08/22/2025
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In EMS, it’s easy to assume that resilience is a fixed trait—that some people can just “handle” tough calls better than others. But the reality is far more nuanced. The way we respond to stress and trauma isn’t about toughness, weakness, or years on the job. It’s about something called the window of tolerance.
What is the Window of Tolerance?
The window of tolerance is a term from trauma psychology that describes the optimal zone where our nervous system can function and regulate effectively. Within this window, we’re able to:
• Stay emotionally balanced, even in difficult situations
• Think clearly and make decisions under pressure
• Remain connected to ourselves and others
• Process and integrate experiences without being overwhelmed
When we’re in our window, we can run a tough call, feel the stress of it, and still keep functioning in a healthy way. But when we move outside that window, our nervous system shifts into survival states:
• Hyperarousal: anxiety, panic, irritability, racing thoughts, anger, hypervigilance
• Hypoarousal: numbness, dissociation, emotional shutdown, exhaustion, detachment
Neither of these states means we’re “broken.” They’re our body’s way of saying the load was too heavy for our system to process at that moment.
Why First Responders Experience It Differently—
Here’s the key: everyone’s window of tolerance looks different. Two paramedics can run the exact same call and walk away with completely different internal experiences. One may shake it off and get ready for the next call. The other may feel flooded with stress and struggle to return to baseline.
This isn’t about strength or weakness—it’s about capacity. A responder’s window can widen or narrow depending on:
• Sleep and fatigue (12-hour vs. 24-hour shift, back-to-backs)
• Cumulative stress (calls stacking on top of each other, workload, family stress at home)
• Personal history (past traumas or triggers that resurface during certain calls)
• Support systems (how safe and connected they feel with their crew and leadership)
• Physical and mental health (nutrition, exercise, therapy, pre-existing conditions)
That means the same traumatic scene could push one provider outside their window while another remains steady. And tomorrow, with different stressors, the roles could be reversed.
The Damage of “I’ve Had Worse Calls Too”
This is why one of the most harmful phrases we hear in EMS is: “I’ve had worse calls” or “That shouldn’t bother you.”
When we dismiss someone else’s response, we invalidate their nervous system. We tell them their window should look like ours—when in reality, windows are shaped by dozens of factors we can’t see.
Comparisons breed shame. And shame is dangerous in first responders, because it silences people when they most need connection. Instead of reaching out, they isolate. Instead of processing, they push it down—until it resurfaces as burnout, compassion fatigue, or PTSD.
Building a Healthier Culture—
The solution isn’t to toughen up our colleagues—it’s to widen our culture’s window of tolerance. That starts with:
• Listening without judgment: “That sounds like it was a lot.”
• Validating experiences: “It makes sense that hit you hard.”
• Encouraging recovery: reminding each other that rest and decompression aren’t luxuries, they’re necessities
• Normalizing differences: understanding that we don’t have to feel the same way about the same call
When we move away from comparison and into compassion, we build a culture where first responders can process stress in real time—before it accumulates into something heavier.
Final Thought—
Every one of us has a window of tolerance, and every one of us has days when that window is wide open—or paper thin. Recognizing that truth doesn’t make us less resilient. It makes us more human. And in a career where we are called to show up for humanity every day, perhaps the bravest thing we can do is extend that same grace to each other.
