James Novello on Encouraging Paramedic Health

James Novello
6 min readApr 13, 2022


As a firefighter paramedic in San Francisco, California, James Novello has meticulously studied physical and mental health and how best to maintain optimal performance. A first responder must be able to respond to any stressful situation quickly and effectively. James Novello has learned how to help others manage stress effectively while also maintaining their physical and psychological health.

Why Physical Health Matters as A First Responder

Fitness is crucial for all first responders on the job, regardless of rank or age. On emergency calls, first responders are often required to use their strength and endurance in many different ways. They may be lifting obese patients at awkward angles or throwing ladders during hectic scenes or even fighting with altered and intoxicated patients. Since the type of strength needed can vary depending on the situation, it is important to train using a variety of disciplines.

Daily cardio and strength training workouts are obviously key to success. They are necessary to build muscle and enhance stamina needed during intense situations. While lifting weights and cardio aerobic activity are essential, a healthy diet and stress reduction maximize the benefits.

James Novello improves performance and reduces the chances of injury by strengthening large and accessory muscles around common injury areas. Many physical injuries are also easy to avoid with proper lifting techniques and vigilance to general conditioning. Maintaining a healthy weight while increasing mobility and strength is key to improving overall performance and reducing the chance of injury in first responders. Many injuries occur due to overweight and physically undertrained responders.

Exercise helps build physical resilience for first responders. Regular cardio exercise such as running, biking, and even swimming will help lower resting heart rate. This results in an easier ability to think properly while the body is under physical stress during demanding or complex incidents. And it’s a powerful tool for maintaining both physical and mental resilience according to studies in neuroscience.

Part of the physical health aspect includes the immune system. Without proper nutrients and vitamins, the immune system response becomes less effective over time. So diet plays an essential role in reducing illnesses, a diet both inclusive of helpful nutrients and exclusive of harmful substances. The flu, common colds, and bacterial infections can all be reduced by avoiding foods and substances that tax the immune system such as refined flour, sugars, and any alcohols or substances. Other health conditions such as depression, anxiety, and fatigue can also be improved with a balanced diet combined with exercise and proper rest.

Is Mental Health as Important as Physical Health in an Emergency Situation?

Paramedics and first responders can face countless difficult situations that are incredibly time sensitive and require rapid problem solving. They include car accidents, natural disasters, and complex medical responses. Repeated exposure to traumatic events or witnessing severe injuries take place have the protentional for negative psychological effects. There are a number of healthy coping techniques and manners of living that are very effective at preventing these sorts of injury.

Paramedics and first responders can develop a variety of mental health issues. Some of these include depression, PTSD, and anxiety. Unhealthy coping mechanisms are unfortunately common among a large percentage of paramedics and first responders which include alcohol, substance abuse, and overeating. These have a compounding effect on mental and physical wellness, leading to worsening problems such as burnout, depersonalization, and irresponsible behavior. Unfortunately, if mental health issues are not handled properly, first responder’s problems usually get worse, or the person suffers silently for years. Most are unaware that they are even experiencing any of these problems until coworkers or family members notice the symptoms. Thankfully with help and enough motivation, most are able to recover.

Mental resilience comes from understanding the pathophysiology behind the problem and being open to put in work in order to reap the rewards. Even extremely resilient first responders with decades of experience are still prone to the effects of repeated trauma. Paramedics are encouraged to periodically check in with counselors in order to assess emotional health and to catch potential issues before they affect their careers. First responders may think certain situations do not affect their mental health until symptoms show up in unexpected ways.

Those experiencing work related stress secondary to trauma exposure may spend more time drinking or performing risk-taking activities. Of course, fire department and police department cultures tend to attract people who are risk takers, but even still most are able to identify unnecessary and irresponsible risk taking. This may not be problematic for many first responders, but it can indicate that they may be having issues processing what they have been exposed to. With the right help, taking care of mental health issues does not have to be a lengthy or uncomfortable process.

There is also a tremendous amount of overworking that occurs when first responders are in departments that are understaffed or extremely busy. First responders need to be encouraged to take proper vacations rather than let their time accumulate or be used one day at a time. Many are so tired that they take a day off as soon as they accumulate the time rather than saving it for a week vacation.

In addition to counseling and support groups, exercise is an excellent way to increase emotional health and resilience. Exercising fulfills an evolutionary need that people have to exert themselves. Humans were not meant to sit for 8 hours a day, so adding some rigorous exercise can fulfill that evolutionary need as well as naturally increase dopamine. The unhealthy coping strategies on the other hand will chronically lower dopamine for extended periods of time, worsening yet again the original symptoms for which they are using the substances or negative behaviors.

Healthy Techniques While in the Field

Depending on the location, first responders may work for days or weeks in a row and be so busy that they have very little time for exercise. Despite a lack of time, quick exercises can be done and small easy changes can help improve their lives.

Getting a full night’s sleep may not always be possible, but there are ways to improve the quality. Using sleep aids on a nightly basis can reduce the quality of sleep over time, and like most drugs they eventually become ineffective. Additionally, reducing screen time before bed can help individuals fall asleep naturally without prescription medication.

Debriefing after work is a way to boost morale, although sharing beers in the station parking lot is not exactly the type of debriefing that is most beneficial. A strong peer support network, available especially after critical incidents, can make a difference if staffed by trained and proactive department members. While most paramedics and first responders usually are only friends with their peers, it is important to encourage outside friendship and hobbies.

Quick 15-minute workouts such as cross fit, TRX training, or even stretching are incredible activities that performed over time can greatly benefit sleep, mental health, and of course physical conditioning. Since stretching can be performed virtually anywhere, this is an activity that can be included in almost anyone’s day. For example, on the engine between calls or while staged on a scene. This helps with flexibility and helps relieve physical tension from repetitive activities or unnatural sitting positions.

The Balance Between Mental Health and Physical Health

Mental health professionals should be specifically trained to treat injuries specific to first responders. While not all departments are the same, James Novello believes department personnel are often the best individuals to treat their fellow members. There is no better way to gain the trust of relatively untrusting people in order to best diagnose and treat complex symptoms.

Additionally, local first responders who are familiar with their department’s culture and inner workings are more able to relate and understand certain problems a coworker may be having. And they may be known to the individual as someone who has helped other department members.

Knowing that the balance between mental and physical health is especially important for first responders should help department members place greater importance on both of these aspects. First responders train for emergency incidents for thousands of hours, it only makes sense to train the best tools they have in order to perform their duties: body and mind.



James Novello

Experienced Ex-Firefighter & Peer Support. Located in San Francisco, California.