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PODCAST : Challenges Faced by People of Color and LGBTQ as First Responders with Steven MJ Nelson

Updated: May 1


Former Navy medical corpsman, active service paramedic and EMS professional, and doctoral candidate in health administration, Steven MJ Nelson, MHA, LP, talks about his experiences as a black, gay man serving in the Navy, going through paramedic school and now serving as a paramedic and EMS professional in Texas as well as the challenges all paramedics face in maintaining their health and wellbeing during a very challenging career with ongoing high stress and trauma exposure.


The challenges faced by people of color and the LGBTQ community as first responders, and how he has worked to raise awareness for diversity and inclusion in EMS. The challenges paramedics face moving from one challenging call to another, needing to compartmentalize to focus on their job, and the risks of not allowing time to process traumatic experiences. His experience of the value of mental health and counseling support and the need to transform the stigmas associated with mental health support and self-care among first responders.

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Transcript


Fleet Maull: 

Hi, welcome to another session on a Global First Responder Resilience Summit. We're here on day three with Steven Nelson. Thank you so much for joining us today. 


Steven Nelson: 

Thank you for having me, sir. Thank you. 


Fleet Maull: 

our focus today on day three of the summit is on emotional fitness and resilience. I'm really looking forward to this conversation. I'd like to tell our audience a little bit about you, and then we'll just jump right into the conversation, okay? 


Steven Nelson: 

Sure. 


Fleet Maull: 

Okay. So, Steven Nelson is a Texas native and served this country as a US Navy hospital corpsman and continues to serve his home community, Houston Texas, as a paramedic. With a passion for advocating for change, Steven enjoys his time standing up for LGBT rights and helping to create a more diverse EMS community. 


In addition to his doctoral studies and working to save lives, Steven, also sits as the current chapter president of one of the largest of the nation's first LGBT Greek-lettered organizations for gay, bisexual and progressive men of color, Delta by Phi Upsilon, a nonprofit community service fraternity. 


Enjoys traveling to different countries with friends, spending time with his standard poodle, and bowling with his family. Steven is a licensed paramedic. The MHA has had a degree. He has a master's in hospital administration. 


Steven Nelson: 

Health administration.


Fleet Maull: 

Health administration, right. 


Steven Nelson: 

Yes, sir. 


Fleet Maull: 

And you're working on your doctorate in health administration? 


Steven Nelson: 

Yes, sir. 


Fleet Maull: 

Is that correct? 


Steven Nelson: 

Yes. 


Fleet Maull: 

Right. 


Steven Nelson: 

Yes, sir. That's correct. 


Fleet Maull: 

Great. Okay. All right. And how long have you been a paramedic now, Steven? 


Steven Nelson: 

I've been a paramedic since 2013. I've been in emergency medicine since 2007. 


Fleet Maull: 

2007, so about 14 years. 


Steven Nelson: 

Yes, sir.


Fleet Maull: 

And then, does that include your time in the Navy as a medical corpsman? 


Steven Nelson: 

Yes, sir. 


Fleet Maull: 

Yeah. Okay, great. Well, thank you very much for your service. 


Steven Nelson: 

Thank you. 


Fleet Maull: 

And so, let's just roll with the conversation here. I'm really looking forward to learning more about your experience as a paramedic. And we're going to focus on some of the diversity issues for our first responders and paramedics as well. 


Let's just start by learning about your career a little bit more. So, you are a Navy veteran and you served as a medical corpsman. What drew you to this vocation? What do you think got you into the Navy? What got you into emergency medical services? 


Steven Nelson: 

When I was little, I was always fascinated with the show Trauma: Life in the E.R. And so, I was like, “You know what, when I get older, I want to do that. I want to be a trauma surgeon. I wanna save lives.” 


And so, just navigating through life, the first job I could get in any type of healthcare industry was a lifeguard at our Six Flags Splashtown, which is one of the theme parks here in Houston. And so, working in there as a lifeguard and everything I learned, CPR and things of that nature. And two of my instructors were also EMTs, and they kept talking about EMT, EMS, paramedicine, and whatnot. 


During that time I was already in the delayed entry program, which is a program that you are in right before you get shipped off and everything for the Navy. Started from seventh grade, I was in a program called Leadership Officer Training Corps. Then in high school, I went to Navy Junior Reserve Officers Training Corps. And so, that kind of really pushed me towards going to the Navy right out of high school. 


I knew I wanted to do something in the health field. And so, the only job that I saw there was a hospital corpsman. And so, I said, "I want that job." And so, my recruiter said, "It's pretty hard to get that job. You have to score pretty high on the ASVAB and whatnot." So, took the test and got a high enough score. I went to MEPS and chose my job. They said a hospital corpsman was available. That's where I started my career in healthcare. Post as a lifeguard. 


And then as EMS, when I got out of the Navy, we didn't have any type of formal certifications. And so, I had to go through school again and everything to become an EMT basic before becoming a paramedic. And so, I just sought out some schools and whatnot. Lone Star College is one of the schools that I came across that was in my area. And so, I did my EMT basic there, EMT intermediate, and then paramedic. And so, now I'm here.

 

Fleet Maull: 

That's great. That's great. So, you wrote a powerful article. That's really how I discovered you. You wrote a very powerful article for JEMS, a Journal of Emergency and Medical Services, the primary professional journal in that field. 


You spoke very directly about your experience as a black American and a gay American in the field of emergency medicine and paramedicine. And so, I wonder if you could talk a little bit about your experience in the Navy and then what the transition was like of both going to school. And I think you referenced that you were maybe the only black student in the school where you were or one of few. And then actually going through school and then starting to work in different emergency services agencies. 


Steven Nelson: 

Sure. In the Navy, everyone wore the same uniform. I think I said that in my article. We didn't really see color. It wasn't like I'm black, you're white, you're Asian. It wasn't anything like that. Everyone went to the same school. We all got along. We knew what the common goal was, and we worked towards that common goal. Or at least I didn't personally have any type of racially motivated anything while I was in the Navy. I was never even called any type of racial epithets. 


Houston is a very diverse city. We have people from everywhere, all over the world in Houston. But when I got out, as diverse as Houston is and everything, when I went to paramedic school, well, EMT and paramedic school, I just noticed that there weren't a lot of 

people that looked like me. So I'm like, what is going on here? Nevertheless or whatever, I just kind of went through my program and became an overachiever. 


I was one of those really book-hard people that kind of kept my head in the books. I wanted to know this, the reasons behind this, what are the pharmacokinetics behind this medication, et cetera. And so, I was like the go-to person to come to when people have questions or whatnot. But there were still people in my class that always wanted to argue or bring up politics. And you know, politics can be a very touchy situation for anybody. They wanted my opinion on certain things and I gave my opinion. It led to some heated arguments. 


I just came to the point where I'm like, “You know what, I'm just going to be quiet. I'm just going to continue to do my work. I'm not going to have these types of arguments anymore.” Because those heated arguments did lead to name-calling and some racial things said and everything under their breaths and whatnot, or behind my back that I later found out about. And so, I just kinda just chose to stay from those types of people. But that was a major change and really a culture shock for me coming from an atmosphere where I had like-minded people that were working towards a common goal and different backgrounds and whatnot, coming into a similar situation that was completely different. 


Fleet Maull: 

Wow. What a journey. Politics is becoming a more and more difficult area for any of us to have conversations around. It seems like it's getting so divisive and then you load it with the issues around race and sensitivity. And so, yeah, I just feel for what you had to deal with there. 


What I've always heard about the armed services is that the armed services are generally way ahead of the rest of the society in terms of dealing with these issues of race and moving beyond that. I'm sure it's not perfect. I'm sure things happen, but seems to be well ahead of the rest of society. 


I guess we've got a lot of catching up and a lot of work to do as we've all know what we're going through over the last couple of years, especially since the tragic killing of George Floyd and so many other tragic deaths. And so, we're in this major social reckoning around issues of race and dealing with this legacy that we have. 


Steven Nelson: 

Our professors didn't know anything about or anything that was going on. After I wrote the article, one actually reached out to me and said that she wished that I would've come to her and she would've addressed the situation immediately and that I should not have had to endure that. 


I'm like, “It's going to happen.” I know that with the statistics of EMS, how it is today, I'm pretty sure it's going to happen again and again, and it has. But I've just learned to just overcome it and deal with it. I'm not afraid to speak my mind and let people know this is not right. You need to cool your jets and think about things in a different manner. 


Fleet Maull: 

How has that progressed for you as you began working, I think you've worked for several agencies now and maybe the first agency didn't end up being such a good fit for you, so how has that proceeded since you left school and began working as a paramedic? 


Steven Nelson: 

The first 911 agency that I worked for, I was definitely like a token, if you will, if you watch South Park. The token black guy. He's like the only one on the show. There was one female and then one black male, and then I was the second black male that was in the field there. And so, I kind of felt out of place. But I'm like, “You know what, I'm going to start making a change and hopefully I can bring some more people in, start talking about this more.” 

It just came to a point where I was called into the office and they said that "We just don't feel that you're a good fit here." I said, "I agree." And that was that. It wasn't any type of bad blood between us or anything like that. And I was happy to leave because I just didn't feel at home. 


Fast forward to the company that I'm at now, and I've been here for almost eight years now, it's been a complete 180. We have everything from LGBT individuals to a mixture of diverse cultures. And so, I just feel at home here. 


And people, they ask me all the time, "You're so educated. You have advanced degrees. Why don't you want to go do this and this?" I'm like, "I could, but I feel home here. I feel secure here. I feel like I belong here. And I feel like I can make a change or whatever, starting with this company." 


Fleet Maull: 

That's great. That's great. We have been going through this reckoning with race over the last couple of years. In a new way, I mean, it's been a long journey. But we're in a new era of that journey and having to look deeper, all of us look deeper, and especially white Americans having to look deeper at our own privilege and/or biases that we may or may not be aware that we have and so forth. And the legacy of injustice is still there. 


And so, there's been a heightened awareness around this. It's been very politicized, as we all know. I'm curious as to how that, in particular, has impacted you in your professional life. Just the fact that we're going through this and it's in the media and there have been the protests. I'm curious how that's impacted your life as a professional. 


Steven Nelson: 

To me, I kind of just stay away from everything that has something to do with politics. I mean, COVID-19, that's been very politicized but I'm in the fight with that and everything so I can't shy away from it. But everything else, as far as the killings of unarmed black people, I hear it talked about around my station sometimes and I just kind of keep quiet because I know that it can strike a nerve with me sometimes. Especially when I'm trying to get a point across and nobody's trying to understand because they aren't going through the same type of things that we have to go through as black people. 


And so, it just comes to a point, I guess you could say, where you're talking to a brick wall. There definitely are people that want to sit down and want to have those conversations and really want to understand. One of those people that I work with currently and everything, she happens to be really good with that. She's open to listening to her black colleagues and whatnot in trying to sympathize and empathize, and then going out and sharing what we've said because some people just don't want to hear from a black person because they might think that we're just biased and whatnot. But I guess hearing it from a white female, she's able to really open the ears of other people and get them to understand, like, this is the actuality that Black Americans are going through, so. 


Fleet Maull: 

Yeah. It is a tremendous burden and it can be really unfair burden that can be placed on you. People look to you to carry this burden or to explain or to educate them. It's certainly not a fair burden to be placed on you. Being in emergency services, there's already a tremendous amount of stress and exposure to both primary and secondary trauma. 

We know the health statistics for all first responders that there's a lot of risks associated with ongoing exposure to high stress, even chronic stress, and both primary and  secondary trauma. It can lead to all kinds of physical health issues and mental health issues and can lead to PTSD, burnout, and even suicidality. 


I led a resilience training in a Midwestern city a couple of years back and there were a number of emergency EMS folks in the audience. It was a mixture of police, corrections, EMS, and fire. They asked me, I think in one of the breaks, maybe lunch break. The EMS professionals came up to me and they were just soaking this up like a sponge. They said, "We really need this. We really need this." 


They were dealing with a lot of stuff. There was a lot of obesity, a lot of unhealthy coping mechanisms to cope with high stress and cope with trauma exposure. And so, on top of all that you have whatever level, I don't want to make any assumptions, but you have whatever level of the collective trauma that Black Americans have. The historical trauma related to the legacy of slavery and Jim Crow and just the current situation. And so, you have all this. It's going to be kind of a double whammy almost. And so, how do you work with that yourself? What do you do to stay resilient yourself, keep yourself healthy and resilient?

 

Steven Nelson: 

I really compartmentalize a lot at work. I know that's not healthy, but at work, I have to. As far as being the black paramedic and everything, when I have a uniform on I feel sort of protected from a lot of things that can go on within the black community. But as soon as I take my uniform off or whatever, I'm like, “You know what, I'm another man that could be dead at the hands of whatever.” 


But you're right. There is a lot of stress factors that go into being just a paramedic in general. And a lot of health-associated risks that go along with it. Right now I'm not 100%. I'm COVID positive right now. So, I’m kind of struggling to even get through. But I know that this is important, and I really wanted to get this out. 


One of the things that I really look to is seeing my therapist. And because of COVID 19, I can't see her face to face and everything so it is virtual. But she's allowed me to either text her, give her a call, FaceTime, whatever. I have her direct number so anytime I'm feeling any type of way, whether it be at work or at home or driving or anything like that, she's open to listening to me and helping me out. 


I've had one therapist before who all she did was listen. I'm like, "I'm not really getting anywhere." And so, I found another therapist. This therapist gets me homework and asks me to report back to her with my findings about myself, about the atmosphere that I'm in, how I can better myself, how I can better my atmosphere, things that I can do to cope. 

And so, I think that EMS, we really have a hard time with taking that step to seek therapy. We want to compartmentalize. We think that everything is okay because we see a lot of trauma and we have to act like it doesn't bother us and everything. 


When I got into this profession, originally, I'm like, “you know what? I have to do this. I have compartment because if I spend too much time on this last eight-month-old baby who just died, that next person might not have a chance to survive because I'm still dealing with that and everything. And so, I have to just take that, move on, and just keep going to the next patient. 


But my therapist has really opened the door for me to talk about the things that I go through and to have an outlet and whatnot. And so, I didn't even wanna seek therapy initially, but I was going down a rabbit hole at work and everything with COVID and when COVID first hit. It was very stressful. I was starting to lash out at people. I was getting upset. Sort of how nurses are right now because people aren't getting the vaccine. Well, nurses and physicians because people don't want to get vaccinated. Well, that was me the whole last wave. 


And my job, I can't preach enough how much praise that they should get because they could have terminated me, but they said, "You know what? We value you as an employee. We value as a person. And so, what we want to do, we want to get you help." And so, we're going to mandate that you attend at least four therapy sessions in order to work on yourself. And so, we can seek help and everything.” 


When I started to do that, it just changed my entire life. If no one could take anything away, I want them to take this away. ‘It's okay to seek therapy as an EMS provider.’ And I think that you should seek therapy as an EMS provider because we deal with a lot of stressful situations and trauma. Emotional/physical trauma, like you said. It's not okay to just hold all of that in because someone is going to end up getting the backlash of it. Either you're going to succumb to your own battles and monsters or someone else is going to be the victim of it. 


Fleet Maull: 

Yeah. Wow, there's so much there. First of all, I'm really sorry to hear that you're COVID positive and going through that. I really appreciate that you're willing to do this interview despite that. I hope you recover very quickly and don't experience much in a way of serious symptomology. 


I'm so happy with what you've said that you have proactively sought help and support. It sounds like your current therapist is not only a good psychotherapist but also kind of a good coach. 


My colleague and friend, Lieutenant Rich Goerling, who's one of our presenters for the summit, also one of our co-hosts for the summit, references his therapist as his mental health coach. He's been a first responder for over 30 years. He was in the coast guard, then in the police. He’s a police lieutenant. He should retire now. But anyway, he says, "You just have to realize this all comes with the job. This exposure to high levels of stress, both primary and secondary trauma comes with the job. It's just being smart to take care of yourself." 


He says, “Just like I work out regularly and focus on good nutrition, I meet with my mental health coach on a regular basis. Just part of keeping my mental health tuned up. Right?” And so, I'm really glad that you're doing that. 


The stigma around mental health and mental illness issues, and just the whole notion of taking care of ourselves in that way is hopefully beginning to shift. And that's really one of the primary goals of this summit is to really shift and get rid of or transform that stigma that we have around mental health and mental illness so that people can reach out and get the support they need. And so, I just really appreciate you bringing that forward. In emergency services, in particular, your job is as a paramedic. Do you work for a particular agency? 


Steven Nelson: 

I work for a company called Harris County Emergency Court. It's a private nonprofit organization. 


Fleet Maull: 

All right. And so, you're going out in ambulances and responds to ambulance calls, 911 calls? 


Steven Nelson: 

Yes, sir.


Fleet Maull: 

And so, how much has the pandemic impacted that? How many of your calls are COVID-19 related, and then also having to take care of yourself, having to protect yourself and so forth, and dealing with the citizenry that may or may not be protecting themselves and protecting you and so forth? 


Steven Nelson: 

Right now it's a little frustrating. I know the first wave. It was what it was. I know the vaccine hadn't really presented itself yet so a lot of people weren't able to get vaccinated, but now that the vaccine is out, we advocate that people should be vaccinated. But like I said before it's become so politicized. And so, it's like, if you're not with us you're against us. 

I have rights and whatnot. I don't want my rights to be infringed on and all of that sort of speak. But at the same time these healthcare providers, EMTs, paramedics, nurses, physicians, respiratory therapists, even the custodial staff at the hospital, we're all suffering. And I know in Houston right now, our numbers of it have grown exponentially with COVID-19 cases. 


I would say maybe about 50% of the calls that I go on right now, I might have a COVID-positive patient. The problem that we have in Houston, and it's the home to the largest medical center in the world, we don't have any ICU beds available. We rarely have any hospital beds available. 


It is not uncommon to transport a patient to the hospital and have the patient holding on the stretcher for two to three hours right now. And so, hospitals that we transport to, it actually looks like a war zone or a zoo. A lot of the hospital is full of COVID-19 patients that are unvaccinated. I know, as I said, I'm COVID positive right now and I don't feel short of breath or anything, but I definitely feel like the other symptoms. 


Fleet Maull: 

And this is a breakthrough infection. And probably as a result of exposure on the job, I would assume. 


Steven Nelson: 

Yeah. I mean, we take as many precautions to protect ourselves in that times. If we have a COVID-19 patient, we put him on a, N95 and ENVO mask to try to alleviate the risk of exposure, but at the same time when you get off of work or something like that or just out in your own community and everything, you don't have the luxury to put that type of protection on. I have my own N95 and ENVO mask and everything. So I do wear that from time to time when I go out. But I mean, I still got it. I think I actually probably got it from my mom. 


Fleet Maull: 

Oh really? Okay. So, probably not even totally a work exposure. 


Steven Nelson: 

Yeah. I mean, I really just don't know. 


Fleet Maull: 

Yeah. Totally. 


Steven Nelson: 

She has stage four cancer right now so I try to make as many precautions for myself as possible so that I don't give it to her, but I'm not sure if I carried it and gave it to her, and then she gave it to me. I just don't know. Or if I got it from a patient this time or what. 

We are all suffering in the healthcare industry. Burnout is real, especially right now.


Because like I said, we go on calls and the majority of the calls might be COVID-19 related. Some of them might not be COVID-19 related. Some of them are just the regular medical patients that we might see from time to time. But those medical patients might be like diabetic ketoacidosis and require an ICU. And because of COVID-19 right now and the spike, they don't have any ICU beds for this patient to go to. And so, we're just like stuck and sitting on our hands just waiting for someone to either die or to be downgraded from an ICU room, so. 


Fleet Maull: 

Wow. And that really adds to the stress and the vicarious trauma for you as a paramedic because ideally, you would like to be able to transport this person and have the confidence that you're handing them over to a well-staffed hospital where they're going to be well taken care of. And when you know you're bringing somebody and they're going to be on a gurney out in the hallway somewhere, that's got to be troubling. It's got to be difficult to hold all that as a paramedic. 


Steven Nelson: 

Or just sitting in the lobby of the ER with other people.


Fleet Maull: 

Right. Wow. Yeah. I have a close friend who's a chief of emergency medicine in a major hospital. He told me, maybe after the second wave, that their staff are just exhausted. They're burnout. They're exhausted. They've been asked so much of, right. And now, here, we're going in. 


There was a lot of concern about this. We probably all saw the newscast in New York City, the people coming out and applauding at shift change for the frontline medical workers, and so forth. But we're all kind of exhausted now. How many people are even thinking about our frontline healthcare workers now? And here we are in the fourth wave with this Delta variant. Right. 


The frontline medical workers who are trying to meet this fourth wave are already depleted, traumatized, exhausted, and so forth. We're asking so much of you all as frontline healthcare workers. I just hope people don't forget what's really going on for our frontline healthcare workers. 


Steven Nelson: 

I'm not sure what state it was, but I know yesterday there was a group of 75 physicians who walked out of the hospital in protest for COVID-19 and unvaccinated people, ICU attendings and ER physicians, and whatnot. And just trying to educate the masses that this vaccine is okay. And that you should go out and get it. I know a lot of people, they get COVID-19 that are unvaccinated and they're struggling to breathe and now they want the vaccine, but at that point, it's too late. 


That's another stressor for us as healthcare providers because we try to do everything that we can to help, but when it's too late and we've exhausted all of our resources, we can't do anything else. 


Fleet Maull: 

Yeah. Hopefully with the Pfizer vaccine having been approved by the FDA, hopefully, that'll make a difference. I would assume the Moderna probably won't be far behind that. Hopefully, that's going to start making a difference for people. 


I can kind of understand people having their concerns, but I mean, when people start kind of drinking the cool laid from certain networks, that's very problematic. But I can understand people going through a process of discernment around it. I’m really trying to  understand the process of sense-making. I've listened to a lot of very well-done podcasts, listening to all sides. Right. If you just work your way through the risk scenarios in a rational way, sooner or later, the scales are tipped pretty strongly in favor of doing the vaccine. But even at some point, if that hasn't tipped the scales enough for you, then what about the public good? 


At some point, we don't act only in our own interests. We act in the interest of the public good. If we don't get back, we're putting everyone at risk and we're putting our frontline healthcare workers at risk, who have to deal with us. So, yeah. I hope more and more people will shift their thinking to more of a public good perspective. And as well, really look at the data and see how many hundreds of millions of people have been vaccinated without anybody suffering ill effects yet, and the data shows that it works. I mean, I don't know. I don't want to be dismissive of people's processes, but it does feel like somewhat of a no-brainer at this point. 


And the public good argument too seems so compelling. We're never going to get out of this if we don't get enough people vaccinated. And putting our frontline healthcare workers, our paramedics, and nurses, and doctors, at risk just seems unnecessary and perhaps even unconscionable. 


I'm curious about where paramedicine stands today in terms of diversity, whether you see increasing diversity, whether you feel there's enough kind of proactive efforts in terms of the schools and how people end up finding their way into that profession, whether it's high school counselors, college counselors. How do people end up getting inspired to move into that profession? 


I'm curious, what is the current, even gender balance, male and female as well as what the race and ethnic balances, diversity? As well as the presence of LGBTQ. How safe has it gotten and how much does that field start to look and feel like America or not so much so yet? 


Steven Nelson: 

I think as far as diversity stands, LGBT, there's definitely a mixture. It's a very diverse community with regards to that. I think with the gender as well, I haven't really studied the numbers or anything like that to give you a direct answer, but from what I see I think it’s almost equal as far as both of those. 


As far as people of color in EMS and everything, there's definitely a disconnect. I think I put in my articles, 6.3% of black people that are paramedics in this country compared to the, I think, it's 18 or something percent total in comparison to the population. And so, I think in order to start to increase this diversity, I think that we are doing a good job right now. Having people like me speak on this matter, really opens a door, and opens up people's eyes because maybe people just didn't see or didn't notice that the statistics were so low. 

After I wrote this article and everything, I started getting a lot of people who wanted to speak with me about this issue and start to research this issue. Someone from NAEMT, the National Association of Emergency Medical Technicians gave me a call and wanted to talk to me about it. And they actually told me about a scholarship that I should apply for. I wrote a paper for the scholarship. It ended up getting that. And then a couple of weeks later, I saw in my email that, I guess it's maybe a quarterly subscription or something like that from NAEMT that they were starting another adversity scholarship for EMTs and paramedics and everything for people of color who wanted to get into this field. And so, I think it started to spark interest in that matter. 


And then only that, within my community for my job at Harris County, my CEO came to me and said that he wanted to sponsor a scholarship to diversify the field as well. And so, I just think as the more people talk about it and everything, I think the more that's going to be done about it. Because if will people remain quiet and everything, the statistics are not going to change. 


One of the ways that I think that we can really start to push this is by putting EMS programs in HBCUs or historically black colleges and universities. They're predominantly people of color already. And then you get people to be exposed to something like this and whatnot, because all we really see in school, elementary, middle school, high school is police and fire. All people really talk about is police and fire. And so, people don't really think about EMTs and paramedics until they actually need one. 


That's when I get the question, ‘What do you have to do to become a paramedic?’ or ‘What do I have to do to do something like this?’ And then, that's the only time I can really educate someone 


We have people come and look at the ambulance. Little children, of course, come and look at the ambulance and we show them around. I think we definitely need to be in the ears of those guidance counselors in high schools, or those people who just don't know what they 

want to do after high school and let them know that this is an option. There's not that much to go to school for this. You could definitely make a lot of money and you don't have to have that much student loan debt to become an EMT or a paramedic. 


But yeah, I think that number one thing that I would definitely push and try to speak to program directors at my Alma Mater at Texas Southern University, which is an HBCU here in Houston, is that we need a program like this at our campus and everything because that's one of the ways that we are definitely going to start to increase the diversity within this profession. 


Fleet Maull: 

Well, I'm very happy that you're reaching out the way you're doing, and that you publish some articles and so forth because that really gets the word out. I could imagine even if you were visiting high schools or something in Houston and just talking about what you do, I can imagine a lot of high school kids getting excited. “Boy, I like to be like that guy. I'd like to do that. He looks like a pretty cool guy.” Right. And, yeah. That's great. 


Steven Nelson: 

I really didn't think this article, when I wrote it, was going to get so much publicity. I was actually at my station at work. It was a slow day. And I was like, “I don't have any homework to do right now. No papers to write. I'm going to look up a way and see how I can get something published.” 


And so, I start looking at different ways to publish things and whatnot. And so, I'm like, you know what, I know a lot about EMS. So, let me go to the journal of emergency and medical services and look at their requirements to publish articles and whatnot. I looked that up and everything. Well, okay. So, what do I want to talk about? And the first thing that came to my mind is, well, I can talk about my experience. I was literally not doing anything at work. And I was just bored. I'm like, “I think I'm going to write today.” And never knowing that it would lead to me and you having that conversation or the NAEMT contacted me about diversity standpoints and creating a diversity scholarship or even my boss creating a diversity scholarship. But I'm glad that I had that work on board though. 


Fleet Maull: 

Well, it just really points to the power we all have as individuals. We never know the ripple effect of actions that we take. Right. We often think, ‘Well, what can I do? I'm just one person.’ But here you're, one person, you took a step and out of that now there's some scholarships in the horizon and different things. So, we just never know what the ripple effects are going to be. And so, yeah. I just really appreciate, not only your heroic services as a first responder but your willingness to put yourself out there and put yourself forward. I'm grateful that's really leading to good things and I'm sure it will continue to do so. 


Just a couple of things that stood out from what you said. You talked about, when you're on the job, you do need to compartmentalize in the sense that you can't do well on maybe a really tough situation you just have with a particular patient, right? Because now you gotta move on to the next patient. 


So, I think one way also we could talk about, I mean, you could call it compartmentalizing it, but it's also just stepping into the now, right. Being present focused. And there's going to be a lot of presenters on this summit talking about mindfulness as simply a skill that helps us be more present, right? We move into the now because you want that next patient to get your very best, your best training, your best skills, and that ability to be now focused. 


And at the same time, we still have to find time for ourselves to revisit these very difficult situations we're facing and finding a way to process that and not get stuck in those things. Because the idea that we can just permanently compartmentalize and keep all that stuff stuffed here and there, it doesn't work in a long time. 


We know clearly from human experience, but also now from current neuroscience, we understand why that doesn't work. Right. And why that's going to sooner or later lead to empathy, fatigue, burnout, even PTSD, and even worse. Right. I'm glad that you're reaching out and you have this kind of counseling and coaching resource for yourself. I really appreciate that you're speaking out about that here at this summit so that we can move beyond those stigmas associated with getting that kind of support. 


And so, I think sometimes that can be a barrier too because I think some first responders, I don't want to make assumptions, but what I've listened to a lot of first responders for many years and some may feel like, well, I have to do that. Right. If I open up those boxes then I won't be able to do my job. Right. So, I have to just keep compartmentalizing and stuffing. 

So yes, absolutely. We have to be able to manage ourselves so we can go on that next and be there. But there are other ways to learn to do that other than stuffing. We can actually learn mindfulness and learn how to shift into the moment, be right there, get the job done. And then there are resources where we can go get support to process things in a way that's not going to destabilize us or make it impossible to do our jobs. And you seem to be a testament to that. 


Steven Nelson: 

Yes. And even after any type of really bad call or traumatic call or anything like that, our supervisors here, they sit down with us. If we have to go out of service to talk and everything, they'll pull out of service and give us the opportunity to take a mental break and just talk about things and everything. And if we have to go home after something like that, then they're open to allowing us to go home just to refresh and pull ourselves together before coming back to work. 


So like I said, I'm fortunate enough to work at an organization that allows us to do stuff like this and really cares about our mental health as EMS providers. Because I have worked with some other organizations that are just like, we want you to get the job done and by any means possible. We don't care so much about whatever else you're going through. We have to make money. We have to take care of patients and we wanna do X, Y and Z. It's not good for any EMS provider to be in any type of situation like that. 


Fleet Maull: 

Well, I'm glad you found your way to a much more enlightened organization to work for. It sounds like they are doing some really good things. I'm glad you have a good home there. 

So, Steven, thank you so much for being willing to be part of this summit. Thank you so much for the service that you have provided for so long to your community and that you're doing currently in the midst of this pandemic. And thank you for speaking up and speaking out and continuing to share your experience so that we can shift the culture, the EMS culture, the first responder culture, and our whole culture. I just really appreciate you and what you're doing. 


Steven Nelson: 

Thank you. And something that I just wanted to end with as far as resilience. It is okay to just say that I'm not okay. Sometimes you just need to take that break. I'm not opposed to taking a mental health day from work if I have to if I'm just not feeling it. I think that any EMS provider out there should adopt the same mentality. 


You have to take care of yourself before you can take care of others. And they always appreciate that our safety is our number one priority because if we're not okay, we can't take care of other people. So, if you're not feeling 100%, take that mental health day, talk to someone or just take the mental health day just to rest, go bowling, do something else and just get your mind off of things for a while and just recuperate and come back and spring back and take care of the patients that you need to take care of. 


Fleet Maull: 

Great. Absolutely great. Great place to end with such a powerful and important message. So, thank you very much, Steven. I wish you all the best and I hope you recover very quickly from the COVID infection. 


Steven Nelson: 

Thank you so much for having me, sir. 


Fleet Maull: 

You're very welcome. Great to have you.

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