By: Howard A. Cohen, Deputy Chief (Ret.)
Firefighting is one of the best jobs around. It is also one of the most dangerous. As firefighters we train and prepare for the many physical risks we face.
We accept that our job involves running into burning buildings, mitigating hazardous materials, working car accidents on busy roads, and dealing with angry, hostile citizens. Unfortunately, we tend to not train or prepare for one significant risk to our health and wellbeing: Frequent exposure to traumatic events.
How stressors affect your job
Studies of first responders show how over time the stressors associated with exposure to traumatic events pose a serious challenge to our emotional, mental, spiritual, and physical wellbeing. The national post-traumatic stress disorder (PTSD) rate in the U.S. is estimated at 6.8%. The rate for firefighters has been estimated anywhere from 7%-37%. It is also important to recognize that studies show that the effects of traumatic events are cumulative. In other words, the longer a person is an active firefighter, the greater the likelihood s/he will experience negative consequences from exposure to traumatic events. It is not an overstatement to say that exposure to traumatic events represents one of the greatest health risks to firefighters.
What is a traumatic event?
A good working definition is that it is an incident that evokes a strong emotional reaction with the potential of interfering in our lives. A technical term for this interference is that our homeostasis has been disrupted. The word “potential” is emphasized because not everyone responds the same way to every traumatic event. For example, a firefighter with a young child at home might be more adversely affected by a call that involves a child than an older, single firefighter. Also, firefighters experiencing other stressors in their life will potentially be less resilient after a bad call. In addition, since the effects of exposure to traumatic events are cumulative, more seasoned firefighters might find themselves affected after what appears to be a relatively routine call.
Stress produces a complex interplay of responses from the nervous, endocrine, and immune mechanisms that impact all systems of the body including cardiovascular, respiratory, endocrine, gastrointestinal, nervous, muscular, and the reproductive system. Long term physiological responses to trauma can lead to depression, anxiety, cognitive impairment, excessive drinking, heart disease and the abuse of drugs. These and other maladaptive behaviors can wreak havoc on relationships, too.
What can we do?
Unfortunately, stress and exposure to trauma are facts of life for firefighters. Consequently, it is very important for us to learn how to handle stress and our responses to traumatic events and to practice these skills so we can return to homeostasis, normal or typical functioning, as quickly as possible. How well we handle emotional, psychological, and spiritual stress depends on how resilient we are. Resiliency is the ability to bounce back in a healthy way. It is the key to coping with stressful events.
The good news is that resiliency is a skill we can develop. It doesn’t require any special equipment and is the natural outcome of very enjoyable and healthy activities.
Here are some ways to build your resilience for when you’ll need it.
• Eat healthy food
• Get plenty of sleep
• Develop hobbies and interests outside of work and the fire service
• Cultivate friendships with those whom you can speak openly and honestly
• Nurture your spiritual life
• Practice mindfulness such as yoga or meditation
• Relax, go on vacations
• Be kind to yourself
• Embrace change
• Remind yourself that you have the most meaningful job in the world
• Embrace healthy thoughts
• Be open to getting help if you think you might need it
• Participate in your department’s after action reviews (AAR)
Recognizing the signs
There are many signs that we, or someone we know, is not coping well after a traumatic event or the accumulation of unprocessed events. These signs may include some or all of the following: fatigue, grief, chest pains, denial, depression, loss of emotional control, difficulty paying attention, change in appetite, nightmares, misuse of alcohol or drugs, intrusive images, anger at god/crisis of faith, anxiety, withdrawal from others, and guilt.
Exhibiting signs and symptoms
When someone you care about is exhibiting any of these signs, gently bring your observations to their attention. Be sure to let them know that you are coming from a place of love and concern. Though it isn’t always easy to approach a friend and colleague who is hurting, the price to pay for not doing so could be very high. As you know, a firefighter not performing at peak levels is a potential risk to themselves or other firefighters. Hopefully, if we ourselves are exhibiting signs of not coping well, one of our friends and colleagues will reach out to us. Awareness of these outward signs is critical.
A fireground skill you should know
Developing situational awareness on the fireground is a critical skill taught to every firefighter. Emotional and mental health situational awareness is a critical skill for building resilience; this skill should be taught to every firefighter because traumatic events and bad calls go hand in hand with the job. Whether it is a fatal car crash, burn victim, suicide, or the death of a child, these encounters take a toll. It is no surprise that many firefighters are haunted by the tragedies they witness as a part of their job every day. Fortunately, with increased awareness and resilience building skills, firefighters today are better able to cope with the stresses that go along with having the best job in the world.
Howard A. Cohen retired from the Bennington (VT) Fire Department as a deputy chief. He spends a lot of time writing and teaching various aspects of firefighting. He is the virtual training coordinator for Africa Fire Mission and an active member of the National Volunteer Fire Council.
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