They’re supposed to be made of tougher stuff than the rest of us.
They’re the ones that rush headlong into burning buildings, face down masked villains, bring the dying back to life.
But emergency responders, be they firefighters, police officers or emergency medical service personnel, aren’t immune to the stresses wrought by their jobs. When the trauma is too much for them to bear, who helps the helpers?
“Over the years, you build up the tough skin, if you’ve been doing it long enough,” said Cicero Fire Department Chief Jon Barrett. “But there are still cases that bother you.”
For Barrett, that case is a 2009 car accident that claimed the life of a small boy and injured another.
“We responded to a call at Whiting and South Bay where a mom got into a crash with her kids in the car, and it came out after that she was under the influence of cocaine,” Barrett recalled. “That one, out of all the calls I’ve been on, and a lot of them have been serious, that was the hardest. The little boy was 6, and at the time my daughter was about the same age. She’s 12 now. I was one of the first on the scene — I was one of the assistant chiefs at the time — and we just did a scoop-and-go. We knew the seriousness of the injuries and we just had to get him to the ER. We rode up to the hospital after and that’s when they pronounced [him dead].”
Barrett said all calls involving kids are particularly trying.
“It’s hardest with children. I think that’s true for all responders with kids, in my experience,” said Barrett, a 20-year CFD veteran who had previously worked at Rural/Metro Ambulance Service. “The kids are always the hardest, whether it’s a 2-year-old or an 8-year-old. Anyone under 20, I think. It’s a little different if it’s a 90-year-old or a 70-year-old who’s lived his life to the fullest.”
Something like the accident Barrett described would be classified as a critical incident, according to Marley Barduhn, clinical director for critical incident stress management for Rural/Metro.
“A critical incident is something that’s out of the ordinary for an [emergency responder], something that maybe involves the death of a child. It can involve someone who is known to the provider, a family member or a friend. It can be a mass casualty incident, a disaster situation or a multi-car pileup,” Barduhn said. “A critical incident is something above and beyond the normal set of calls people generally go on.”
Both Rural/Metro and Onondaga County have a critical incident stress debriefing (CISD) management team, which includes trained professionals who work with emergency responders after a particularly bad call or event to manage stress. Onondaga County’s program is headed up by the Emergency Management Office.The team utilizes a three-part process involving defusing, debriefing and follow-up. Defusing, which happens immediately after the incident, is designed to bring together those directly involved in the incident and assure them that their feelings are normal, to alert them to any symptoms to watch for over the coming days and to offer them support and address immediate needs. The debriefing is done within 72 hours and gives the individual or group the opportunity to talk about their experience, how it has affected them, brainstorm coping mechanisms, identify individuals at risk, and inform the individual or group about services available to them in their community. Follow-up is done in the following days and weeks to see how the individuals involved are dealing with the incident.
“We’re very fortunate to have the county crisis management team here,” Barrett said. “Some counties don’t have a team in place. We’re fortunate to be the frontrunners with that program.”
He himself benefited from the CISD management team after the Whiting Road accident.
“That call bothered me for days,” he said. “You sit with the team, and your mind is going a mile a minute. Did we do something wrong? The emotional stress wears on your body. You’re not sleeping. You’re not eating.”
But he debriefing with the team helped ease the stress.
“We went back to the firehouse, everyone involved in the call, and did the debriefing. It helps to talk about it,” Barrett said. “It put it in perspective to talk to my crew members and the crisis team.”
Barduhn said Rural/Metro employs a similar process, which was introduced after the shooting of Syracuse Police Officer Wallie Howard in 1990. She said such intervention is critical in order to avoid post-traumatic stress disorder and other catastrophic stress responses in emergency responders.
“Without any sort of intervention, the incidence [of post-traumatic stress disorder] is higher. You have to have some sort of plan in place and to act on whatever your policies and procedures are,” Barduhn said. “If you don’t have a plan and you’re just winging it, that’s very dangerous. If you have a plan and procedures in place and you have people that are known to your workers, the incidence [of traumatic response] is very low, and there are good research studies to back that up.”
While the Onondaga County Sheriff’s Department doesn’t utilize the CISD team, it does have its own plan in place. According to Deputy Herb Wiggins, public information officer for the department, officers can turn to Department Chaplain Denny Hayes in the event of a critical incident. Hayes is not only a religious figure, but he also has psychological training in order to aid officers in trying times.
“Father Hayes is also there to assist. He’s the man for that. He’ll determine if he believes that officer is fit to return to duty, if he has the support he needs from his family and the other officers in the department,” Wiggins said. “He follows up with the members and helps them to cope with whatever it is that the incident might have caused.”
In addition, Wiggins said the department enlists the support of the officer’s family to ensure that he or she is getting the necessary support.
“We also speak with the member’s significant other, if appropriate and desired, to help the family members of the individual realize what the officer is going through and what they can do to be supportive of them during the crisis,” he said.
As is the case with all emergency responders, helping an officer recover from a traumatic incident is not just a matter of their own personal health, Wiggins said, but also a matter of public safety.
“It’s important for the well-being of the officers, that they’re fit for duty and not too overwhelmed, as well as the ability of the department to provide the best service to the community that we can,” he said.
That’s why it’s so important to have entities like the CISD management team, said Barrett, who pointed out that other counties and smaller agencies don’t have access to the same resources, often to the detriment of their emergency responders.
“We’re fortunate to have the right people,” Barrett said. “Smaller agencies don’t have the right person there. They take it to work and it filters out, and that’s a bad thing.”
