A moment to reflect

We were on a wreck recently where an individual had gone off the interstate going about 90 mph. He impacted a concrete drainage ditch and flipped several times before coming to a stop. After we got the patient into the ambulance and on the way to the hospital, I managed to capture one of my crew taking a moment to look back at what was left of the car. It brought recent events to mind.

It was brought to the department’s attention recently that one of the guys on the crew had a serious problem with some of the less desirable aspects of our work; the cleanup of bad car wrecks to be more specific. It bothered him to the point that he went to a psychiatrist. I was troubled that he not only was troubled by this enough that he went to a psychiatrist, but that he felt ashamed enough that he had to hide it from the rest of us. I guess it may be the mentality that comes with the perfusion (don’t show weakness, don’t falter, I have to set an example.), but it’s something that needed dealt with. My department has always provided the option to go see a psychiatrist if you wanted it but it’s obvious that that offer wasn’t being take up on, and we almost lost a good man because of it. In this line of work, there’s always going to be something that bothers you. Some of us take a moment to reflect while on scene, and some of us go home to talk to our spouses, but then there are some of us that don’t do anything and instead let it eat us up inside.

Everyone seems to take their own approach to dealing with these types of stresses, and many take more than one approach at a time. Studies have shown some of the most common ways that this was done many of which were found that were subconscious approaches.

Some of the personal efforts are:

Wait and Self- Monitor Changes in Evoked Reactions
Deliberately Let Time Pass

Rest and Relaxation
Deliberately Go Somewhere
Get Comfortable and Deliberately Relax

Find Physical and Verbal Relief
Deliberately Use Humor
Deliberately Release Feelings
Deliberately Exercise
Confide in Spouses
Have loosely structured discussions with colleagues

Re-establish Personal Routines and Sense of Subjective Control
Deliberately Take Charge of Your Life
Deliberately Re-establish Routines

In some of the more serious events where a department needs to step in it is recommended:

Mental Health Professionals Unilaterally Recommend Mandatory Attendance
Intervene Within 48 – 72 hrs
Convene Group Meeting and Commit Officers to Attend
Graded Confrontation of Memories of Critical Event
Deliberately Talk About Events In General Terms
Deliberately Avoid Some Reminders of Events
Adhere To Prescribed Agenda of Successive Protocol Stages.

Obviously not wanting it to get to the more severe situations; our department decided to take a more direct approach to this. We’ve always tried to do after action reviews but after our latest event we decided to make AAR’s, or critical stress debriefings mandatory after fatalities or mass casualties. I’m still not comfortable at these particular meetings but I feel it a necessary step, whether they are effective or not I guess only time will tell. I guess my purpose in sharing this is to encourage my fellow first responders and emergency personnel to pay attention to their colleges and themselves. If you notice stress starting to build up or if you need to just talk, do it; don’t try and hide it until it reaches a critical point.

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Strike a Pose: The importance of image

When on the job, our image that we portray to ourselves and to the public is crucial. The public relies on us to provide stabilization to their lives when they’re at their worst, and support to the community when we aren’t on calls. When it comes down to it we as firefighters agree to put ourselves on display when we agree to be on the department.

There are many ways that this is done. First and most obvious is through our physical appearance. When we take pride in our equipment and our gear the public sees it and they take comfort in it. When our equipment looks broken down and our gear looks tattered it’s difficult to have confidence in a department’s ability to perform. It’s seen when we are doing charitable events, by spectators when we are on scene and by the victims on scene. It can affect our funding and more importantly it’s embarrassing. It’s hard to hold your head up high and look the public in the eye when they don’t think you can do the job you promised.

On the bright side, this is one of the easiest things to remedy. When I first got on my department, we didn’t have state of the art equipment, heck we didn’t even have new equipment. The apparatus that we had were used, and the gear was “hand downs”. Even so we kept a good appearance. We cleaned and polished our trucks, washed the hoses down, and made sure everything was inventoried after every call. Even though our stuff was old we looked good.

This carried over into our confidence, which in turn brings me to the most important way that we put ourselves on display. The way we react isn’t only important to the public but to ourselves. When on a scene the attitude is infectious. If a firefighter is unsure or panicky not only will it adversely affect the patients but it can have drastic effects on your fellow firefighters. This holds true for all firefighters but especially for the seasoned firefighters and officers. When you have a strong adverse reaction those that look up to you can question their ability to perform; and the people that rely on you to watch their back can start to question whether you’ll be there or not. On the other hand, being able to show confidence in what you’re doing and not over react to situations will instill confidence in your crew and everyone around you.

Sadly this isn’t the easiest thing to deal with. There are a litany of things that can cause us to react adversely from how the people around you react to tragic things you might see. Your best ally will be experience, but even then you’ll have to be careful. I remember a call many years back. There was a bad pile up on the interstate. It was a particularly bad winter storm and we had to put civilians in our command unit to get them out of the cold and off of the interstate as vehicles were continuing to add to the crash. The interstates were closed down, and I don’t know how they were getting past the HP but that’s aside from the point. I had just got the last individual into our command, an old suburban, when a car appeared out of the snow sliding sideways towards us. I jumped in and holding on to the spare told them to gun it. The car ended up bumping the car we were just helping and coming to a stop short of us. One of the newer guys on the department was reasonably scared and asked if we should go back and see if they needed help. I was embarrassed when the first thing for the civilians to hear was one of the other guys saying to hell with that.

It’s an incident that still bothers me today. I keep looking back on it and wondering if there was a way we could have prevented it. When it comes down to it there wasn’t really. It didn’t stop us from doing our job, we were tired, and the individual said the first thing that came to mind. It was a simple over reaction to the circumstance. But the look in the civilian’s eyes that was next to me was really hard for me to deal with. It’s a prime example of what not to do and we put on classes on how to act in front of the public because of it. But when it comes down to it, I find that it’s far more effective to instill confidence in my crew by showing confidence to them. It’s not easy some times and it’s an individual battle for each person, but one that needs to be undertaken.