The Rehab Station

Photo by Steve Baer | FireDog Photos

How one department is fighting back against exhaustion and burnout

If you’ve been in the fire service longer than five minutes, you already know one thing: the job is getting busier. Not “a little busier.” Not “seasonal bump” busier. We’re talking non-stop, no-breaks, where-did-the-shift-go busy. Our busiest companies are operating beyond sustainable limits.

Population growth, an aging demographic, widespread reliance on 911 as primary healthcare, a worsening homeless crisis, a mental health crisis, and hotter temperatures fueling more frequent fires are all intensifying our workload. Meanwhile, society is leaning on local government more than ever to address every problem. The result? At my agency, call volume went up by 30% in a 10-year period with a 0% increase in staffing.

In Contra Costa County Fire, our heavy-use companies now average more than 10 hours of “time on task” per 24-hour shift. That is the time from enroute to available on radio. That number alone tells a troubling story. When nearly half — or more — of a firefighter’s shift is consumed by incidents, little is left for the essential work that keeps companies effective and safe: apparatus checks, reports, training, station maintenance, physical fitness, cooking, and even basic human needs, like eating and sleeping.

We all signed up for the job knowing we wouldn’t sleep well. But what’s happening now goes way beyond “a rough night.” It’s long-term sleep debt, and it’s killing firefighters.

The Hidden Emergency: Sleep Deprivation in the Fire Service

Research shows that lack of sleep contributes to:

• Mental and physical exhaustion
• Burnout and deteriorating morale
• Family and relationship strain
• Increased personnel issues, including legal complications
• Poor customer service
• A drop in testosterone equivalent to aging 10 years
• 40% reduction in learning and memory formation
• 15× increase in vehicle accidents
• 30% increase in dementia risk
• 70% decrease in cancer-fighting immune cells
• 200× increase in the likelihood of fatal cardiac events
• Altered activity in 711 genes — turning on harmful ones and turning off beneficial ones
• Complete ineffectiveness of flu shots and other vaccines when administered to sleep-deprived individuals

If a piece of equipment was putting us at this level of risk, we would pull it off the rig immediately. But because it’s “just sleep,” we shrug and grab another cup of coffee.

We often preach about the importance of diet and exercise — the two pillars of firefighter health. But science is clear: sleep is the foundation. It is the world’s best performance-enhancing drug. Professional sports teams and the military have already embraced this. Lawyers call it what it truly is: risk management. Sleep deprivation is destroying firefighter health and increasing operational risk.

I worked at our busiest companies for 20 years. Then I was promoted to battalion chief and got some regular sleep for the first time in decades. I couldn’t believe how much better I felt! I had no idea how badly I was affected by sleep deprivation until I finally had the chance to feel “normal.” I knew a lot of my brothers and sisters were suffering in the same way, and I felt a calling to do something about it.

Building a Solution: The Rehab Station Concept

In 2022, we set out to try something new: The Rehab Station Experience. The idea was simple — create a designated “Rest and Rehab Station.” Think of it as a structured, department-supported way to help our busy crews pay back sleep debt and get their health back on track — without leaving the job. We selected Station 4 in Walnut Creek — one of our slowest stations at around two calls per day. It was closed during the great recession, but was being reopened, and we had the opportunity to capture it before anyone had the chance to bid a spot there.

Participation is optional. Companies rotate in for one full month, and are backfilled with OT. Working closely with the union, we were granted permission to temporarily “violate the bid system” for a one-year trial, with the plan to vote after 12 months on whether or not to continue the program. It was so well received, that after the trial, they didn’t even bother to hold a vote.

The vision was to “throw the kitchen sink” at our members — offering the most comprehensive wellness environment possible, and using Station 4 as a testbed for department-wide improvements.

What’s Inside the Rehab Station?

We didn’t mess around. Station 4 is loaded with tools that top athletes and military units are already using to improve sleep and recovery.

Sleep Optimization

• Sleep number beds
• Tempur-Pedic pillows
• Weighted blankets
• BedJet cooling systems
• Blackout shades
• Hatch noise machines and gentle alarm clocks

Physical Recovery

• Avantikul Everest cold-plunge machine
• Avantikul AV2 infrared sauna
• Shiftwave therapy chair
• Visits from department physical therapists (Reconperform.com)

Physiological Tracking and Coaching

• Three-month Whoop strap access (the months before, during, and after Station 4)
• Optional sharing of anonymous sleep and recovery data with the district
• Breathwork coaching from Trybe Summits

Behavioral Health and Mindfulness

• Department-paid subscriptions to Headspace
• Yoga instruction subscription from Firstgevity with Paige Arnone
• Leadership Under Fire (LUF) firefighter resiliency training

Nutrition and Education

• Department-provided chow/staple fund
• Subscriptions to RescueRD dietician Megan Lautz
• A curated library of 40+ books on health, performance, and leadership

This is not a “vacation station” — it’s an education and recovery hub designed to help firefighters regain baseline health and return to their home companies with stronger habits and greater resilience.

The education piece is huge, too. When firefighters understand how sleep actually works — and how much it affects performance — they go home motivated to keep the habits going year-round. The most common thing I hear is, “I had no idea how badly I needed this.”

The Whoop data we’ve collected shows improvements in all biometrics. Sleep need, sleep actual, HRV, and resting heart rate all improve. Interestingly though, strain scores went up. This obviously isn’t due to call volume, it’s because firefighters are exercising more, playing with their kids more, doing more chores and projects at home, and generally living a more active and fulfilled lifestyle on and off duty! They’re not short-tempered zombies anymore.

Station 4 serves as a test kitchen. Products, practices, and policies that prove effective can then be rolled out department-wide. The goal is not to create a luxury outlier — it is to identify what actually works and scale it. Our department now has sleep number beds in all stations and a “Whoop library” where folks can check out a Whoop for four months at a time.

This Is About Risk Management, Plain and Simple

If your department is seeing burnout, rising call volume, slow recovery, more injuries, short tempers, or constant fatigue — and let’s be honest, who isn’t? — you don’t need permission to start taking this seriously. Staffing takes time, but a rehab station addresses the critical need right now. Build your own version of a Rehab Station.

Start small if you have to. Buy blackout shades. Improve beds. Pick one slow station and rotate people through. Every department should implement a version of this program.

My advice would be to have “the cool kids” and informal leaders go first. Then it becomes culturally acceptable for others to take a turn. Encourage your captains to lead their crews and to tell, not ask, their crews, “Hey, we’re doing this, what month do you want to go?”

I was too stupid, prideful, arrogant, and stubborn to do the right thing and leave my crew, bid a slow station, and take a break for awhile. My identity was too wrapped up in being the guy who worked at “the busy station.” I was lucky to get out unscathed. I’m sure it took a few years off my life, but if I knew then what I know now, I would have bid in and out of busy stations throughout my career. That is the lesson I hope others can learn from The Rehab Station. The folks at ConFire are learning this priceless lesson.

Sell it as a recruitment tool. People are always jealous when they hear about this program. The program shows how much the fire chief cares about his employees’ well-being. It’s worth it if we prevent one disease, one apparatus crash, one divorce, one career-ending personnel issue.  Let’s stop someone from being crippled physically or mentally. Help them make it to the finish line in one piece. Go home and talk with your union, talk with your chief, and implement a Rehab Station at your agency.