©2019
National Volunteer Fire Council FirefighterStrong News for a Better You and a Stronger Crew
Sufficient staffing means a stronger, safer department. Pull-out guide for recruiting tips included inside!
In This Issue:
A Stronger Fire Service Starts pg 2 Responding to Active pg 14 6 Improving Your Culture Here Shooter/Hostile Events PAGE of Safety Growing from the Pain: Lessons pg 3 The Body, Mind, & Soul of pg 16 to be Learned from Firefighter Opioid Responses Cancer The Mindful Firefighter pg 18 Strains and Sprains: Preventing pg 8 Firefighter/EMS Injuries Growing Our Ranks: Equity, pg 20 Inclusion, and the Path to Survival Mediterranean Style pg 10 Success Firefighter Functional Fitness pg 12 What Do You Say to Someone pg 22 for Real-World Results Struggling from Emotional Trauma?
www.nvfc.org About the A Stronger Fire Service Starts Here National By Steve Hirsch, NVFC Chair Volunteer Cancer. Post-traumatic stress. Injuries. Low retention. There are a lot of risks and challenges that today’s fire and emergency services face. It may seem daunting to Fire address all of the issues, but the truth is they are all connected. That is the idea behind the National Volunteer Fire Council’s (NVFC) Serve Strong Council campaign. In a nutshell, a better you means a better crew. In other words, by proactively addressing issues relating to health, safety, and overall wellbeing, we become stronger and more effective as a whole. The NVFC is the leading nonprofit It starts with the culture and priorities of the department. A department that membership association representing embraces a culture where the health and safety of members comes first will see a the interests of the volunteer fire, reduction in injuries, fatalities, and life-altering illnesses while also seeing an increase EMS, and rescue services. The NVFC in morale, productivity, and member satisfaction/fulfillment. Members will feel valued serves as the voice of the volunteer and appreciated, and you’ll be creating an environment and a community to which in the national arena and provides people want to belong. resources, programs, education, It is also the responsibility of each individual. Placing value on your own health and and advocacy for first responders safety as well as that of your crew makes you a better and more capable responder. across the nation. Many of the NVFC’s Every action you take as a firefighter, EMS provider, or rescue worker has a direct programs and initiatives apply to all impact on your crew, your family, and the community you protect. That includes the members of the fire and emergency decisions you make in regards to health and safety. services, whether volunteer or career. It all ties together. Proactively addressing critical issues including cancer, behavioral Membership in the NVFC is low-cost health, physical health, safety, and inclusion makes us stronger, both as individuals and provides a wide array of benefits; and as a team. By emphasizing overall health and safety and creating a positive find information atwww.nvfc.org/ culture in our departments, we will perform at our best and be more successful in our BeYourBest. Learn more about the mission to serve our communities. NVFC and access resources at www.nvfc.org. The NVFC is here to help. This newsletter provides information and resources to assist all members of the fire and emergency services – whether volunteer or career, from chief to new recruit – recognize and understand critical issues impacting our overall wellbeing. The next step is up to you. By taking action where there are areas you can improve upon as an individual and as a department, you are creating a safer, healthier, Disclaimer and better workforce for all. A stronger fire service starts here, and it starts with each The information and resources presented in this document are for informational purposes of us. only. They are not intended to offer a diagnosis or treatment of any health issue. Consult a Find additional resources to help you Serve Strong at www.nvfc.org/ServeStrong. The healthcare professional if you feel you may NVFC board of directors and staff are here for you. Contact our office at 202-887-5700 be experiencing a health issue or for any questions you may have. This document or [email protected]. does not provide a comprehensive listing of resources that are available.
Serve Strong | FirefighterStrong Growing from the Pain: Lessons to be Learned from Firefighter Cancer
By Cathy McCray Photo credit: Lauralee Veitch
I would like to share the last eight months numerous follow-up procedures. I live First and foremost, you must be your of my life with you. I have never been one alone and had to move back in with my own advocate and fight for your life. No to share a lot of personal things, but I think mom in order to be cared for while going that telling my story is necessary in order through the treatments, despite it being Continued on page 4 to impact others in changing their thought 3 ½ hours away from my job. It has been processes. I have survived to tell you an extremely difficult process and it has about my experience and help in the fight changed me. against firefighter cancer. Fortunately, I am now in remission. I was I have been employed with Loudoun able to return to work, first with light County (VA) Fire & Rescue for 14 years, and duty at the fire training academy, and I have been exposed to many different eventually back to full duty. I have a long IDLH (immediately dangerous to life or commute and was able to stay with a health) environments throughout my coworker and his family while working career. Like most firefighters, my focus has admin hours. It is very humbling. My work always been to serve and protect others. family has made it less stressful, and they However, what I have found is that when have bent over backwards to help me it comes to occupational cancer, we must mentally, physically, and emotionally. For fight for ourselves. It is a very different this I am very grateful. battle, and it is very personal. I want to share some very important I had my annual 1582 work physical in lessons I have learned from this life- April 2018 and no issues were found. That changing journey. Wisdom is what makes Learn the 11 actions every firefighter made it all the more shocking when I was change, and wisdom comes from learning. needs to take to lessen their risks diagnosed with stage III ovarian cancer We have so much to learn about firefighter of cancer. Download the Lavender on May 30, 2018. It has been determined cancers. By telling our stories and raising Ribbon Report at that my cancer is occupational. I had awareness of the dangers, we will gain www.nvfc.org/cancer. extensive surgery followed by chemo and wisdom. Change will come. www.nvfc.org 3 … continued from page 3 I also want to emphasize the one else is going to do this for you. When importance of you receive your annual work physical or documenting all calls any checkup, keep records of all that you we respond to and go through and the results. The reality filling out appropriate is that you need to ask doctors to check exposure forms you for cancers and other illnesses. Most every time. For one fire department physicals only evaluate thing, this helps you and treat what is listed in NFPA 1582. better understand Make sure that your personal healthcare your risks and share providers are aware of your occupation them with your Track your exposures for free using the tool from FirstForward. and/or volunteer status. You also need to healthcare provider. https://info.firstforward.com/exposure-nvfc/ educate them of the types of exposures For another, this is you encounter. necessary when it comes to getting benefits under cancer only cover paid firefighters and not It is necessary to ask lots of questions — presumption laws. Multiple states have volunteer. There are some states that do even the hard ones — and pay attention passed these bills to assist those in public not have any cancer presumption laws. to your body. I had routine checkups, safety. Under these laws, if a firefighter It makes me angry that politicians would mammograms, pelvic exams/pap smears, is diagnosed with a cancer and there are put money above providing needed and I thought I was in great shape. I was no legitimate explanations of the cause, benefits to all firefighters, but this is told ovarian cancer can only be found from it is presumed that it is from their work what happens. While in this battle, I have a scan. It was very scary for me to learn environment and considered occupational learned a lot about how a bill is introduced that in spite of what I was doing for myself, cancer. Each state is different as to what into legislation and the process that takes it wasn’t enough. types of cancers are covered, and it may place for it to move forward. I encourage all firefighters to educate themselves on this and on the cancer presumption laws in your state. If you do not have one or if the laws are inadequate (such as not covering volunteers), then fight to get this changed.
Being able to produce records of exposure is a critical step in the process for getting a worker’s compensation benefit as the burden of proof is placed on the firefighter. Once you’ve received a diagnosis, this can seem overwhelming. My diagnosis felt like I was being handed a death sentence. I didn’t want to feel that way, but I couldn’t help but have those thoughts. As I have made progress and am preparing myself to pursue a work-related injury, I will have to go back and relive every event that I have gone through. I have been informed that my claim will most likely be denied the first time and that I will need to retain an attorney. I will be required to have facts about specific exposures in order to prove occupational cancer. I will need to make sure that I have exposure forms completed appropriately for every IDLH environment to which I have been exposed. Cancer is not cheap, and the cost of paying out is the drive behind making it difficult on those who are trying to fight. It is a frustrating and painful process on top of what I am already going through,
4 Serve Strong | FirefighterStrong but that is the reality and the reason why Be the voice of positive change in your family has been an amazing support firefighters need to make sure they keep department. system every step of the way. They have these exposure records. also stood up for our organization and To my brothers and sisters who are worked to advocate for additional cancer I am very grateful and blessed to work for struggling with cancer or other presumption legislation in Virginia. an organization that has become proactive occupational illness, I encourage you to in cancer prevention. We have the ability reach out to those around you as well as I encourage those of you that are fighting and resources to educate all of our people educate yourselves as much as possible. for yourself or for other individuals to keep and to provide extra equipment when Take as much time as you need so that you fighting and know that you are making ours needs to be decontaminated. We don’t become overwhelmed. Remember a huge impact on the lives of many. We are also still learning how to handle the that there are people and organizations will continue the process of growing and circumstances that occur when one of that are willing to assist you, and this learning, and through these efforts we will our own receives a cancer diagnosis. My support can make so much difference. create change and innovation so that we perspective of my work environment will I found the Firefighter Cancer Support can put an end to firefighter cancer. n n never be the same, but I do feel secure in Network to be a great resource. My work knowing that those above me are trying to understand and see it from a different perspective as well. They are working ABOUT THE AUTHOR to change the toxic cultures that have evolved so that we can reduce the cancer Cathy McCray is a career firefighter/technician in Loudoun risks our firefighters face moving forward. County, VA. She has served with Loudoun County Fire & Rescue Regardless of your department’s size or for 14 years and is also an adjunct instructor for West Virginia budget, there are many things you can do University Fire Service Extension. She started her career as a to reduce the risks for your responders. volunteer firefighter in West Virginia in 1993.
www.nvfc.org 5 Improving your Culture of
By Chief Judy Smith Thill
Researching articles on firefighter safety, if your department has a high number Funding a new initiative is often looked there were quite a few that focused on of injuries, you will probably also find a at as a barrier to any safety improvement. “creating” a culture of safety. With all the leadership problem. Leadership needs to However, many times, little to no money information we now have at our fingertips involve company officers and firefighters is needed to make an impact, even for on line-of-duty injuries and deaths, all fire in all aspects of improving the culture. concerns involving the most recent focus departments should already have some Company officershave the most influence of cardiac, cancer, and post-traumatic kind of safety culture started. It might over firefighters, and the firefighters are stress concerns. not be documented, and it might not be the ones who will be most affected by perfect, but my guess is you all have a any changes. So, input by everyone is Cardiac issues have been the leading safety culture, so you really don’t need critical when trying to improve your safety cause of firefighter on-duty deaths for to “create” one. However, you most likely culture. years, and although the root causes go far need to improve on the culture of safety beyond fitness levels, functional fitness is you have. Leaders need to communicate their still extremely important. Some may think commitment in both words and actions. a gym full of fancy exercise equipment We all know that safety improvements Words can be in the form of written is needed to start a fitness program, yet can get very expensive with adding policies and procedures, and actions there are many departments that use their equipment, vehicles, and fire stations; include setting examples and walking own station layouts and fire equipment however, the first thing you need in order the talk. Policies, procedures, and actions to create workout routines without any to improve the safety culture of your need to be supported and promoted by added costs. department is actually free. Having the all levels of leadership. That consistency is right attitude costs nothing! You need to crucial. The fire service is now seeing higher rates start with the attitudes of leadership, as of cancer in firefighters. Maybe you can’t well as of the firefighters. If leadership What about the rank and file? Firefighters afford extractors to wash gear, but you doesn’t have or show a commitment need to follow policies and guidelines can set up procedures where you require a to safety and firefighters take no established; however, firefighters also must gross decon before heading back after fire responsibility themselves, it will be difficult take personal responsibility for their own calls. Firefighters can also wash their hands for you to improve the safety culture, or safety and the safety of fellow firefighters. and faces while still on-scene, and shower any part of the organization, no matter They cannot simply point to leadership as soon as possible once back at the how much money you have. and say, “It is their responsibility” or “S/he station. Just those simple acts can remove doesn’t care, so why should I?” For those a significant amount of cancer causing When looking to improve anything who may have less than supportive contaminants with little to no cost. in your fire department, it needs to leadership, firefighters can still develop begin with leadership, since that is the and follow their own good safety habits foundation for everything. For example, and practices.
6 Serve Strong | FirefighterStrong There has also been an increase in Improving your safety culture starts you need to start somewhere to move firefighter suicides because of post- at the top, but it needs to include all forward so you don’t stay stagnant. If the traumatic stress injury/disorder. There are levels of leadership, as well as the organization never starts moving in the many free resources you can offer. First, do firefighters. Cultures are not programs. right direction, there will be zero hope for you encourage talking after bad calls, or Safety should not be a program. Safety improvement in your safety culture. are firefighters told to suck it up and deal needs to be integrated into the regular with it? Don’t feel comfortable talking? routines, policies, and guidelines of the Start small. Get creative. Be a champion for Maybe a local clergy person is willing to be departments and continually evaluated safety. n n on-call. Have you gotten the NVFC Share and improved. You won’t see a miraculous the Load materials for your firefighters? change overnight as it will take time, but They have all kinds of resources, including a 24/7 helpline number you can post for firefighters to call if they need to talk. More information on these free resources is ABOUT THE AUTHOR available at www.nvfc.org/help. Judy Smith Thill has been chief of the Inver Grove Heights As you can see, large sums of money are (MN) Fire Department since 2007. Her 30 years in the fire service not always needed to make a significant include 19 years as a paid-on-call firefighter and 23 years as a improvement in your safety culture. full-time chief officer. She is a board member of the MN State Fire It starts with the right attitude and Department Association, vice chair of the MN State Fire Chiefs committing to start tackling some of these Association Education Committee, and one of two MN directors issues with the resources you have. Yes, to the National Volunteer Fire Council. Judy has a BS degree in there will always be improvements that safety management from Indiana University of Pennsylvania, cost more money than you have; however, MBA (abt) from Cardinal Stritch University, and has completed my guess is there are many free and three Executive Leaders Programs. inexpensive actions you have yet to take.
www.nvfc.org 7 Strains and Sprains: Preventing Firefighter/EMS Injuries
By Kenn Fontenot As a disclaimer, I am not a gym instructor 24’ extension ladder raise is another skill or trained as a physiologist. I did train that requires practice and teamwork. While working a multi-vehicle pileup under the direction and guidance of a While not particularly heavy, these ladders on the interstate, my partner and I were competent instructor and strongly suggest are unwieldly and cumbersome. Good loading one of two patients into the that at first, responders should do the teamwork and proper lifting techniques ambulance. As my partner was turning to same. This avoids injuries, poor techniques, are necessary to prevent injury. lower the backboard onto the jump seat and helps guide you toward a desired for the first patient, I heard a crack and physical condition outcome. If the load or person you are trying to then a loud groan. My partner had suffered lift is excessivley heavy, ask for help. It a severe lower back strain; he had turned Lifting is far better to take a couple of seconds sideways with a heavy load, and his back longer waiting for assistance than to gave way. With all the injury prevention information get injured. Departments should have out there today, it amazes me how guidelines as to what is a “heavy lift” when Strains and sprains are the most common many responders still use poor lifting moving or lifting patients. Our ambulance of injuries suffered by firefighters and techniques. This is particularly true with organization used anything over 300 EMS providers. According to the National younger responders. When I was working pounds as our threshhold for asking for Fire Protection Association, 48% (24,495) on the ambulance, I would often have to more help. Also, use additional responders of injuries during fireground operations slow down enthusiastic younger members when moving patients across ditches and 53% (30,970) of overall injuries for when moving patients so that we could or up/down inclines as these are often firefighters in 2017 were strains, sprains, position ourselves for a good, safe lift. slippery and more support is needed for a and muscular pain. The CDC reported that These young’uns did not realize the safe transport or transfer. for the year 2016, EMS providers suffered dangerous position and lifting techniques 7,500 sprains and strains. Many of these they were using. They were still very The best way to lift loads is with bent are preventable. strong and not concerned with long-term knees and a straight back. The quads back injuries. They did not realize that (thighs) are the strongest muscles in the Improper lifting techniques, poor or no on a normal shift, we would lift several body; use these muscles to lift and not physical fitness training, overreach, lifting/ thousand pounds when moving and lifting your lower back. This is the technique that moving loads that are too heavy, and patients. Over time, this takes a toll on I have personally used for my entire career improper shoes or attire are some of the your back even when using good posture and avoided back injuries. It takes practice reasons why responders get strain, sprain, and techniques. It only gets worse if you and awareness that on each lift, you and muscular pain injuries. Additionally, use poor lifting practices. need to take the time to position yourself we go from zero to full throttle without properly with your legs under you before the opportunity to warm up our joints and I cringe when watching a firefighter moving or lifting. muscles. The combination of these factors moving a 14’ roof ladder using a one- can result in emergency scene injuries. Let person lift and using their back instead of Turning or twisting your back while us look at each individually as well as some the legs to lift it. I immediately stop them, moving a load is another way that many solutions to help reduce these injuries. and we have a discussion about better back injuries occur. When you need to ways to lift this equipment. A two-person
8 Serve Strong | FirefighterStrong turn, turn your whole body, not only your cumbersome or heavy, put it down and the first year was indeed remarkable. upper torso. This prevents a twisting seek additional resources to help move it. Responders started bringing healthy, movement, which when under a load will home-prepared meals and the eating strain your lower back. Even a relatively One of the most common times I see of fast food almost stopped. Injuries light load can cause injuries. overreaching is when using hydrauallic dropped drastically, many stopped using rescue tools. Often, the rescuerer is tobbaco products, and the overall health Physical Fitness Training working the tool at arms length or above and wellness of our members was greatly mid chest height. As you can imagine, this improved. Many strains, sprains, and back injuries places a tremendous strain on the arms, can be avoided with a proper exercise shoulders, chest, and back. Ask for help or Responder exhaustion is another piece to program. To fully prepare for the tasks use a ladder. the injury puzzle. After a certain amount you do as a first responder, your exercise of hard work, responders need rehab. routine must include both muscle Providng hydration and good nutrition strength and cardio. I did circuit training Proper Attire to tired emergency workers should be a to incorporate both cardio and muscle Ankle strains and sprains also account componet of all emergency action plans. strength into my workout. This technique for a large number of responder injuries. Additionaly, command should ensure provided a good balance for both. We want to ensure that our foot wear is that there are enough fresh personnel to properly suited to our needs and that the conduct the activities needed to mitigate You will benefit most if your fitness routine fit is good. Boots play an important role the emergency scene. Calling for additonal includes exercises that prepare your body in keeping the ankle stable when walking resources is an excellent way to keep on- for what you will be doing on the job. I or operating at emergency scenes. They scene workers from becoming too tired to would do specific exercises that targeted should fit properly and be of a design work safely, effectively, and efficiently. my back and quads. My favorite, because that will provide stability for the ankles. it closely mimicked lifting a spine board Low-quarter foot wear, even when worn as Leadership should encourage safe and or stretcher, was the “Sumo Squat,” which station wear, is not well suited for keeping healthy work habits and lifestyles, and lead you can do by itself or with the addition ankles stable. by example. Providng for the well-being of a weight. Another favorite was the of your members is money well spent. “Wall Squat,” where you hold a balance Additional Factors Healthy, strong responders will be less ball against the wall with your back while A good, well-balanced nutrition program likely to suffer sprains, strains, and back doing squats. These are two great moves will increse your overall health and injuries, and time off due to injury will be to strengthen the muscles needed for wellness, which may lessen your chance reduced. safe lifting. I truly believe that these two of being injured. Rewarding and/or exercises played an important role in recognizing the healthy achievements of In conclusion, a good, well-rounded injury preventing injuries to my lower back. your responders is a great way to motivate prevention program that includes all the crew. We had a trained nutritionist of these components and is supported It is important to do all the exercises in who worked with us to develop healthy by leadership should be a part of any your routine correctly or you risk injury, eating programs, discouraged fast food, organization’s safety initiatives. The result which of course defeats the whole point. and worked very hard to have tobbaco can be a reduction of strains, sprains, and Consult with a trainer, and there are many use eliminated. The organization provided back injuries at the emergency scene, online resources that demonstrate proper financial prizes and rewards to encourage at the station, and while off duty. Begin fitness techniques. The National Volunteer members to participate. The change over implementing your program today. n n Fire Council’s Heart-Healthy Firefighter Program has some video examples of functional fitness exercises available at www.healthy-firefighter.org. ABOUT THE AUTHOR Overreaching Kenn Fontenot is a Louisiana director for the National Volunteer Fire Council and past chair of the NVFC Health, Safety, and Overreaching is another common Training Committee. He is also a charter member and first fire cause of shoulder and back injuries. chief of the LeBlanc Volunteer Fire Department and captain/ Try not to extend your reach to the full safety officer for the Milton Volunteer Fire Department. Kenn is extension of your arms as this places a principal member on the National Fire Protection Association undue strain on the shoulders, chest, and 1001 standards committee and alternate member of NFPA 1021. back. Additionally, the load may beome He is the chief of training for St. Landry Fire District #3, served for unbalanced and injure knees or ankles. 14 years as the regional fire training coordinator at the Louisiana Keep the load as close to you as possible State University Fire and Emergency Training Institute, and is a when moving anything or when using past-president of the Louisiana State Firemen’s Association. equipment. If the load becomes too www.nvfc.org 9 Survival Mediterranean Style
By David Rainey, MD and Stefanos N. Kales, MD
Firefighters and other emergency you and your loved ones live longer, they Government’s 2015 expert nutrition panel. responders face many dangers while improve the quality of life you’re living Moreover, for two years in a row, multi- on the job, including exposure to now. disciplinary expert panels put together smoke, chemicals, severe heat stress, by U.S. News and World Report chose sleep deprivation, job stress, and other The Mediterranean diet is one of the the Mediterranean diet as best in several environmental hazards. Often, these hottest and most talked about eating specific health categories, best overall, and are accompanied by a lack of exercise styles in America. However, unlike many as the “easiest to follow” among 40 popular and unhealthy food choices. As a result, popular trend diets (e.g. Keto, Paleo, diets. volunteer firefighters are at increased Atkins, South Beach), the Mediterranean risk for obesity, heart disease, cancer, and diet has a safety record of thousands of Despite its name, the Mediterranean Diet behavioral health issues. years. Additionally, it is the most widely isn’t a specific “diet” in the sense of having studied and scientifically supported a list of foods you can and cannot eat. It is The United States Fire Administration and eating pattern for reducing chronic a lifestyle most closely associated with the National Fire Protection Association have disease risks and enjoying a longer, traditional eating patterns and essential reported that the leading cause of on- healthier life. Based on decades of rigorous foods of Greece, Spain, and Southern Italy. duty firefighter deaths each year is heart scientific evidence, the Mediterranean The primary features of the Mediterranean attack, also called sudden cardiac death diet is one of only three eating patterns diet include ample intake of extra (SCD). Scientific research has documented highlighted and recommended by the U.S. virgin olive oil (instead of butter), fruits, that in almost all these cases, firefighters succumbing to SCD were found to have significant underlying heart disease that made them vulnerable. Moreover, many of ABOUT THE AUTHORS the cancers related to firefighting are also Stefanos N. Kales, MD, MPH, FACP, FACOEM, is a professor related to obesity. of medicine at Harvard Medical School and director of the Occupational and Environmental Medicine Residency (OEMR) There is reason for hope, however. Healthy at the Harvard T.H. Chan School of Public Health. David Rainey, eating, physical fitness, and good sleep MD, MPH, MEd is the assistant director of the Harvard OEMR and habits are all important “countermeasures” instructor of medicine at Harvard Medical School. Their research first responders can employ to significantly seeks to improve health outcomes among firefighters and other lower your risk of heart disease, cancer, public service workers through healthy lifestyle initiatives. depression, and many other chronic diseases. Even more appealing is that these lifestyle measures don’t simply help
10 Serve Strong | FirefighterStrong vegetables, unrefined whole grains, water of life. In 2014, Dr. Kales and his team of 1. Replace butter and stick margarine as a beverage, and fish. This way of eating researchers at the Harvard Chan School with extra virgin olive oil and eat at also encourages moderate intake of dairy, of Public Health received a grant from the least four tablespoons per day. eggs, wine, and lean meats, and low intake U.S. Department of Homeland Security 2. Drink water instead of sodas, energy of red meat and sugary sweets. There is no to research the Mediterranean diet’s drinks, and other sugary beverages. A calorie counting and no food is forbidden. benefits for first responders. The team glass of red wine with off-duty dinners You can try small changes and follow the worked together with other researchers is fine. suggestions as much or as little as you like. and fire service partners including the National Volunteer Fire Council to develop 3. Choose chicken, turkey, fish, eggs, and As you see in our Firefighter’s the program “Feeding America’s Bravest: beans. Limit red and processed meat. Mediterranean Pyramid graphic, the core Survival Mediterranean Style!” A multitude 4. Eat more fruits and vegetables. Eat elements we recommend for responders of resources (information, tools, recipes, fresh berries instead of sweet desserts. are Mediterranean eating along with good and videos) to help you live a firefighter’s 5. Choose whole grains. Avoid refined sleep, exercise, and spending quality time Mediterranean lifestyle are available at carbohydrates. with friends and family. www.hsph.harvard.edu/firefighters-study/ feeding-americas-bravest. We thank firefighters and emergency Research conducted worldwide has proven medical personnel for their service to help this way of eating is effective in reducing Getting started is easy. We suggest these keep the public safe. We hope you will try the risks of heart disease, diabetes, cancer, five small steps to improve your health. out these tools for living a Mediterranean depression, dementia, and premature Feel free to try one at a time or all of them lifestyle to help prevent unnecessary line- death. It is also associated with better gradually. of-duty deaths and promote healthier, sleep, sexual function, and overall quality happier lives for America’s bravest. n n
Firefighters’ Mediterranean Pyramid
www.nvfc.org 11 before we ever pick up a barbell or set foot Applying a Method to the By Dan Kerrigan and Jim Moss on a treadmill. First and foremost, there Madness is absolutely no room for entitlement The list of hazards is endless Consider some of the tasks that we or mediocrity in our fire service. It is not for firefighters, but you can perform: connecting the supply line to the a hobby or a right. It is a privilege that control your fitness. hydrant, stretching attack lines, advancing/ comes with lifelong responsibility. We operating attack lines, forcible entry, must hold ourselves accountable by carrying and raising ladders, ventilation, First Things First committing to the fact that regardless of and more. All of these activities require us Year after year, the leading cause of on- age, gender, rank, or status as a volunteer to be in peak physical condition so that we duty deaths as documented by the United or career firefighter, our fitness for duty can perform our duties safely, effectively, States Fire Administration is stress and is a requirement – it is an integral part of and efficiently. overexertion. This is the category that the oath we swore when we decided to includes heart attacks and strokes. become a firefighter, and it must be taken At Firefighter Functional Fitness, we seriously. stress the fact that fitness training should replicate the physical demands “Research provides consistent Next, it is imperative that all fire service of the fireground. With that in mind, organizations take whatever steps are we created The Big 8 of Firefighter evidence that an inadequate necessary to provide their firefighters with Functional Fitness, which consists of three level of physical fitness places access to annual NFPA 1582-compliant foundational components – core strength, medical evaluations. The implementation cardiovascular capacity, and flexibility firefighters at direct risk of an annual occupational physical – along with five functional strength for a cardiac event and program is proven to save lives by components – push, pull, lift, carry, and identifying undiagnosed cardiovascular drag. indirectly through elevated conditions, among other things. If your body mass index (BMI), organization does not provide appropriate medical evaluations, download the Taking Action triglyceride levels, and blood International Association of Fire Chiefs’ free In the simplest terms, every workout pressure.” Health Care Provider’s Guide to Firefighter should be focused on at least one of the - Dr. Stefanos Kales Physicals and take it to your own doctor. components of The Big 8. Doing so ensures that we are focusing on the strenuous Once these commitments are made and athletic tasks required of firefighters. If we are going to take steps to truly appropriate actions taken, we can turn In fact, combining functional strength improve firefighter health and fitness and our attention to another very important training with near-maximal heart rate make a meaningful impact on reducing component of overall firefighter wellness: cardiovascular training represents the deaths suffered by the fire service, there We are occupational athletes; therefore, essence of what we do on the fireground. are a few things that we must agree on we must train accordingly.
12 Serve Strong | FirefighterStrong There are a number of ways that we can • Tire, sled, or dummy drag Training Together Yields Better put The Big 8 into action around the • Sledgehammer tire strikes Results firehouse, in training, and during down Training as a group increases individual time at the station and at home. Here are • Bear crawl with rapid intervention pack effectiveness and success, while also some simple examples of how to improve • Farmer’s carry (saws, rescue tools, or building camaraderie and providing your fitness for duty without the need for a foam pails) “positive peer pressure.” And most lot of specialized equipment. • Ground ladder carry and raise importantly, it is fun. Just remember that training is not meant to be punitive. 1. Drill Tower Evolutions: If you have • Ground ladder climb and lower Provide encouragement and recognize access to a drill tower, you know that they that varying fitness levels will require present almost endless opportunities 3. “Flex Time”: Whether career or different levels of intensity and difficulty. for tactical training. They also present volunteer, we all have opportunities Be inclusive, not critical. numerous opportunities for improving around the station and at home to mix in your functional fitness. One of the simplest some functional training during our less- ways to accomplish this is to complete busy moments. Incorporating flexibility Workout Levels an exercise or movement at each level of training into your regimen will go a We must all be cognizant of the varying the tower, essentially creating a vertical long way toward reducing your chances levels of conditioning in our groups. It is firefighter fitness circuit. Here’s a quick of a musculoskeletal injury while also also important to consider how a workout example of a circuit that primarily focuses increasing mobility, core strength, and may impact the rest of our day. For these on body weight movements with the muscular endurance. Flexibility training reasons, we encourage firefighters to additional challenge of the stair climbing. can be completed as a stand-alone session adapt their workout attire accordingly. (consider basic functional yoga) or as • Ground Level: 10 push-ups As your level of fitness allows, progress part of a warm-up or cool-down during through each stage. • First Floor: 10 air squats a functional strength or cardiovascular Stage 1: Gym clothes • Second Floor: Plank for 30 seconds capacity training session. Stage 2: Add turnout coat and pants, • Third Floor: 10 lunges Here is a simple flexibility routine that you boots, helmet, and gloves* • Fourth Floor: Bear crawl for 100 feet can do in the station or at home: Stage 3: Add SCBA cylinder* • Fifth Floor: 10 supine leg lifts • Mountain Pose (stand tall) Stage 4: Add wearing SCBA mask and • Roof: 10 burpees • Chair Pose (hinge your torso forward 45 breathe from air from cylinder* degrees at your hips) *If you choose to work out in your PPE, make Once you’ve finished your burpees, • Forward Fold (hands reach down to feet, sure that everything is clean and free from descend the stairs down to ground stretching your back and hamstrings) smoke and particle contamination. level, catch your breath, and start again. Complete 3-5 rounds. Increase the • Runners Lunge (right leg forward, left Take your fitness and health to the next intensity by adding clean turnout gear, leg back and straight) level. Learn more about Firefighter Functional an SCBA, or even go “on-air,” breathing off • While in runners lunge, twist your torso Fitness at FirefighterFunctionalFitness.com. your cylinder. and reach your right arm high. Access additional firefighter health and wellness resources from the National • Repeat the sequence, performing the 2. Firehouse Circuit: This is a more Volunteer Fire Council’s Heart-Healthy runners lunge on the left side. traditional workout circuit method that Firefighter Program at www.healthy- can be completed prior to the start of firefighter.org. n n training or even as part of your regular training, because it improves skills and proficiency as well. A firefighter training ABOUT THE AUTHOR circuit combines wearing firefighter PPE and specific firefighter tasks. You’ll Dan Kerrigan and Jim Moss are co-authors of Firefighter also notice that there is no specialized Functional Fitness and share the message nationally with a fitness equipment needed. Using The mission to “create a healthier fire service, one firefighter at a Big 8 concept as the foundation, you can time.” Dan is a chief fire marshal, an IAFF peer fitness trainer, an push, pull, lift, carry, and drag objects ACE-certified group fitness instructor, and an at-large director on in your firefighter training circuit for a the IAFC Safety, Health, and Survival Section’s board of directors. 5-minute round. Perform each station for Jim is a career fire captain, NASM-certified personal trainer, and 30-60 seconds before moving on to the an IAFF peer fitness trainer. next. Complete 3-5 rounds total, with 3-5 minutes of rest in between.
www.nvfc.org 13 Responding to Active Shooter/Hostile Events
By George Stevens
Fire departments Security, Department of Justice, Federal risk facilities in their jurisdiction. This spend thousands of Bureau of Investigation, Department is no different than pre-planning for a dollars on firefighting of Defense, International Association fire. They also need to know what other equipment to fight fire of Fire Fighters, National Volunteer Fire agencies will be responding and what effectively and efficiently. Council, fire service, law enforcement, responsibilities each agency will have at an Firefighters spend thousands of hours EMS agencies, hospitals, universities, and ASHER, just like they would need to know attending training classes and meetings others. All firefighters and EMS providers for other types of response. so that they can safely and effectively fight need to become familiar with NFPA 3000. fire. We know these efforts are required, ASHERs require responders to maintain and that is what we do. We know that For your firefighters and EMS personnel to situational awareness and plan for unless we prepare to fight fires, when respond safely and effectively to an active the unexpected. Firefighters and EMS called upon, we will not save lives or shooter/hostile event, your department providers need to be aware of what they property and we will put our firefighters at needs to plan the response and equip might be facing when dealing with an undue risk. and train your firefighters to save lives. ASHER. Many responders think of only Advance preparation is an important having to be concerned about a shooter; However, in the course of the last few step in mitigating the hazards to which however, they may also have to deal years an increasing amount of our time, firefighters and EMS providers will be with improvised explosive devices (IED), effort, and money has been directed to exposed. a vehicle used as a weapon, or other EMS calls. This has impacted how we hazards. There may also be more than one prepare and train for the job. For instance, Fortunately, for the most part, to be able shooter, as has been the case at several with the rise in opioid responses, many to respond safely and effectively to active school shootings. Be prepared to react to fire departments are now equipping their shooter events we only need to expand on the unexpected. firefighters with Narcan® and training what we do day in and day out. them in administering the drug. Many of us respond to bomb threats First, fire departments need to assess the at schools by staging in a certain area. Unfortunately, the number of active risk in their jurisdiction. Even the smallest Your department needs to consider a shooter events are also increasing. So volunteer fire departments have high different staging area when making much so that the National Fire Protection risk facilities such as schools and places repeated responses to a facility. Whenever Association has issued NFPA 3000™ (PS), of worship. Once high risks facilities have responding to an active shooter event, Standard for an Active Shooter/Hostile Event been identified, work with the facility and always keep in mind the possibility of Response (ASHER). This document was other agencies to plan an ASHER. For their ambush. prepared by more than 40 members of a safety and effectiveness, firefighters need committee that included representatives to know the layout of schools, churches, To meet NFPA 3000 and for firefighter from the Department of Homeland synagogues, mosques, and other high- safety, firefighters must be protected
14 Serve Strong | FirefighterStrong by a minimum Level III-A ballistic vest Casualty Care (TECC) Guidelines for First accidents. We are encouraging businesses, and an identifying garment to enter the Responders with a Duty to Act or TECC schools, government facilities, and places warm zone. Because the cold zone could Guidelines for BLS/ALS Medical Providers. of worship to store CATs and blood become a hot zone without any warning, There are also many courses available stopping bandages in strategic places in firefighters in the cold zone should also be to teach how to apply combat applied their facilities. protected with a ballistic vest if possible, tourniquets (CATs) and blood stopper and must have on an identifying garment. bandages. We should always evaluate our actions Firefighters staging in the cold zone and based on risk/reward. The better equipped those entering the warm zone should be My jurisdiction has been providing CATs and trained firefighters and EMS personnel aware of the possibility of an IED being to our firefighter and EMS personnel for are, the lower the risk and greater the planted in the area, the possibility of over two years now. These tourniquets reward. n n unexpected sniper fire or an active shooter have been credited for saving the lives entering the area, and the use of a vehicle of patients of MVAs and lawn mower as a weapon.
Purchasing ballistic vests for firefighters and EMS providers will be an added ABOUT THE AUTHOR expense for many departments, but one George Stevens has served as a volunteer firefighter/first that is proving necessary to keep today’s responder on Pine Ridge Volunteer Fire Department since 1986. responders safe. Every day volunteer He serves as Mississippi director to the National Volunteer Fire firefighters and EMS providers respond to Council (NVFC), chairs the NVFC Homeland Security Committee, calls that have a potential to expose them and represents the NVFC on the NFPA 3000 Committee. He also to the threat of gunfire. There have been serves as president of the Mississippi Volunteer Firefighters instances of firefighters and EMS providers Association and works as fire coordinator for Lamar County. being wounded or killed by gunfire when responding to what they thought would be a routine EMS call. Some of these responders were not shot maliciously or with harmful intent, but rather from people suffering from a medical condition that caused irrational behavior. Unfortunately, these patients perceived the responders coming to help them as a risk to their life.
Firefighters and EMS providers are also at risk while responding to motor vehicle accidents (MVA). The person trapped in the car may be a fugitive from the law or suicidal. Your department should consider issuing ballistic vests to all of their personnel that respond to EMS and MVA calls. For day in day out use, when responding to EMS and MVA calls, a Level III-A vest will offer a considerable amount of protection. The cost of these vests is starting to come down. Level III-A vests are now available from several companies for less than $500. Additional protection from rifles can be added by inserting plates into sleeves in the vests.
To meet the standard to deliver threat- based care, firefighters and EMS personnel responding to an ASHER will need to complete training on Tactical Emergency
www.nvfc.org 15 The Body, Mind, & Soul of Opioid Responses
over and over before. Some 10 minutes so tightly to the storekeeper. You wonder By Tom Miller later, she thinks to ask about her child if there is a new memory in the little girl’s – after she has been telling the driver mind. It’s 3:00 p.m. on a Saturday afternoon. Your how much she loves him and that, “… department is dispatched to an MVA with he didn’t do anything…” To get away Many first responders struggle with how injuries at a local service station. You roll from the cacophony, you and another to keep events like this in perspective. up on a single vehicle into the guardrail. firefighter take the child inside the small We see people and situations at their Upon doing a 360, you discover a male convenience store to get her a clean diaper worst. With the opioid epidemic, we see driver and female passenger unconscious and something to eat. The child quickly self-destruction on a grand scale. It gets and unresponsive in the front of the calms in the arms of the storekeeper, a harder and harder to “box it all up” or not vehicle and a toddler in the back of the car grandmother who has just the right touch. get cynical or even angry at having to screaming. There is no airbag deployment, respond to the same types of self-inflicted but there are needles and heated spoons You wore gloves, were careful to not get a calls day-in and day-out. The stress turns visible in the console between the driver needle stick, and helped hold the patient into compassion fatigue – sometimes and passenger. In your mind you think, down when he decided to come out of called vicarious traumatization – which “Here we go again…” his high swinging. Your body is stressed is an indifference to the pleas for help but intact. The two patients will live to from those who are suffering due to the You quickly check and the driver and get high another day. Your crew is safe. frequency or number of such appeals. passenger; both have faint pulses but are The EMS team is safe. Law enforcement is They want us to help keep them alive, but not breathing. Neither appears physically doing their investigation and have called it feels like they don’t want help with the hurt and there was no air bag deployment. Child Protective Services for the child. You root cause of why someone had to call By now EMS and law enforcement are see the stress that it takes on all. There is 911. In other words, “Save me so I can go on scene. The child is removed from the the usual gallows humor banter generated destroy myself again.” back seat and you note the heavily soiled by frustration from this scenario, which diaper that doesn’t appear to have been seems to repeat itself over and over in your Departments need to pay close attention changed in quite a while. The driver and community. to their members and closely monitor their passenger are pulled from the vehicle and mental health. In areas where call volumes are being worked. The passenger is given 4 Your mind thinks back to the first time you spike, the risks are greater. Officers and mg of naloxone and starts to come around. ran a call with this couple. How they were peers can get clues from social media The driver is a big guy who gets 8 mg of found at a park and ride unconscious and posts, comments made in passing, and naloxone before he stirs. Suddenly, he unresponsive from another overdose. You from direct pleas for help. If left untreated, wants to fight – but is quickly restrained by start playing the “What if?” game which compassion fatigue can lead to burnout, a several firefighters and the medic. has no right answers. You mind goes to cumulative process marked by emotional the little child and wondering if she is OK. exhaustion and withdrawal associated The female starts the, “I don’t know what You go back inside the store and see that with increased workload and institutional happened…am I going to jail? I don’t the child is sipping on the juice that you stress that is not trauma-related. do drugs…” tape that you have heard and your buddy bought and clinging ever
16 Serve Strong | FirefighterStrong Continued exposure without intervention In addition to taking the time to re-stock class on Psychological First Aid, CISM, can lead to more serious stress-related the rig, take the time to take stock in your or other clinically proven interventions. issues, including post-traumatic stress members. Make sure that they know that Don’t forget to lead by example. Take disorder. you really care and that they can talk about care of yourself as well. Don’t make stress their reactions and emotional responses a “taboo” subject at the station. Every Organizations should have a plan to to problem calls. Learn the signs and minute of every day is an opportunity address the emotional and behavioral symptoms of compassion fatigue, burnout, to help…not just our communities, but health of their members. Whether it and stress disorders. If needed, take a ourselves. n n is an Employee Assistance Program, Psychological First Aid, Critical Incident Stress Management (CISM), department chaplaincy, peer-to-peer programs, mentor ABOUT THE AUTHOR programs, or other similar processes, Tom Miller has 35 years of experience in the fire service. He is members should have access to healthy a Pro Board-certified Firefighter I & II; Driver Operator - Pumper; mechanisms for dealing with cumulative Fire Instructor III; Hazardous Materials Technician & Incident stress. Organizations can promote access Commander; and is certified as a Swift Water Rescue Technician. to free resources such as the NVFC’s He is also state certified as a Fire Officer I & II. He has been Share the Load support program or local on the adjunct faculty of West Virginia University Fire Service behavioral health programs. Members Extension since 1990. Tom is West Virginia’s director to the should be able to seek help without fear of National Volunteer Fire Council, serves as a principal on the NFPA reprisal. Officers and leaders must be ready 472/473/1072/475 Technical Committee for HazMat and WMD to confront this issue head-on, including Response and is on the Joint 1001/472 Task Group, and is active the risk for member suicide, or they risk with the various committees for the West Virginia State Firemen’s increased turnover or poor on-scene Association. performance.
www.nvfc.org 17 The Mindful Firefighter
By Hersch Wilson
One of the regular tasks we do on any The gist of this article is that no matter the The tiger is our ruminating about the past, fire department is wash trucks. It is a past, no matter the difficulties that the the python is our worrying about the point of pride to have clean vehicles. As universe has in store for us, we can adopt a future, and the strawberry is the present. a firefighter, in doing so, I have a choice mindset — a way of thinking — that helps The present can be today, or it can be every Saturday morning. I can think that us stay calmer and be in the present. a singular moment, the sweetness of a this is a tedious and ridiculous task — the strawberry, the gloriousness of a smile. The trucks will just become dirty over a week If I’ve learned anything as a firefighter, goal is no matter the past or the future, to of calls. I can be on autopilot: not really it’s that the present is all we have. Stuff enjoy the “nowness” of that strawberry. present but just caught up in a million happens, the universe doesn’t care about different worries, not even aware of what I our plans, the future isn’t a promise. am doing. The past is over. We can only A story to illustrate: learn from it. The future is out Or I can be mindful; I can realize that A Buddhist monk was being chased by a all over the country, firefighters are of our control. This moment is tiger through the forest. He came to a cliff washing trucks and I am part of this great all we are guaranteed. community. I can allow myself to become with a long vine hanging down into the absorbed in the task, the sound of water, valley below. He grabbed the vine and the camaraderie of the firehouse, the feel began furiously climbing down. Looking Being mindful is not merely a practice for of a soapy sponge, the look of a truck as it up, he noticed that the tiger was climbing monks and the spiritually inclined; it offers reappears clean and shining. The choice down after him. He started to move real-world benefits to help us stay calm is mine. Two paths can lead to boredom and reduce stress. and even despair (the thought of doing quickly, and then he looked this every Saturday for decades), or one down. There below was a How Mindfulness Reduces Stress decision leads to fulfillment. Just like in python, the largest he’d ever Mindfulness can help us reduce stress in a our “regular” lives, full of mundane and seen, wrapped around couple of ways. sometimes absurd tasks, we can practice the vine staring at mindfulness. 1. Often we are on mental “auto-pilot.” him. So above him The tigers and the pythons are loose was the tiger and in our brains, and we are reacting to “Mindfulness is the basic below was the them without really thinking about human ability to be fully python. Stressed, them. Hitting the mindful pause he glanced to the button allows us to put them in present, aware of where we are side, and there he perspective. and what we’re doing, and not saw hanging from 2. When we pause, even if only for a overly reactive or overwhelmed the vine was a big moment, we tend not to just react. We can consider alternatives to how red strawberry. He by what’s going on around us.” we want to respond rather than paused for a second responding automatically. - Mindfulness.org and then ate it and enjoyed it.
18 Serve Strong | FirefighterStrong 3. We are more self-aware. When we take A Final Note that moment to be mindful, we are By its very nature, firefighting teaches in touch with our bodies and notice mindfulness. Think about how many where stress hits us. times you’ve been in a non-fire situation 4. When we are mindful, we tend not where people are upset, going a little to overreact. We can better keep our crazy (maybe at a family gathering). And perspective and respond to problems we think to ourselves, there is nothing more creatively. here to be upset about: everyone is alive, no one is hurt, why go crazy? That is a Practicing Mindfulness mindful moment brought to you by your Becoming more mindful takes practice, experience of being a firefighter. Because just like any new habit, from learning how we see what we see, it puts everything to operate a new pumper to practicing else in perspective. Because we see what your golf swing (which can be a very we see, 90% of the time we know we can mindful activity). Here are a couple ways make a choice to stay calm. That’s being to start. mindful.
Meditating The payoff of being calm and mindful The gold standard, of course, is carving is the strawberry; all those beautiful out regular time daily to meditate, even if moments in life, that if we don’t slow for 10 minutes a day. It is a valuable and down, we’ll miss. And that is a real tragedy. worthwhile practice that can help calm to rise, learn to step away. It can actually So be brave, be kind, fight fires, and be n n your mind, reduce stress, and help you be physically stepping away. For example, mindful! keep perspective. There are a variety of when a heated argument is beginning at resources available online to help you start a scene, it is often best to step away and a meditation practice. calm down. Or it can mentally be stepping away, being mindful of the situation: The Mindful Walk does this situation really call for me to get Turn off your smartphone (leave your upset? It is surprising how often — when pager on!) and take a walk. In Zen practice, we practice a little mindfulness — the walking meditation is called Kinhin. Focus answer is “no.” on your breathing, on being outdoors, on the sky, and how your body feels as Breathe. it moves. Don’t plan your day or use this In both situations, whether physically or time to worry; just walk and focus on the mentally stepping away, the next step is to rhythm of your walking and breathing. focus on your breathing. This is a relaxation exercise. Stand up or sit up straight When You’re Stressed… and take six deep and slow breaths: It’s called square breathing. Two seconds in, Learn to Step Away. two seconds holding the breath in, two Although there are significant problems seconds out, and two seconds hold, and that we need to deal with, often what repeat. Soon, after a little practice, taking causes us stress are minor things: a petty that first breath will begin to relax you. argument with a sibling, being stuck in Your shoulders will relax, the anxiety in traffic, responding to the same address for your chest will diminish, and you will calm the fifth time for a false alarm. Before we down. get hooked, before our stress level starts
ABOUT THE AUTHOR Hersch Wilson is the assistant chief with Hondo Volunteer Fire and Rescue in Santa Fe County, NM. He has been with the department since 1987. In his “other life” he is a writer and a soccer coach. Visit him at Herschwilson.com or on Facebook at ‘Hersch Wilson-Firefighter.’
www.nvfc.org 19 Growing Our Ranks: Equity, Inclusion, and the Path to Success
sign of comradery and of a job well done. department believes in equality for all is By Ali Rothrock Doing that to someone unfamiliar with positive and a step in the right direction, it it or to someone of the opposite gender is again missing the mark. In today’s fire service, the issues of could contribute to them questioning their “diversity and inclusion” are frequently physical safety in the station. Someone I remember a training chief telling me discussed. They are buzzwords that come else might think severely criticizing the a story about a situation at her local up at fire service conferences and in new person is a way to show them that academy that perfectly illustrates this departments as leaders strategize how they care or that they are a member of point. Each day she would get a report on to bolster their dwindling ranks. I think a the team, but the person on the receiving the status of all candidates in the current more accurate way to both describe the end may come to dread the station as academy class. A few weeks in she started problem plaguing the fire service currently a hostile environment. You might be an getting word about an issue with one of and show us a clearer path to eradicating it affectionate person and think that giving the candidates, the only woman in the is to actually switch the order of the words. bear hugs is a way to show inclusivity, but class. This candidate was competent, We cannot have a diverse fire service until to someone else that is a violation of their passionate, and was doing well in all areas we first have an inclusive one. personal boundaries. In these cases, well- except for one, the ladder skill. None of intentioned attempts at inclusivity miss the instructors could tell the training chief We can entice people from all walks of life the mark. exactly what the issue was, so she set out to walk through the firehouse doors, but if to see the problem for herself. the environment they find does not allow Equality and equity are terms that are also room for them they will walk right back often misinterpreted. Equality is thinking The next day the training chief, a few out. We see this time and time again in the that everyone needs the same thing to be instructors, and the candidate stood on fire service. successful. Equity means we understand the academy grounds at the back of the that different people need different ladder truck. The candidate was poised Inclusivity has a lot to do with perspective things to reach the same goal. While and ready at the ladder bed. The instructor and personal life experiences. Someone having “equality” as a part of your fire had the skill sheet in front of him and a who grew up playing sports might think department’s mission or vision statement pen ready to write down any issues. He that slapping someone on the butt is a or telling prospective members that your then gave the candidate the command to
20 Serve Strong | FirefighterStrong start. She took a step up on the tailboard Creating a Safe and There are plenty of ways to create a and was reaching into the ladder bed to Positive Work Environment more inclusive environment to get your grasp the ladder rung when the instructor department ready for diverse ranks. yelled, “Stop!” The training chief asked All members of fire, EMS, and Be clear on your expectations for your what the issue was. “She has to keep both members and leaders. Be very clear on rescue services should be treated feet on the ground,” the instructor stated, what comments and behaviors you will and treat others with dignity and showing the chief the skill sheet where not tolerate. Take anti-discrimination that specific requirement was noted. respect, free from harassment, training. Make sure that your SOPs/SOGs The training chief realized the issue and bullying, and discrimination of are up-to-date and reflect your diverse crossed out the requirement that the any kind. The NVFC and partner ranks. candidate needed to have both feet on organizations have released a the ground. She gave the candidate the It is important to understand that equity Joint Anti-Harassment, Bullying, go-ahead to begin again. The candidate and inclusivity are not a zero-sum game. and Discrimination Statement as stepped up on the tailboard briefly, pulled In a zero-sum game there are no winners the ladder out, stepped back down, well as compiled resources to help without losers. For every point you win, and completed the rest of the evolution departments implement their own someone else loses a point. But making successfully and safely. policies to protect personnel and sure that someone has gear that fits them create a safe and positive work doesn’t mean you get less gear that fits In this situation equality would be exactly you. More value is created when we treat environment. Visit www.nvfc.org/ what that instructor was doing. He others with equity. In the fire service, anti-harassment-resources. assumed that all candidates must perform we are all winners when we create an a skill in the exact same way. Equity would inclusive and equitable environment for be recognizing that a shorter candidate (it demographics to fill the ranks. That time our members and recruits. Having more could be male or female) would need to is now. participants in the game means we all perform the skill in a slightly different way. have a better chance to be successful. n n This change did not cause the candidate There are many reasons someone might or anyone else to be unsafe, nor did it be unwelcome in a firehouse. This applies bend the rules to allow her to unfairly to all genders and other demographics. succeed. The candidate was not excused There could be more dangerous reasons from performing the skill as it is certainly like abuse or harassment. If this abuse a necessary proficiency for the job. The or harassment is not properly dealt with training chief simply recognized that the immediately, you will see that toxic candidate’s stature made it so she needed attitude spread and spread. There could to perform the skill in a slightly different be less obvious reasons someone feels way than her taller counterparts. unwelcome, like not having gear that properly fits. This is a big safety issue but Perpetuating the myth that firefighters not one that many departments feel is a need to all be the same size and weight priority. Another reason someone could contributes to an exclusive culture that the feel unwelcome in a firehouse could fire service cannot ultimately survive. If we come from them realizing that the proper continuing to operate from a standpoint facilities don’t exist in the station for of equality and not equity, we will lose them. All of these situations contribute to competent and passionate firefighters. negative consequences for the individual, The well is only so deep. We eventually the department, and the fire service as a will have to start appealing to other whole.
ABOUT THE AUTHOR Ali Rothrock has been a member of the volunteer fire service for 14 years and currently serves as a firefighter and EMT in Pennsylvania. She works full time in mental health education, serves on her local CISM team, is the Eastern Division Trustee of the International Association of Women in the Fire and Emergency Services, and is CEO and lead instructor of On the Job and Off.https://onthejobandoff.com
www.nvfc.org 21 What Do You Say to Someone Struggling from Emotional Trauma?
By Chief Jared Meeker
You might already know that mental themselves or shutting down in response Some of the more common signs that health conditions occur at higher rates for to the grief or sadness. someone is struggling include: first responders compared to the general • Avoiding people, places, or activities public. We are routinely exposed to You want to help them, but you don’t that could remind them of the traumatic physical and emotional trauma, sometimes know what to say. What if they get event(s) on a daily basis. defensive when you approach them? What if they deny there is a problem? What if the • Trouble sleeping or nightmares Most people in this world do not see what depression has taken over and the person • Trouble concentrating as their minds we first responders see, and they cannot is having suicidal thoughts? What if they wander easily relate to what we feel after a tragic call refuse your help? • Overwhelming guilt or shame — the change of mood, the feeling of depression, the attempts to file away those It may seem intimidating to approach • Recurring distressing memories of an images from that traumatic event in hopes someone who is struggling, but we are event or series of events they never return. It is not surprising, firefighters and we don’t turn our backs • Irritability with angry outbursts then, that for many firefighters a traumatic on someone in need, especially one of incident or the accumulation of witnessing our own. Reaching out may be the key to • Drinking or using prescription trauma over time can have a significant getting that responder the help they need. medications too much impact on their mental wellbeing. First, it is important to be able to recognize Unfortunately, I know all too well what You may notice that a fellow first the signs that someone may need help. it is like to walk in their shoes. I recently responder is struggling from one of Many in the fire service try to hide or recovered from one of those situations those calls, or a series of stressful bad downplay what they are experiencing, that overfilled my stress bucket and placed calls that just won’t leave their minds. perhaps out of fear of how others might me into a state of depression. I wrote You might have overheard them discuss perceive them, or because the department’s about my experience in the last issue of their sleepless nights, their nightmares, culture doesn’t foster open communication, Firefighter Strong. In that article, I explained and their increased anxiety. Or it might or maybe because of lingering how each of us has a bucket in our minds be the opposite; they may be isolating misconceptions about mental health. that gets filled with stressful moments over time. For some, their stress buckets
22 Serve Strong | FirefighterStrong can keep filling up and never spill. But call will stress me for a while as she was only so much you can do if the person is for others, we reach a point where it just the similar age as my niece. How is this not ready or willing to open up or accept becomes too much, and the stress bucket going to affect you?” help. starts to overflow. • Listen actively. When you get someone talking about the stress they are feeling, I also want to say a few words to those What is it that will finally overflow that do not interrupt them. Just keep who are struggling. Don’t be afraid of stress bucket? Will it be a traumatic stress listening and let them open up. professional help. Many responders won’t incident, such as a senseless motor vehicle seek the help of a professional because of accident caused by a driver under the • Do not try to compare one of your prior the stigma that it shows weakness. That influence? Or will it happen unexpectedly, traumatic events in an attempt to lessen is so far from the truth. There are some maybe while watching a movie, when a their traumatic event. things that we can’t fix by ourselves, and part of the film takes your mind back to • All conversations must be in confidence. the way your mind works is one of them. one of those traumatic events in your past? The only way an individual in crisis is It is important as first responders that we going to open up is trusting that you recognize when we truly need help. The After my incident, many people would will keep what they say in confidence. treatment can only start with you standing not approach me because they didn’t The exception is if they express that they up to say that you need help and that you know what to say or felt they couldn’t are planning to commit suicide, at which want your life back. help. At the same time, I didn’t reach out point follow department protocol to get to anyone as I wasn’t sure what I wanted them through the crisis point. It is always important that we prioritize to hear. After many months of struggling taking care of ourselves, and also that • Only offer help to your ability, then with the depression and PTSD on my own, we are there for our brothers and sisters suggest options for additional help, such an acquaintance I ran into broke through to ensure their mental wellness and as a local peer support team, a seasoned the barrier I had built up. He asked me emotional health. veteran, or behavioral health specialist. how I was doing and told me about resources that could help me. Although Stand up for yourself… life is too short. n n A simple “I want to help” or “I will listen it still took me some time to follow when you are ready” can go a long way, through on getting the help I needed, that but sometimes you will need to give the conversation was the first step and opened person time to heal by themselves and up the path to recovery. then be there for them when they are ready to talk or show emotion. There is So, what should you say or do when you know someone is struggling? Here are some tips to help you: • First and foremost, be compassionate. The National Volunteer Fire Council & American Addiction Centers We use compassion on every call. partner to provide the Talking to someone who is struggling with emotional trauma doesn’t require Fire/EMS Helpline at 1-888-731-FIRE (3473). any special training. Let the person know you are there for them and that Calls are anonymous and confidential, and the trained counselors they are important to you. who answer the calls can get you the help you need. • Notice what you are observing that creates concern and have a conversation with them. Explain to them the signs and symptoms that you have noticed ABOUT THE AUTHOR and that you want to help. Jared Meeker is a 30+ year fire service veteran currently serving • Periodically check-in with the individual. as a fire chief for the Lake Shore Fire Department, a combination Volunteer firefighters can hide by just fire department in upstate New York. His passion for the fire staying home and struggling in silence. service includes teaching incident command skills to aspiring fire • Avoid asking questions that prompt officers and career survival skills to all first responders. Jared has limited or vague answers. For instance, written two prior NVFC articles, When the Stress Bucket Overflows: when I ask my firefighters “How are you A Firefighter’s Story of Pain and Healing and Fireflies and the Fire doing,” 99.9% of the time the response Service, available at www.nvfc.org. He currently offers a training will be “I’m okay chief.” Instead, phrase program on firefighter behavioral health; learn more athttps:// the question in a way that will seeingincoloragain.wordpress.com/sizing-up-your-behavioral- encourage a more detailed and open health response, such as: “That child drowning www.nvfc.org 23 National Volunteer Fire Council 7852 Walker Drive, Suite 375 Greenbelt, MD 20770
Join the Conversation! #Recruitment #FirePrevention #rentention #Cancer #Budgets #SOPs #funding #safety #SocialMedia #Fitness #training #Bullying
Your time. Your talent. Your Voice. Ask questions, share advice and tips, and connect with fellow firefighters and EMS providers in the NVFC’s members-only, online community.
Let your voice be heard. Join the NVFC at www.nvfc.org/BeYourBest
VolunteerVoices.nvfc.org