If you work in the fire service long enough, you’ll undoubtedly be faced with some kind of tragedy. Traumatic events are commonplace in our line of work, but there has never been a single event that struck the entire U.S. fire service like the one that occurred on September 11, 2001. The loss of 343 firefighters in a single day was unimaginable.
As a member of a department on the West Coast, I couldn’t even begin to comprehend what the FDNY went through and continues to deal with even today. Most of us will never experience a fraction of the death and destruction that occurred on 9/11, but at some point, we will all have to deal with critical incidents that affect us emotionally and psychologically.
We can all probably recall several calls or horrible accidents that stick in our mind to this day or have really bothered us over our careers. Traumatic events aren’t natural things to witness for most human beings, but it’s a common occurrence for us.
We’re generally very good at dealing with a wide variety of critical incidents, but as a group, we tend to blow off what can happen during the aftermath of a traumatic event. The fire service culture doesn’t easily lend itself to firefighters admitting that a particular call is bothering them, because the admission can be mistaken for weakness.
When we’re faced with one of these events, we usually joke about it later or talk about it around the kitchen table like it was no big deal. But as a company officer, pretending that a disturbing incident isn’t a big deal is one of the worst things you can do. The “man up” mentality sends the wrong message to your crew and can have long-lasting negative effects. To correct this, the fire service is undergoing a significant change in how we deal with potentially traumatic events (PTE).
The Paradigm Shift
Since the early days of critical incident stress debriefing or management (CISD/CISM), we have acknowledged the need for personnel to receive help when trying to cope with highly stressful situations. Since the 1970s, we’ve been utilizing these methods in an attempt to adhere to NFPA 1500: Standard on Fire Department Occupational Safety and Health Program, which requires the fire service to provide assistance programs to their personnel; however, serious questions arose about CISD/CISM after researchers began proving that these techniques were inadequate for dealing with PTE.
In response to those findings, the National Fallen Firefighters Foundation (NFFF) began working with a team of researchers on an evidence-informed behavioral healthcare program to establish a more practical approach to dealing with stressful and traumatic events. Chief Ron Siarnicki, executive director of the NFFF, has done a great job of breaking down much of the program information in a series of articles found on www.my.firefighternation.com.
I read through this series of articles and did some additional research of my own, which really opened my eyes to the paradigm shift that the fire service is undergoing when it comes to treating behavioral health. It’s exciting to realize that a change in our philosophy is taking place that could provide us with different coping tools–tools that are not only based on best practice models, but are also designed specifically for firefighters.
Who Needs Help?
One question I often ask myself when dealing with a behavioral health situation is, how can we really tell if someone is OK or if they need help? This isn’t an easy question to answer, because all of us react to stress differently and have developed different coping skills. Your crew may respond to the same traumatic call, but every crewmember may have completely different reactions to the incident because of their differences in experience, coping skills, personal backgrounds, etc.
I used to think my crew and I had similar thoughts and reactions regarding a stressful situation, but in retrospect, I was probably wrong. My reaction to stress may have been dramatically different than some of my crewmembers over the years, and in turn, I may have missed an opportunity to make sure my crew was good to go.
So back to the question, how can we really tell if someone is OK or if they need help? Honestly, there’s no black or white answer, but the NFFF’s new program offers some tools to help us move in the right direction, one of which is a flowchart (above) that helps determine whether a person needs assistance and how they can get it. The chart provides a straightforward protocol based on best practices already found in the fire service for how to deal with lingering effects of traumatic incidents. Concepts included/addressed in the chart:
- Determination of a PTE
- Time out/hot wash
- Traumatic stress questionnaire
- Complete assessment
- Treatment by a clinician
Important: Knowing when your personnel aren’t acting like themselves is a big part of being a company officer–getting the right help is the other part. Personal counseling should always be offered to someone you think could benefit from professional help. Sometimes the suggestion is all someone needs to let them know it’s OK to seek professional assistance.
Conclusion
The fact of the matter is that we all could use a little help sometimes–and by “help” I don’t mean kicking it around the kitchen table a couple times. That might not be enough. Like it or not, traumatic events are part of our job, and whether we realize it or not, these events can have short- and long-term effects that can stick with us for the rest of our lives if we don’t get the help we need.
To read more from Ray Gayk, visit /content/fr/en/authors/g-k/ray-gayk.html.
And to read the series of articles from Ron Siarnicki on the fire service’s new approach to behavioral health, visit http://tinyurl.com/NFFFSiarnickiarticles.
