A hazard among deployed medical SM’s, including OTs, is the potential for burnout. Burnout can manifest in forms of physical and/or psychological fatigue, loss of morale, depression, hostility, or reduced commitment. This is demonstrated by the following account from CPT Francisco Rivera while stationed at a Combat Out Post (COP) in Afghanistan (Fig. 5.2).
We arrived once again at one of the most dangerous places in Afghanistan. The COP was being manned by a Stryker Brigade Combat Team; one of the Army’s most effective fighting forces.
Fig. 5.2 CPT Rivera with SFC Zeke, COSC Therapy Dog, transporting to perform a Combat Stress Prevention Assignment, Afghanistan, September, 2011 (Courtesy of CPT Rivera)
The Commanding Officer, other senior unit leaders and I were tasked to complete Traumatic Event Management debriefings, which were required to assess and manage emotional and physical responses of unit members when experiencing comrades killed in action (KIA).
Alpha Company had 4 KIAs, along with 12 wounded in action who sustained multiple amputations and other life threatening injuries. We conducted 11 debriefings accounting for over 100 Soldiers with a goal to help them process the trauma and constructively manage emotional reactions to these combat experiences.
A number of Soldiers were struggling with and concerned about thoughts of trying to avenge the deaths of their fellow Soldiers while on patrol off the COB. It was very difficult to encourage them to “drive on” and stay focused on their mission. Many had lost the motivation to fight or carry on with their assigned mission. Some struggled to identify with the mission and had difficulty rationalizing the worthiness of it all and risk of more loss of life. Others lacked confidence that higher command was supporting their needs.”
CPT Rivera, OT, US Army Reserves
CPT Rivera’s narrative attests to the mental and physical exhaustion SMs endure while on deployment. Factors such as suffering from injury, witnessing severe trauma or loss of life amongst friends and fellow SMs can severely disrupt one’s emotional state. Additionally, performing military operations without meeting calculable success, perceptions of neglect or lack of support from superiors despite individual efforts, sacrifices, or losses can lead to emotional collapse or burnout. Deployed OTs must be able to recognize burnout in order to rehabilitate, rejuvenate, and return a SM to duty with the capacity to independently and safely perform their mission.