Rescue Resiliency: Training for the Mental Assault of Acute Stress

By MATT BROKAW

The traditional form of instruction among fire departments nationwide involves three common threads: classroom, hands-on training, and skill checkoffs. We all have to start somewhere, and this standard form of education is the basic requirement for becoming a firefighter. Although it is not wrong to train on these three forms of traditional learning, too many circumstances exist where skills are only trained on to sufficiently pass a check sheet, and that is simply not enough. Unfortunately, you cannot count on these skills in times of great stress and pressure.

In recent years, the fire service has slowly begun to look at how thinking occurs on scene. We hear terms like “situational awareness,” “combat readiness,” “recognition primed decision making,” and “Observe, Orient, Decide, and Act (OODA) loops,” among others. I am a fan and follower of these terms; all these concepts point to a cultural shift that is occurring before our eyes. Collectively, we find that the standard and traditional training that we have come to know may be not only insufficient but also damaging. We have all seen our sharpest members “lose it” or, in more definitive terms, become indecisive, frustrated, angry, or worse-overwhelmed. If members have been adequately trained, why would this happen?

A number of years ago, fellow members of the Fort Wayne (IN) Fire Department and I had the opportunity to facilitate departmentwide training that consisted of our self-contained breathing apparatus (SCBA) confidence course. Those involved took particular pride in our training “smokehouse”; it is exceptionally challenging and versatile. At the time, however, we felt it truly didn’t tax and stress the members enough mentally. Adding to the confidence course was easy; we wanted some form of auditory distraction such as heavy metal music and a lot of yelling. Visually, it was dark, featuring zero visibility, while the only discernable goal was to make it out through to the other side.

Over the next few weeks, we observed nearly 300 individuals’ experiences inside the smokehouse, and I began to see patterns of behavior that intrigued me. I noted an incredible range of reactions, from calm to violent and every behavior in between. After the training was over and some months had passed, I kept reflecting on that particular evolution. Why were seasoned, experienced members ripping off their regulators? Why would personalities change so drastically? These firefighters had been trained to negotiate obstacles and conserve air, but there were still an alarming number of members who exhibited great difficulty, displaying behaviors that would cause great concern in an immediately dangerous to life or health atmosphere.

I started researching topics associated with stress and performance. There is a tremendous amount of information available, but there are limited writings specifically for or about the fire service. Yet, this is not a new concept; for decades, that concept has been incorporated into the trainings of the military, law enforcement agencies, athletic teams, and even the business world. I can sum up my findings in one statement: It is not enough to train hard; we have to train correctly! The fire service as a whole has put together some exceptional programs to prevent-or at least lower-firefighter line-of-duty deaths (LODDs). In my relatively short career, I have witnessed the advent of formal trainings in Mayday/LUNAR (Location, Unit, Name, Assignment and Air Supply, Resources), rapid intervention crew (RIC)/team, self-rescue techniques, integrated personnel-activated personal alert safety system devices, and comprehensive health and wellness programs, among many others. Yet, our LODDs hover right around the same number every year. Many have asked this same question; there seems to be something missing.

Intrigued by my own experiences and the impromptu human behavior study in the smokehouse, I pored over countless articles and academic studies on the relationship of stress and performance and compared that to various LODD reports. It became evident that we in the fire service community can teach ladder bails and RIC drills until we are blue in the face, but we must train our members to truly handle the emotional assault on the mind associated with these events. Train for it! Instructors need to do more than just tell their students that “it will be stressful” and to “remain calm”; they have to show them how. It is simply not enough to train hard; we have to train correctly!

Additionally, the painful truth is that the leading cause of LODDs is heart related. Despite extensive health and wellness programs to reduce these numbers, they remain relatively static year to year. Health and wellness is only half of the battle. Think of this standard firehouse prank: A firefighter creeps down the hallway of the firehouse with an air horn, stealthily finding his mark; at the push of a button, he makes an unsuspecting victim jump in terror. Now, we all know the heart rate of the startled firefighter has undoubtedly increased, as anyone’s would. Yet, the physical workload of that firefighter hasn’t increased; this reaction has more to do with the victim’s emotional fitness rather than physical fitness. Repeated exposure to the stressor (air horn) would eventually result in the victim’s ability to control that response based on experience and understanding. To compound the problem, a combination of poor physical fitness and an inability (having not been trained) to regulate emotions can result in extraordinarily high heart rates, putting potentially catastrophic loads on the heart. Being fit for duty is not only how often you run or how much you lift; you must place as much effort and importance on your mental and emotional fitness.

In the past few years, more and more articles and books have been written detailing the correlation of heart rates and how the uncontrolled ascent interferes with cognitive (thinking) ability. Before this condition was connected to heart rates, Prussian General Carl von Clausewitz famously called this the “fog of war.” Others refer to it as the transition between the forebrain and the midbrain.

Training for this response is as important as training for any other fireground operation. Some refer to it as “stress inoculation training,” which implies that a student can be inoculated from stress through careful and measured doses. I prefer the term “stress exposure training” because there is no way to conduct a training system that can make a firefighter impervious to stress; there are simply too many uncontrollable factors. You can do a methodical exposure to increasingly stressful situations that mimic our work environment. This training concept in turn bridges the gap and lessens the impact on the brain as it provides the individual with additional resources and coping techniques-much like preparing for a tornado: You can’t stop the tornado from coming but, through proper preparation, you can make it “hurt” less.

Every skill, once learned, should be trained on to the point of repeatable success under increasing stress. Bring individuals up to a desired level of stress through calculated and balanced steps, each level having a desired goal. Stress exposure training is not about endurance; it is about building the mental pathways through experience and coping techniques to turn crisis into success. You can endure negative circumstances, or you can learn/train to cope with and triumph over negative circumstances.

The success of the American fire service depends on the ability of every firefighter to read situations as they are unfolding in real time. Simply, you must train your mind just as completely as your body. In the words of Bruce Lee, “Without a behavioral delivery system, the body is useless.” Don’t train just to get it right; train to get it right in any condition at any time.

RESCUE RESILIENCY

This research has led to the development of rescue resiliency. The objective is that each student will learn to maximize his ability to control and direct his emotional response to stress. Rescue is the number-one incident priority nationwide; resiliency is the stressor involved in those rescues, whether for a civilian or a firefighter.

This course can be delivered several ways, depending on the available time. Information is presented in the following three-phase format:

  • Presentation.
  • Skills introduction.
  • Confidence building (skills practice).

The half-day option involves the presentation of information and skills with in-depth discussion. The second option is a full day, which increases the presentation length and includes short, hands-on evolutions that will tax the individual in a way that illustrates the information discussed in the course and provides opportunity for using the new coping skills. The third option includes two full days where students will be challenged tremendously as the evolutions grow in number and duration.

Rescue resiliency is designed and encouraged for firefighters at all levels; success and safety are the priorities.

MATT BROKAW is a lieutenant with the Fort Wayne (IN) Fire Department (FWFD) Operations Division. He is also a member of the hazmat and water rescue/dive teams. Brokaw is an instructor at the FWFD Training Academy and the author and lead instructor of the Rescue Resiliency training course.

 

More Fire Engineering Issue Articles
Fire Engineering Archives

 

Hand entrapped in rope gripper

Elevator Rescue: Rope Gripper Entrapment

Mike Dragonetti discusses operating safely while around a Rope Gripper and two methods of mitigating an entrapment situation.
Delta explosion

Two Workers Killed, Another Injured in Explosion at Atlanta Delta Air Lines Facility

Two workers were killed and another seriously injured in an explosion Tuesday at a Delta Air Lines maintenance facility near the Atlanta airport.