For first responders, job-related stress and strain can be off the charts. Police, fire, and EMS personnel often see and do things most people cannot imagine. Repeatedly encountering dangerous situations can lead to post traumatic stress disorder (PTSD); depression; and eventually, in some cases, addictive behaviors and suicide.
Knowing when to seek help can be a difficult step in the healing process. Some first responders might feel they require treatment to resolve their issues; others might be in denial or unable to identify their needs. Friends and family members often seek advice and treatment before the affected officer or firefighter can truly confront their issues.
Here are some symptoms that could help identify potential PTSD sufferers:
- Anger and irritability.
- Substance abuse.
- Suicidal thoughts.
- Guilt, shame, and self-blame.
- Depression and feelings of hopelessness.
- Feelings of mistrust, betrayal, and loneliness.
Symptoms of depression can include the following:
- Persistent sad, anxious, or “empty” feelings.
- Feelings of hopelessness.
- Feelings of guilt, worthlessness, or helplessness.
- Irritability, restlessness.
- Loss of interest in pleasurable activities, including sex.
- Fatigue and decreased energy.
- Difficulty concentrating, remembering details, and making decisions.
- Sleep issues including insomnia, early-morning wakefulness, or excessive sleeping.
- Overeating or appetite loss.
- Thoughts of suicide; suicide attempts.
- Persistent aches or pains, headaches, or other physical distress.
Here are some signs and symptoms of alcohol or drug dependence that first responders and family members should look for when deciding to seek treatment:
- Tolerance.
- Withdrawal.
- Loss of control.
- Desire to stop but can’t.
- Neglecting other activities. Alcohol and drugs take up greater time, energy, and focus.
- Continued use despite negative consequences.
Resources are available for those who may be suffering and not know where to turn for help. Admitting there may be an issue is the first step. Talking to a supervisor or chaplain about these issues can also facilitate the healing process. To address the growing need for behavioral health support and resources, American Addiction Centers has created a program aimed at helping law enforcement officers and their families. This dedicated hotline is available at 1.855.99.POLICE (765423). Additionally, the National Volunteer Fire Council (NVFC) has launched Share the Load™, a support program for firefighters and members of the emergency medical service (EMS). As part of that program, the NVFC has partnered with American Addiction Centers to create the Fire/EMS Helpline, a free, confidential helpline available 24 hours a day, seven days a week to assist firefighters, emergency medical technicians, and their families. Callers receive compassionate, nonjudgmental support for a variety of behavioral health issues, such as PTSD, addiction, depression, suicide prevention, stress or anxiety, critical incidents, relationship issues, and other areas affecting their work or personal life. The helpline is available at 1-888-731-FIRE (3473). Help is just a phone call away.
Mark Lamplugh
First Responder Specialist
American Addiction Centers
Captain
Lower Chichester (PA) Fire Company
Role of first-arriving officer
It was with interest that I read Chief Bobby Halton’s Editor’s Opinion “And the Band Played On” (March 2014). I knew I wanted to respond, but the words avoided me. A trip to Montgomery County’s (MD) Strathmore Music Center to hear the Baltimore Symphony Orchestra (BSO), under the direction of Marin Alsop, perform Gustav Mahler’s Symphony No. 1 in D major (also known as Mahler’s Titan) made the difference. As I watched the orchestra and its conductor perform, the crafting of my response was taking shape, and what better metaphor to use than that used in the editorial?
The concert master, taking the role equivalent to that of the first-arriving company officer, set the stage, providing direction to each orchestra section, much as the officer sets the direction of the incoming units and establishes divisions and groups as necessary and gets them in play. The various orchestra sections (strings, percussion, and so on) represent the divisions and groups assigned by the initial incident commander (IC), the first-arriving company officer.
National Institute for Occupational Safety and Health firefighter fatality reports continually show that failure to establish command is a major factor in line-of-duty deaths. In the editorial, Halton noted a study related to the Russian conductor Yuri Temirkanov and the control of orchestras that sought to find out if “it made more sense to devote more energy to ‘the first and greater portion of training and establishing conditions that lead to desired outcomes rather than devoting energies into the online process management.'” Halton asks, “Does it make more sense to train diligently and thoroughly so that you establish tactical procedures and policies that match conditions and contexts identified by arriving officers rather than placing the onus on the first arriving to discern those conditions and make subsequent tactical decisions for subsequent arriving units?”
If we challenge each arriving unit to determine its own tactical response, then, in my view, we open the door to freelancing, and freelancing is another leading cause of firefighter fatalities.
That being said, the first-arriving officer, who has significant training and experience, should be competent enough to lay out the tactical response of the first-arriving units. This competency is gained only through a rigorous command and control training program that implements realistic simulations. Guaranteed, “on-line” command training does not cut it. Company officers need to sit in the seat with appropriate coaching to begin to understand the intricacies of setting the incident. Two excellent National Fire Academy courses-“Command and Control of Incident Operations” and “Command and Control Decision Making for Multiple-Alarm Incidents”-provide company officers with the initial IC training that allows them to grow in the command role. At home, departments need to implement at the company officer level command-level training that includes simulated responses to target hazards in their respective communities. Montgomery County (MD) Fire and Rescue Service requires all command officers to complete annually a recertification program that includes a simulation portion.
Back to the orchestra for a minute: In the editorial, Halton cites a study related to a conductorless orchestra and its ability to play. He notes that the study says the orchestra “played beautifully, almost flawlessly.” There’s the rub. We in emergency response need to play perfectly-anything less can lead to a disastrous outcome. In watching Conductor Alsop lead the BSO, it was interesting to see her interaction with the orchestra. She made eye contact with orchestra members, cueing them to respond for their parts. During a Question and Answer period following the concert, an attendee asked about her movement on the podium (she moves smoothly from one side to the other). She responded that even though she may be working with the violins, her ears are still tuned to the rest of the orchestra. If she hears the cellos not delivering as she wants, she can quickly turn and bring them back. That wouldn’t happen without the conductor (IC), nor would a rapidly changing emergency incident find life-saving decisions being made without a well-trained IC. Alsop related to her work as a “communication’s ballet,” and isn’t that what we as fire/rescue ICs do too?
The problem was eloquently stated in a question by Halton, which asked in part, “Is the first-arriving officer, who is generally less experienced (emphasis added) than subsequent-arriving chief officers, in the best position to make decisions about subsequent arriving units?” It’s my observation that lacking context-based simulation training, neither the first- nor subsequent-arriving officers will have the knowledge, skills, and abilities to make those life-saving decisions. It’s the department that develops IC training from company officers to chief officers that will be successful in this initial incident command, regardless of who is leading the band.
Chief (Ret.) Roger A. McGary
Silver Spring (MD) Fire Department
Training Committee Chair
National Capital Region IMT
Why wait? Mentor the new hire
I have a photo of a six- or seven-year old boy dressed in a firefighter outfit with an ax ready to slay the dragon. This boy would walk past the neighborhood fire station and dream of being a firefighter-not a firefighter in the bigger, more populous cities but at that particular station. Twenty-one years later, he is a recruit at this station, my station.
The first fire service dates back to the Roman Army in 6 A.D., when the Corps of Vigiles was formed to protect Rome and its empire for the next 400 years. The same core paramilitary value of that first service is instilled into the American fire service to this day: deconstruct, reconstruct.
We do everything we can to hire the best firefighters and then, unfortunately, we do everything we can to run them off or find something they are doing wrong and chastise them for it. How did the fire service culture evolve to the point where it tears down a recruit who has the most passion for the greatest job in the world?
Why not find something the recruit is doing right and praise him for it? If we search for the bad in our people, their performances will start dictating our pursuit. Why try 20 years to develop a great firefighter when we can do it in one year? Greatness isn’t tenure. It is about mindset and attitude.
In the past, our fire service culture was such that when new firefighters were brought into the ranks, they were nothing until their rite of passage. My question is, “Why do we recruit a new hire with all the passion in the world for the fire service and then try to take that passion away from him?” I had the privilege, as a newly promoted captain, to mentor that newly hired recruit mentioned above. The chief and I wanted to do something different with this probationary firefighter, something that would change the culture. We wanted to embrace him, lay the road for success, build his future, and invest in him not only as a member of the American fire service but also as a member of society. Moreover, we wanted to invest in his future as a husband, father, brother, and son. We wanted him to realize why being a firefighter truly is the greatest job in the world.
I let him know that he was accepted not by horseplay, degrading remarks, hazing, or practical jokes but by taking him out into the bay and sitting with him, listening to him, training with him, and showing him what it was going to take to be successful in our department. In my office, I sat across the desk from him and let him know that I wanted to come back after I retired and find him sitting at that desk as a captain, mentoring his recruit.
I had to give him a vision, a goal, a light at the end of the tunnel. By doing this, I hoped he would fully understand where I wanted him to be and what I expected from him. He began to understand that I was investing in him as a firefighter and a brother, not merely as an employee.
Believe it or not, as he neared the completion of his first year, he had not fought a good working fire; he participated in the occasional small trash fire or showed up just in time for overhaul, but he was not able to say that he had responded to a fire of his own. Then, about two weeks prior to his full year, he finally had his first working fire. I was able to capture a picture of him after overhaul was completed. I had the picture blown up, and all the firefighters/mentors at his station, including me, signed it. The picture was presented to him on the day of his swearing-in ceremony. He was so proud of that picture; he said he would never forget that day, the day he got to put into use the training we had worked so hard on in the past year. That moment, that day, was his rite of passage!
My hope for my legacy is that it will be based on how I leave this department and its people. I want my people to say they succeeded in their career and life because of my influence.
One of my firefighters stated that when he was in fire school, the instructor told the class, “Instructors are not here to make you a firefighter; they are here to help you pass the state test. You become a firefighter when you get hired by a department.” When you hire new recruits, the goal or mission is that you inspire, motivate, cultivate, and invest in their future. By implementing these four valuable points, it comes full circle from the new recruit back to you, whether you are the officer, senior firefighter, or just in the recruit’s presence. The new fire recruit inspires, motivates, cultivates, and invests in your future as well. The passion for the fire service is continued.
At the swearing-in ceremony for my firefighter, I realized that while welcoming him to the brotherhood, his passion renewed my passion. I was able to look at the room full of his family members, including his fiancé, and realize that I am leaving a legacy behind that not only groomed an American firefighter but also laid a path for his family to be a part of the American fire service. In the near future, there will be yet another young person standing in front of the fire station dreaming about how it would be to be a firefighter and slay the dragon. Now, a legacy and new culture wait to change that person’s life forever.
Jason Bonds
Captain/Paramedic
Fire Station 1
The Colony (TX) Fire Department
Navigating the contracted fire service
The contracted fire service is not new to me. I originally began my short-lived contracting career in early 2001 when I worked for one year at an organization out west. The contract did not prove as lucrative as I had hoped, so I returned home. I continued to work within public safety until I eventually “retired” and briefly took on a gig in the general service of the federal government. However, I soon realized the sterile cubicle office environment was not for me. As fate would have it, I eventually followed the path of so many brothers and sisters who have made their trek to southwest Asia as a “contractor.”
The fire service contractor is a little known and equally little discussed component of the fire service. Similar to the career paid, combination, and volunteer fire service family, we contractors also provide an invaluable service to the community and agencies we serve. Yet, our rules of engagement may vary widely. Therein lie the confounding variables that may become a huge source of role stress, role conflict, and overall stress for many fire chiefs and senior fire officers. Habitually, as senior fire officers, we bring our previous experience and service to the contracted department. Our expectations are often those of the agencies, services, or military components we have served proudly and faithfully. Yet, it is at this juncture where we must depart from the known and delve into the unknown, the business side of the fire service.
With respect to the contracted fire service, the lack of experience within the business spectrum has significantly impacted many leaders. Senior fire officers were often unaware of the requirements of the contractual obligations of the contract they served, as they often relied on their prior service experience and overall culture of “that’s the way we have always done it.” This mindset has led to many a downfall of otherwise competent and adept senior fire officers.
Likewise, senior fire officers often implemented “programs” and “requirements” believing that the additional personnel hours and equipment expenditures would magically appear as it satisfied the mantra of “that’s the way we have always done it.” However, as a contract fire service, we cannot implement without question. Rather, we should ask, “What cost is associated with implementing this particular service or supporting this particular move?” The question should beg which modifications to the contract are implicated.
Within the business aspect of the contract fire service, senior fire officers are encouraged to review their contract and any applicable references prior to implementing the measure stipulated by their customer. The questions a senior fire officer should ask include the following: Is this requirement currently in the contract? Is this requirement mandated by reference publications tied to the contract? Is this requirement mandated by state law or policy? Is this requirement mandated by federal law or policy? Senior fire officers are encouraged to work with their senior executive leadership within the company or corporate attorneys should any questions rise above the question, “Is this requirement mandated by state law or policy?”
Prior to implementing any fire service, senior fire officers should carefully review the contract, reference any publications attached to the contract (to include publication year), and compare against customer expectations or revised National Fire Protection Association standards.
Hilda Moses
Fire Chief (Contracted)
Enid, Oklahoma
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