Founders Story:

I was hired as an EMT at the at of 18 for a rural EMS company based in Arizona. I remember my mother telling me, “You are either going to love this profession, or it won’t be for you.”

To sum it up, in my first 48-hour shift, I delivered a baby on the side of the road, and I was hooked. About a year later, one night, around 11 pm, my partner and I were dispatched to an MVA (multiple vehicle accident) on the 2-lane highway about 20 miles from our station (and approximately 40 minutes from the closest hospital). To paint a picture; in rural EMS you don’t have the luxury of Fire, PD, or other EMS units responding. Also, this was about 20 years ago, and at that time rural areas had major communication issues with cell phones and radios…

We arrived on scene to find a small car with (once) 6 passengers who were traveling Eastbound when they hit a cow… the cow then impacted another vehicle with 4 passengers going Westbound.

There were bodies scattered like dolls on the highway… 10 patients total. There were 5 victims DOA (dead on arrival),  4 critical/immediate, and 1 walking wounded (who only spoke Spanish)… we played God that day. We decided which of the 4 to work… there was another unit 10 minutes out (which is an eternity when you are on the scene) and the only 2 helicopters available with 20-minute and 30-minute ETAs

We get to work on the first patient… the next unit arrives, and they take patient 2… we load patient 1 into the helicopter… next to patient 3… patient 2 is loaded by the other crew in the helicopter… now onto patient 4…

We are out of helicopters, so we need to “load and go” up to that point, I am fine… I’m holding C-spine and bagging… then I realize the sensation of the shattered skull being held intact by the skin on the patient’s head… “I ask myself…why are we doing this? He is not going to live… what is the point?”

I still don’t remember anything after that thought… somehow, I drove to the closest facility and back to the station… the next thing I remember is my medic sitting on the picnic table next to the station driveway, charting, as I am cleaning out the back of the ambulance with a garden hose… the water red. I am covered head to toe, as is my medic, in the blood of multiple patients.

The supervisor pulls up. He gets out of his nice clean suburban in his spotless, pressed white shirt and asks, “Hey, how long until you get back in service?”

I look at him, astonished. “You know… if you take about 3 seconds to look around… I’m going to say we need a few (*explicit*) minutes.”

Fast forward a few weeks later… I’m in the grocery store with my then-husband. He simply tosses me a bag of rice. The moment it touches my hands I drop it… rice explodes down the aisle like pins sliding down a bowling alley… all I can think about is the feeling of that patient’s head in my hands.

For years I battled similar PTSD symptoms and had brief suicidal ideations. There were no resources available to me, no preventative programs or sources of support, and honestly did not even know it was PTSD at the time. (Now we call it PTS).

After counseling and (later) some attempted EMDR, I realized how little support there was for first responders like myself, how much of a need there was, and more devastating, the pressure surrounding the stigma of even mentioning that you were struggling and needed help.

According to a 2018 study by the University of Arizona College of Medicine, “Arizona emergency medical technicians’ risk for suicide is 39% higher than the general public.” The percentage for firefighters and police suicide rates are even higher. I attribute this to the constant accumulation of exposure to High-Stress Incidents like the one I experienced early in my career.

Knowing what I do now, it is my personal mission, and the focus of Thin Line Consulting to provide resources, advocacy, and support for all first responders through resiliency and mental health first aid training, well-vetted resource connections, and assistance in developing effective peer support teams and suicide prevention programs.

2024 Update: We have added 2 new services to include grant writing assistance and event booking. Over the last five years of serving amazing organizations, we have seen success in winning millions of dollars in grant funding through our consulting services and have decided to offer grant assistance from research, writing, and submitting, to even ongoing maintenance after the award.

Thanks to great relationships with affiliated hospitality partners, we now offer a FREE event booking service that gets steep discounts for room blocks and meeting space. We simply pass this through to you, it doesn’t even have to be a Thin Line Consulting training, use it for awards banquets, training, etc.

“We are in this, together.”

-Nicole Swartwout, Founder- Thin Line Consulting

Share your story

Are you a first responder and have a story like the one of our founder?

Sharing is not only healing, but it humanizes the profession, and reduces the stigma.

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Thank you for sharing!