By Howard Cohen

Fire fighting is one of the best jobs around.  It is also one of the most dangerous.  As firefighters we train and prepare to run into burning buildings, mitigate hazardous materials, work car accidents on busy roads, and deal with angry, hostile citizens.  But we tend to not train or prepare for one of the greatest risks to our physical, emotional, and spiritual health:  Frequent exposure to traumatic events. Studies in North America show how over time the stressors associated with exposure to traumatic events pose a serious challenge to our emotional, mental, and spiritual health.  For example, a study of firefighters in the United States revealed that 46% experienced suicide ideation; 19% participated in suicide planning; and 15% attempted suicide.  In addition, studies conducted in other countries[1], including Kenya[2], also show that post-traumatic stress symptoms and illness rates among emergency services workers are significantly higher than in the general population. Firefighters every where face the same physical dangers and traumatic events.  Therefore, as studies show, firefighters worldwide also suffer higher post-traumatic stress symptoms and illness rates than the general population.  Fortunately, we have the tools to help us, and our brothers and sisters in the fire service, address the stressors that arise from encountering traumatic events.

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.  Unfortunately, as first responders we often hide our emotional responses to bad calls behind a mask of toughness. This means that sometimes the impact of a tough call unfolds over time.  This can make it harder for us to recognize a connection between what we experience on a call and its emotional, physical and spiritual effects on us.  It is also important to realize that not everyone’s emotional response to a call will be the same.

Stressful events produce a complex interplay of nervous, endocrine, and immune mechanisms responses.  In other words, our normal way of being is disrupted.  The fight or flight or freeze response is an example of this.  How quickly we regain our homeostasis and return to normal or typical functioning depends on how resilient we are.  Resiliency is our 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 or hours of exercises.  In fact, it is the natural outcome of some very enjoyable and healthy activities.  Here are some ways to build your resilience for when you’ll need it. 

          • Eat healthy food

          • Develop hobbies and interests outside of work

          • Cultivate friendships with those whom you can speak openly and honestly

          • Nurture your spiritual life

          • Practice mindfulness such as yoga or meditation

          • Exercise

          • 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.

There are many signs that we, or someone we know,  may be adversely affected by a traumatic event or an accumulation of unprocessed events.  These signs may include some or all of the following:

        •Fatigue                                            • Grief

    • Chest pains                                                   • Denial    

         • Loss of emotional control                              • Depression

        • Difficulty paying attention                            • Anger

          • Difficult making decisions                     • Change in appetite

          • Nightmares                                                   • Misuse of alcohol or drugs

          • Intrusive images                                            • Anger at God/Crisis of faith

          • Anxiety                                                         • Withdrawing from others

          • Guilt                                                            

When someone you care about is exhibiting some of the above 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 to doing so could be very high.  As you know, a firefighter not performing at peak levels because of stressors is a potential risk to herself or other firefighters.  Hopefully, if we are ever exhibiting signs of not coping with the stressors in our life well or with a particularly bad call one of our friends and colleagues will let us know.  Awareness of these outward signs, whether as the result of self reflection or because it was brought to our attention, is critical.

Developing situational awareness on the fire ground 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 with having the best job in the world.

[1] First Responders and PTSD: A Literature Review By Ashley Fitzpatrick, BSN, RN, EMT -

7.28.2020

[2] Rationale for Early Psychological Intervention Among Disaster Actors in Nairobi County, Kenya by Eunice K. Ndulu & Dr. Maragret Iyaya, Journal of Education and Practice; Vol. 10, No 32, 2019.