A continuation from last post

September 27, 2011 § Leave a comment

Have you seen this story?

http://www.tulsaworld.com/news/article.aspx?subjectid=11&articleid=20110924_16_A17_CUTLIN501742

http://www.newson6.com/story/15535279/wife-of-murdered-nichols-hills-fire-chief-arrested

It blows my mind, and while I do not know the reason for her actions, and certainly do NOT condone them, it got me thinking about what is offered to spouses of Fire/EMS personnel.  Last post https://stickysidedown.wordpress.com/2011/09/22/taking-care-of-your-own-recognizing-stress/ focused on treating the stress of the Fire/EMS/EM personnel. And that’s the most important treatment to offer, but what do we do for the spouses?

I consider myself lucky. Not only am I blessed that my husband is in the emergency services field and is extremely and sometimes OVERLY supportive of what I do, but I am also in the emergency services field and can provide the same support to him. Now, I’m not saying there haven’t been times where we have looked at each other and had that “you need to stop giving so much time to the job/volunteer and start giving some time to the family talk”, but those are few and far between. And while many of the couples that I interact with are dual service couples (both in fire/ems/Emergency management/dispatch/nursing), I look at those couples that aren’t and see the struggles.  The struggles of the non-service spouse to understand the commitment and dedication their spouse has. The understanding of the non-service spouse to understand that their spouse ISN’T going to talk about their day sometimes.  Heck, my husband doesn’t always tell me about his calls, because he knows that I can internalize them and make them personal.

What do we do for those non-service spouses to help them understand what being involved with a signficant other in the “service” can involve. One of the best books I’ve read was “I Love a Fire Fighter” (http://www.ellenkirschman.com/work3.htm) It really provides a great overview of the life of a fire service family. But, a book is only one way. How do we prepare a spouse, especially one who didn’t start a relationship with a non-emergency services individual, for the issues that will arise?

I can tell you, that I myself have sepnt many a christmas, hallowee, easter (heck, pick a holiday) alone or alone with our kids because my husband was on shift. I’ve had to go into work late or leave early because or late calls, call backs. And even I have to admit I haven’t always handled it well.  But there have also been many a situation where I have looked at other spouses and shook my head because I didn’t understand or suppor the response they had to an incident (having to hold over/miss an event/show up late).  In fact, many of my friends often say they wish that their significant others were as understanding as I am.  Looking back, I wonder what I, as a felow fire service spouse, could have offered to that individual to help them see a better way to react.

While, I don’t believe that the actions of the wife in Oklahoma are as a result of being married to an individual in the fire service, I wonder how many incidents have resulted because we can’t help those spouses work through the stressors of being an emergency services spouse. And we don’t provide the recognition that they deserve for putting up with what they do.

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Taking Care of Your Own – Recognizing Stress

September 22, 2011 § 1 Comment

Have you ever been this guy?

Maybe you aren’t sitting at a computer screen with your stress.  It’s hard not to have felt stress in the job we do. From the calls we run, the people we deal with, the administrators we would prefer NOT to deal with there’s stress.  Add to that the roles we fill outside of our jobs. As I was thinking about this post, I thought about the various different roles that add stress to my life. They include: Wife, mother, employee, boss, Instructor, Student, Author, Daughter, Sister, Friend, Homeowner, Bill payer.

And that’s just daily stress! Add to that the unexpected, the stressors that we can’t plan for (which as a planner can really throw me into a tailspin) and a normal person can really be thrown off. Heck, in just the past month I’ve dealt with a hurricane (no power for 5 days), start of EMT-I Class, my five year old starting kindergarten, the first anniversary of my mother’s death, and the list could go on.  As EMS providers, Firefighters, Emergency Managers, the expectation is that we can deal with stress, that we know how. But do we really?

I’m putting together a new program for my office that focuses on Health and Safety for responders and in doing so am trying to figure out what the focus needs to be. We are looking at physical and mental well-being, as well as overall incident scene safety. One of the biggest issues is figuring out how to teach maintaining mental well-being.  We are GREAT at recognizing individuals who are having PTSD symptoms.  We have plans in place in many areas on how to offer help to those individuals.  But, why do we wait until they have already been impacted to offer help? Why aren’t we preparing them for the field first, then offering help IF something happens (not WHEN)?  Why do the basic training courses only skim over the emotional impact of the calls we run?  We’ve got to start being more proactive instead of reactive, even though it’s what we are used to. One of the ways to do this is to offer resliency training.

Resilience is an individual’s ability to adapt well and recover quickly after enduring stressful, life-changing situations. It provides mechanisms to allow an individual to deal with the incident AS it occurs, not after. Most resliency training provides training on building four types of resiliency:

  • Cognitive — preserving attention, memory, judgment and problem-solving skills.
  • Physical — maintaining well-being through regular exercise, a healthy diet and restful sleep.
  • Emotional — approaching life with a realistic, balanced and flexible disposition and addressing rather than avoiding problems.
  • Spiritual — practicing and keeping in mind the concepts of forgiveness, acceptance, compassion, true meaning and purpose.

I once asked “Why can’t we add reslience training to basic EMT courses, Fire Courses, or even agency orientation?” The answers I got focused mostly on money and time. Really? Consider the time and money spent providing assistance to the provider who ends up suffering from PTSD and maybe it will seem like a much better investment.

Providing this type of training will build stronger providers, develop a better relationship with the provider, and hopefully allow individuals to stay in the system longer.  We are so great at getting the community ready for a big event or emergency, why aren’t we doing more of that for our own?

Not exactly something to be proud of…

September 15, 2011 § Leave a comment

So, a bit ago I posted about the impact of Hurricane Irene and some of the issues that arose during response to the impacts (https://stickysidedown.wordpress.com/2011/09/05/an-emergency-managers-dream-come-true/). I wanted to take tonight to look at the issue of work/rest cycles and talk about what can be done.

While dealing with issues associated with Hurricane Irene, I spoke with an individual in one of the affected jurisdictions. In the initial “hi, how are ya’s”, he mentioned that he had been at work since the previous Wednesday (it was now the following tuesday…six days later). Another individual from the same jurisdiction mentioned that he had worked 90 hours straight.  Honest to god, when I heard this I wanted to reach through the phone, grab each of them by their shoulders, and shake them while screaming “THIS IS NOT SOMETHING TO BE PROUD OF”. WHile I understand that there are times where we definitely don’t get the break we need to get back to 100%, the work cycles described by these individuals is not something I will EVER be okay with.

When we think of rehab, we often think of the house fire, long-term extrication, or even mass casualty incident (MCI) that initiates a need to provide food, drink, and rest to the firefighters for only a short period of time. We don’t think about the fact that we may need to give firefighters a restful night’s sleep before expecting them to return to duty.  Studies have been done regarding the impacts of the 24/7 cycle and the ability to cognitively and physically function. I don’t think you have to read the study to know that the less sleep you have, the more erractic and impaired your decisions become. In fact, an article I found at http://www.emsworld.com/print/EMS-World/Seeking-Shift-Work-Solutions/1$16575 cites a study that finds that a person who functions without sleep for 24 hours works at the impairment level of someone with a .10% BAC!

In the situation I presented at the start of this post, the defense could easily be, “Well, we let them sleep for X-hours””. I’d argue that it wasn’t beneficial at all. Why? Because the rest area offered to these individuals is not only in an environment that has no electricity/air conditioning/water (and therefore, comfort), but is the same place as the work environment. There is a need to separate the EMS provider from the station, even if just for 6 hours, to allow them to get a true physical and mental break from the activities of the job.

How do we solve this? We preplan. We recognize that we don’t have the appropriate staffing levels or personnel and we start early in the process to request assistance. In events such as the hurricane, we are lucky because we have forewarning. We KNOW that hte potential exists that our area will be hit.  Begin the mutual aid request process. Look to neighboring jurisdictions/agencies within your state and get the help there early. You also need to recognize your limits. At what point are you just going to have to say “We can’t do that”?  It’s a hard concept, because you have to be able to answer to the questions that will undoubtedly be asked. But I personally believe it’s easier to answer to the bosses, then to the opposing atorney when you are being questioned on the witness stand.

Does your agency have a workplan for the long term event? Are you guarateed (by contract, by SOP, by whatever) the ability to have a specific length break when working 24/7?  Any thoughts?

Also, check me out on twitter – @stickysidedwn.

Stay safe!

Today We Are One

September 11, 2011 § 1 Comment

Unless you’ve been hiding under a rock, you are well aware that today is the 10th Anniversary of that fateful day in September that our world was changed forever.

I remember that day well, much like those who were alive when JFK was assissinated or when Pearl Harbor was attacked.  I remember things I said that day, where I was, how I felt. I remember the time I spent at the Pentagon. The people I talked to, the smells, the fears, the emotions.  I remember looking at the downed light poles along the path that airplane took as it approached the wall of the Pentagon.  These are things I’ll never forget. Not just on the anniversary, but every day.  Because it’s my job. As an emergency manager, much of what I do has been impacted by what happened on 9/11/01.

Today I was honored to participate in a 9/11 Memorial Stair climb. I, along with hundreds of other fire and EMS providers throughout Virginia (and other states) converged on the Suntrust building in Downtown Richmond to climb the stairs 5 times, representing 110 floors, the height of the twin towers. Each of us worse a tag with a picture and name of a firefighter who perished that day. At the completion of the climb, we rang the bell, calling out the name of those we were walking for.  I can only say that it was an amazingly humbling experience. Some guys walked in full gear, others (like myself) chose street/workout clothes. Regardless of what we wore, we were all there for the same purpose. To show that we will never forget.  The emotions of the day were high and if you ever get a chance to attend the event DO IT!  Even more so, if ever given a chance to climb, DO IT!  I was proud to do the walk with my husband and brother in law, as well as many other friends.   Here are some pictures from the event.

The Procession In. With Amazing Grace on the bagpipes playing.

My husband ringing the bell in honor of David Halderman, Squad 18

My brother-in-law ringing in honor of Firefighter Thomas J. Foley

I was honored to climb and ring the bell for Firefighter Matthew D. Garvey, Squad 1, USMC.

Whatever you did today, I hope you did it with the almost 3,000 people who lost their lives 10 years ago on your mind and in your heart.

An Emergency Manager’s dream come true…

September 5, 2011 § 1 Comment

…Always seems to be John Q. Public’s nightmare.  This has been one crazy and hectic 10 days in my area. On August 23, a 5. 8 earthquake occurred just outside of Mineral, Virginia. The damage was signficant in the immediate area, and the shaking felt from Canada to Georgia, Ohio to New York.  We continue to experience aftershocks. The funny part is that people were shocked that Virginia would have an earthquake.  Guess they forget the fault line in that area, that has caused earthquakes previously.  Four days after the initial earthquake, as people are beginning to feel a bit more comfortable, Hurricane Irene made landfall in North Carolina and worked her way up the entire East Coast, leaving behind devastation, damage, and despair.

I found myself without power for five days, and a portion of people in my area are still waiting to get their power back. For days before the storm the weather forecasters couldn’t agree on which way the storm was going to go and while it wasn’t as strong as anticipated, it took direct aim at the Outer Banks. Oddly enough, the most signficant damage in Virginia was not on the coast, but in a county just 10 minutes from my own front door.

After taking stock of the impact to my property (a few trees and two power lines), I was able to work with the State EOC and ensure other localities had the resources necessary to begin the recovery phase. Thankfully, now 8 days from the initial impact, we are down to less than 10,000 customers without power, all shelters closed, most EOCs closed, and most of our EMS agencies are back to running under normal operations. A few things have stood out over the past week though, that I want to mention here, and will probably hit on some a bit more in depth in later posts.  Feel free to add your two cents:

1.  The irony of having Hurricane Preparedness Month in September is that we are getting hurricanes earlier and earlier, which means by the time people are reminded of what to do to be prepared, it’s probably already too late. With hurricane season extending well outside the June to November timeframe, maybe we as EMS providers/Emergency Managers need to put a bigger focus on making sure people consider the threat of catastrophic weather events all year round

2.  While I understand that disaster response can impact your regular shift cycles, work/rest cycles are still a MAJOR consideration, especially considering the fact that work conditions are even worse than normal daily operations. Working your crews for days at a time without a break from the station, or bringing in OT guys and letting them sleep through the night while other crews bust their ass, is NOT a smart decision.

3.  Prepare your own families for the impact of the storms. Just as much as we want the citizens to be prepared, we should ensure our families are prepared. If you have a generator or additional power source, make sure they know how to use it. Make sure any medical, nutritional, and even emotional needs are handled so that you can focus on the incident and not worry TOO much about what is happening at home.

Here are a few pictures of the devastation in my state:

Until next time!

Incident Command Training for EMS

September 3, 2011 § Leave a comment

When I started in EMS 15 years ago, it seemed as though training (outside of patient care courses) were geared specifically to the firefighter. Scenarios were written around personnel arriving on the fire truck. I took my first ICS training long before NIMS came into the picture and felt lost. At that point I was an EMS purist. I only rode of the ambulance, and while I understood the basic functions of the fire service (wet stuff on red stuff…ha ha ha), I certainly didn’t know enough to work exercises that put me in charge of a fire incident.  I felt lost.

Fast forward a few years. Through my job I was introduced to Mass Casualty Incident Management training. Now, here was an incident whose main goal was the treatment and transport of patients. That was more like it! Initial courses unfortunately still placed the EMS provider specifically in the EMS role and didn’t allow them much flexibility outside of the patient care positions. As the MCI courses have been rewritten in my state, we’ve been able to ensure that EMS providers have scenarios that fit their knowledge and their roles, but ensures they can “flex” their knowledge outside of the patient care roles (i.e. serving as Incident Command, Operations, Staging, etc). This provides a much more realistic view in the training realm. So, the training is there, but what about publications that can be used as reference material? Because we all know that we don’t remember everything after we leave a class.

Over a year ago I was offered the opportunity to begin the process of writing a book for Pennwell Publishing. The book, titles Incident Management for EMS, focuses on the EMS roles in the ICS structure.  While it brings in the expectations of the basics (since everyone should be ready to serve as the Incident Commander), the focus is on the roles the EMS provider may fill.  The book also covers various types of incidents from single unit response to mass casualty to disaster.  Information on preplanning are also covered.  Here’s a link to information on the book, and if you are interested, it is in presale, with a hopeful release this fall (fingers crossed); http://www.pennwellbooks.com/inmaforems.html.

Thanks for letting me do a little self promotion. I’ll be back with a post this week on Hurricane Irene!

 

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