BUILDING RESILIENCY IN THE FIRE/EMS SERVICE Scott A Robinson
W
hen I joined the fire service in 1995, I never imagined I would spend so much time advocating about resiliency in the fire service. In 2003, while assigned to the back step of Engine 4 for the City of Cranston, Rhode Island, we responded as a mutual aid company to the Station Night Club fire in West Warwick, Rhode Island where we assisted the Town of West Warwick in fighting the fire from around 11:30 p.m. until about 2:00-3:00 a.m. and then assisted with body recovery until after 7:00 a.m.. Afterwards, we were placed back in service and returned to our city for our reliefs. The tragedy of that fire yielded 100 fire fatalities and about 300 injuries. Little did I know the experience would affect me for years to come as well. Today, the word “resiliency” holds a much different definition for me than if I had been asked for the definition in 2003. In 2003, I would probably have said simply, “Resiliency means to withstand adversity.” Knowing what I know now though, I can safely say that that simple definition is a bit inadequate. The American Psychological Association (APA) defines resiliency as the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress — such as familial and/or relationship
problems, serious health problems, or workplace and financial stressors. Today, I would define resiliency as a process. Resiliency is one’s ability to face overwhelming stress, find a way to overcome that stress, and then thrive after having had the experience.
Seventy billion of that cost was spent on depression treatment alone. (APA, Lea Winerman March 2017, Vol 48, No. 3). The numbers have surely increased since then. Stress reactions are normal physiological responses and are our body’s way of maintaining homeostasis in the presence of a “threat”. When we respond to a stressor, our bodies trigger a cascade of stress hormones that produce well-orchestrated physiological changes. Our heart pounds, our breathing quickens, our muscles tense, and beads of sweat appear. Sometimes, we even experience nausea and vomit, as a reaction to the neurochemicals that are released into our system.
at increased risk for many health problems, including:
• Heart disease, heart attack, high blood pressure, and stroke (the number one killer of firefighters)
• Anxiety • Depression • Digestive problems • Headaches • Muscle tension and pain • Sleep problems • Weight gain • Memory and concentration impairment
Today, the word “resiliency” holds a much different definition for me than if I had been asked for the definition in 2003. In 2003, I would probably have said simply, “Resiliency means to withstand adversity.” Knowing what I know now though, I can safely say that that simple definition is a bit inadequate. In order to understand why resiliency is important, first, we have to understand what stress is and how it affects us. Stress is a non-specific physiological response that occurs in our bodies from either a real or perceived threat, challenge, or change. Imagine, 75% to 90% of all visits to physicians are stress-related (The Effects of Stress on Your Body, 2021) and in the U.S. alone we spent $187.8 billion on mental health conditions and substance use disorders in 2013.
These physiological responses happen to avert stress or protect our lives from the stress at hand; however, when stressors are always present and one is constantly exposed to stressful situations, like when the bell or tones go off for the next run, that fight-orflight reaction stays turned on. The long-term activation of the stress response system and the overexposure to cortisol and other stress hormones that follow can disrupt almost all the body’s processes. This long-term activation puts individuals
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(https://www.mayoclinic.org/ healthy-lifestyle/stress-management/ in-depth/stress/art-20046037) The mantra I heard while “growing up” in the fire service was: If it’s not broke, don’t fix it. Obviously, this advice was not related to unseen behavioral health issues but was formulated on the premise that if you were managing through something, you would be fine. That is not the case, however. Eventually, things that cause stress may, and often do, become unmanageable and when an individual lacks the skills necessary to handle that overwhelming stress, that person suffers. Of course, it’s not only the individual that needs coping skills but our organizations do also as well. When our organizations do not embrace developing and practicing skills that make our workforce resilient, we suffer. This is why, not only is individual resiliency important, but also building organizational resiliency is paramount. Unfortunately, there are not many studies on resiliency and coping strategies within the first responder community, but there are several studies that have been done within the nursing and physician workforce from which the first responder community can learn. For instance, inside the health care field, several common characteristics or traits contributing to resiliency have been identified within those workforces. A study that included 1554 nurses from around the Pacific rim found that regardless of culture, there were four characteristics most utilized for the purpose of healthy coping skills that contributed to WWW.CAROLINAFIREJOURNAL.COM
