a professional emergency responder, and do those in tandem to provide the best care for both and I can.

Jerry D. Lund  
That's you're gonna be a busy man.

James Boomhower  
Yeah, you ask me about health and wellness and like a year and a half. Make sure that I'm still hanging.

Jerry D. Lund  
Do you think your experience is going to make you a better clinician?

James Boomhower  
I hope so, um, I think if anyone here is looking for a counselor, right, I think the idea of cultural competence or essentially in layman's terms, like do they know what it's like to be a paramedic, right? Like, does my counselor know what it is to be a firefighter or paramedic or police officer or in the military? Um, I think it's really important to remember that that can be overstated. I have had phenomenal counselors that I had to walk through every acronym every you know, this is what it is. And when I said this, I mean that, but they were just a great counselor, which is really well, and I got really good help from them. I've also had really terrible therapy from people that advertise themselves as like the paramedics counselor, right? Like, they were, this was their, you know, cream of the crop and this was their jam. And, and we didn't get along, we just didn't have, you know, great provider patient relationship. So, I always am cautious to say that the idea of cultural competency is great in knowing your field and knowing that people are interacting with and kind of understanding the profession and the stressors there. And I think a really helpful, and I do truly hope that it helps me be the best mental health professional that I can be. But I say that to not shun people away from what could be a wonderful therapist, but doesn't know the difference between an engine and a ladder, right? Like, just tell them the difference between you. And I worry, because you don't like, like so many of the other guests on your show, right? We all hammer home this idea of cultural competence and, and how important it is to have this understanding before you walk in, we can teach that to mental health professionals that are already very strong. And we can then you know, capture it and absorb it with individuals like myself, who come with a very strong background in this space, and also want to then evolve and become a mental health professional. So in short, my answer is I really hope so. It really Yeah, helps now helps me be the best I can be.

Jerry D. Lund  
I think I think it will, I think like Destiny was definitely more so saying on her episode is, sometimes you're just not going to jive with your therapist. And that's okay. Like, you're gonna need to find somebody new. It's just like, you're not going to sometimes jive with the dentist you go to, you're just not going to like his style and stuff. So you need to go find something new unless you want to endure some terrible dentistry or endure some, you know, taking your time to do some mental health care for yourself and not actually benefiting from it.

James Boomhower  
Yeah, people, people often forget that. And Destiny is a perfect example of somebody who, who, you know, wasn't in the field, right, but has a tremendous immersion in the field through her lived experience and her tenacity and learning about it and kind of where she lives in the profession. Because you can't tell me that the significant others of us emergency responders are any less of an emergency responder than we are right. But you know, it's so important to remember that sometimes you just don't jive with someone. It doesn't mean they're terrible therapist, although I've certainly expressed that opinion of before. But it doesn't, also doesn't mean that you're so broken that no one can help you. Right. And and I think the only safeguard that you put in there is when you start to have this, maybe I should talk to someone kind of in your ear, you do it sooner rather than later. So you're not in a state of crisis. And you're not you don't force the clinician to be this like impasse of I either do everything right, or it's all over it. And I think because we were stigmatized, and it takes a while and you know, we're still really maturing into this idea as a profession, on the emergency responder side of the coin, that it is, it's not that easy to just go early. And that's my best advice is go early. And if you find a great counselor, yes. If you don't then leave, that's okay. Give us I always say give them a session or two. Right? You have to sit with somebody at least more than once. Unless it was a pouring, you know, yeah. And and make sure that everybody jives and if they don't, you can literally ask the mental health professional you're with if they have another recommendation. Like it feels personal, and it feels rude. But you can ask, is there anyone else in your office? Is there anyone else that takes my insurance? Is there anyone else through employee assistance or anything like that? Those questions are perfectly appropriate to ask one another. And I think in the 911 world where you don't get a choice, either Jerry shows up Virginia, reporting that day, we forget that you have that option.

Jerry D. Lund  
Yeah, I like how you recommend going sooner than later. It took me 28 years, 29 years, basically, to actually actually even more than that almost close to 30 years before I actually went out. I didn't have anything that felt was bothering me. But I felt after so much time, there has to be things that are bothering me. So I tell like our newer members of the department, like I know you only been here for a year or 14 months, but you should go like it should go like early and maybe a little more often than somebody like me waits too long. Because if you can keep that mess, I'll call it a mess in your head sometimes cleaned up, then you're gonna have a much better career, a much healthier career and be able to give more and then be able to not just give more to your patients be and give more to the significant others that people in your life.

James Boomhower  
Exactly, exactly right.

Jerry D. Lund  
And I think, itjust hopefully cultures changing where people feel more comfortable about doing that, you know, um, I think sometimes the stigma of like, there's just talk therapy, that's the only therapy that was out there for so long. And so a lot of first responders, I feel like they don't want to talk to anybody after they're off shift. They want to be like, war secluded. And last thing I want to do is go talk to somebody about you know, their, their problems or how they're feeling. What, what's your kind of favorite, like, type of therapy?

James Boomhower  
That's a good question. I am, I primarily seek mindfulness practitioners. So not formal talk therapy, in the sense of like, lay on the couch and like, tell you everything that's bothering you, but but more of a conversation, and then how you can reframe that conversation in your head. I personally feel it gives you you the person a little bit more control, which would probably not surprise any of us. That's where I'd like to be right? If you have like, you helped me, show me how to fix this kind of thing, right? Yes, instead of just like giving me a prescription. As far as like, you know, you need to do these three things, and then you're gonna be fine. But you're right, there are mental health care comes in all shapes and sizes. There are, you know, group counseling sessions that work really well for people, they have group counseling specific to first responders of every shape and size that worked really well for people. They have immersive activity styles, where you go to say, a horse farm. And the group session kind of happens while you're working with horses, and then laboring and doing all this stuff. There is like good old fashioned traditional, like cognitive behavioral therapy, right, and like, sit on the couch and talk about it. I, I really think I think mindfulness and CBT are good, like, start, if you have like no idea where to go, I would start there. And then work your way through it from there. But there certainly is no wrong way. As long as you feel safe with the individual that you're talking to you. You feel that that you can trust them and they can trust you. And that you understand that you always have options.

Jerry D. Lund  
Yeah, yeah, there's there are just so many different types of options. And I do, like, the mindfulness stuff, I do some practice that, you know, myself, I think, if we feel like we're just going to be able to go to therapy, and be that is going to be the end all thing for us. I don't feel like you're doing yourself a full full service is like, you can't just go to therapy, you have to do a lot of inner work yourself. And, you know, that takes time and patience with yourself. And it's like, he's like you're saying, you know, you always want to be better and stuff. And so just just try to be better each day each be give yourself more grace, just try to work on yourself continually. I feel like most people are still trying to do that everybody's trying to bring their best to work or to wherever they're at. They don't intentionally come to work or whatever, and you know, not bring their best.

James Boomhower  
Absolutely. Nobody is trying to be a slob kebab the whole day, right? Yeah, not not a soul, right? We're all given it all we got, we are putting in, you know, whatever we can put in, we're dealing with everything else that we have going on. And right now Oh, my God, that list is long for everyone. Right? And that's kind of important to understand overall, you know, is it easy when you know, a colleague of mine is driving me nuts? Because they're tired? Or they're not paying attention or whatever. Or am I driving a coworker of mine. Yes. Because I'm really hyperactive and like all over the place. Well, what's, what's actually going on there? And how can I be helpful? And how can we, you know, kind of make that work together. And sometimes that's, you know, being more helpful. Sometimes it's being less and kind of letting it go and is just helpful for everyone to remember that, you know, well, well, we don't want to give anybody excuses, right? Nobody's got a pass to come into work drunk, or, uh, you know, yeah. over like that, like, we're all really just trying to do the best we can every day. And if, if we look at everyone with that lens, I think we get a little bit more judgmental and a little bit more empathic as far as how we can help those people.

Jerry D. Lund  
Yeah, I think far too often, we maybe see things from our perspective only. And we don't really take account like looking from their perspective, or another person's perspective of, of what's going on. We all know, like, if you watch, you know, there's been some documentaries done on like, Hey, watch this bank robbery, you know, and you be the witness, and then they show all the witnesses, you know, including yourself, you know, you're what you're kind of taking down and doing, like, we're all terrible witnesses, we're all seeing something totally different. Like, yeah, and it just happened in front of us. And I tried to, like, tell my guys a lot, just like, you know, we got to look at things in a different point of view sometimes to understand where patients are coming from or where coworkers are coming from.

James Boomhower  
Exactly, exactly. I think it's a really useful tool, especially to build in earlier you can thing it takes away some of that kind of hard on that, you know, really negative attitude of the me versus the patient or me versus the color, right instead of me, you know, working alongside that person and thing.

Jerry D. Lund  
Yeah, James, what couple of tips could you give someone listening to maybe start implementing in their lives very, very soon?

James Boomhower  
First thing, every single time anyone ever offers me a microphone, it's okay to not be okay. That's thing one. Like, that just needs to be your caveat. The idea that, like helpers can't need help the idea that like, I'm a protector, so I can ever need help. It's antiquated, it's wrong. Step one, give yourself the grace to recognize that you need help. If you do need help, I don't mean to project on anyone. Step two is just know that there are so many resources. I don't think it's a it's a stretch to look at any of my stuff, any of Jerry stuff, any of the countless people that live in this space, and offer some help. Just don't be afraid to reach out and ask for help. That is really, really the first thing, know that it's okay to need help. Don't be afraid to ask for it. And then remember that early on, especially in crisis, the things that we can do to be helpful are super fundamental. And well, you may need more or less help depending on what's going on. The earlier parts are really, really fundamental, making sure that you're getting rest, making sure that you're staying hydrated, that you're, you're able to put down some food, and then recognizing if you're not if you know, days have gone by and you can't do that. There's your sign right now. Now you need some more help. And now we can start to work out from there. But it is okay to not be okay. And there are resources and people willing to help you and ready to help you.

Jerry D. Lund  
Yeah, I think there's so many resources now that you can find one to fit your style and maybe or fit the mood that you're in to how you feel comfortable about reaching out from calling texting, gosh, you know, or actually physically going in and seeing somebody there's just so many different ways to get help. James where can people follow you on your journey to getting your degree and being a clinician?

James Boomhower  
Thank you. I'm a couple places I am most active on Instagram and Facebook. Jerry has all of my info put in the show notes, but the handle is stayfit4dty. That's where we're 99% of my stuff is in there. I also have a link tree to some of the podcasts I've done. And some of the other work that I've done. I've been super fortunate to ask to write a chapter for an ontology on mental health. So mid February, I'll be able to have some some details out if anyone wants to purchase a book on mental health in kind of the totality of the scheme, but I write a little essay there on healthcare providers. That is called Scars to Stars. And I'll have plenty of information to that when as soon as I get it. I'll get to Jerry and get as everyone else. And then I can always be reached out by email at stayfitforduty@gmail.com

Jerry D. Lund  
Very good very good. James, thank you so much for being on today and taking the time and sharing your your knowledge and your and your wisdom.

James Boomhower  
Jerry Thank you very much, man. I really appreciate you reaching out and I'm glad we were able to connect.

Jerry D. Lund  
Yeah, thank you. 

James Boomhower  
Take care.

Jerry D. Lund  
You too. 

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Outro  
Thanks again for listening. Don't forget to rate and review the show wherever you access your podcasts. If you know someone that would be great on the show, please get a hold of our hosts Jerry Dean Lund through the Instagram handles @jerryfireandfuel or @enduringthebadgepodcast. Also by visiting the show's website, enduringthebadgepodcast.com for additional methods of contact and up to date information regarding show. Remember the views and opinions expressed during the show, solely represent those of our hosts and the current episodes guests.

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