By: LeRoy Harbach
We spend a great deal of time (or should) attending training, then cleaning, organizing, packing and preparing equipment to ensure it is in top notch operational condition for the next call out. We follow the manufacturer’s recommended procedures for inspection, maintenance, cleaning, storage and usage. We want to be the very best we can be.
But what if there is a piece of gear or equipment that doesn’t come with operator instructions or user guide? What if there are no maintenance instructions, or field repairs available?
As emergency response personnel paid, part paid or volunteer we are often exposed to people at their absolute worst. Witnessing the results of accidents and tending to the injured, often in some of the most remote and/or inhospitable environments take their toll on responders. Some of the toll is physical due to the incident location, time of day or night, or difficult access. Every time however, there is an emotional toll paid. Every response to emergency situations, solving the problem, then returning to quarters taxes the brain and problem solving abilities of the personnel involved.
Some incidents are easily resolved by what I call the “5 minute fix”. You know the ones, arrive on scene – deploy a quick access line for medical personnel for a car over an embankment for triage and to initiate treatment. Meanwhile, the rest of the crew sets up the main and belay, collects the remainder of the EMS supplies required, pack it in the litter and lower the rest of the over-the- side team. Then package the patient(s) and raise them back to the roadway or trail for transport or carry out. Straightforward. Generally speaking, easy.
Others are much more involved and require a significant commitment of time, personnel and equipment. Remote access, inhospitable weather or geographical conditions, occasionally even finding the patient are problematic challenges. Additional effort requires additional energy (both mental and physical), and an additional emotional investment into what we hope is a successful outcome.
All too often we have the tendency to overlook the rescue team as a part of the problem. Not as a problem to be solved but as an overall portion of the problem that needs to be addressed.
What about the rescuers – we are all highly trained, empathetic, emotionally invested and want to help make it better for the victims and/ or their family members. Oftentimes the additional emotional investment provides extra motivation that enhances physical performance. Face it, we all kind of like that adrenaline rush when the call goes out for assistance; an opportunity to put to use all the hours of training and all the shiny toys we play with (or should be) on a regular basis. When the operation is successful, the feeling of a job well done cannot be explained it has to be experienced in order to understand. On the other hand, when the operation is unsuccessful, or has a negative outcome (many times prior to our arrival on the scene) what steps do you or your organization take to make sure your most precious resource – your people – are “properly packaged, prepared and ready” for the next response?
I still vividly recall the first emergency response I was ever involved with well over 30 years ago. I remember the weather (spring day, sunny and warm), the location (two lane road with a speed limit of 45 mph – I looked at the sign), the bystanders and other people (especially the victim’s mother screaming at me to “do something”). Last but certainly not least, I remember the blond haired, blue eyed 6 year old boy that had ridden his bike into traffic. He was struck by a vehicle travelling at approximately 50 mph. I remember his agonal respirations, the intermittent pulse, and when we did move him to fully stabilize him, the feeling in my hands similar to that of picking up a beanbag. He succumbed to his traumatic injuries enroute to the hospital. Not a great way to begin an emergency services career. It was a very quiet ride back to the station, none of us had much to say. When we finally got back to the station the Chief met us and asked about the call. The officer on the rig filled him in on the call and the outcome, as well as the absolute silence on the return from the hospital. The Chief looked at me and said, quote “well kid that’s our job, if you don’t like it, quit”, and walked away. (A kinder more benevolent individual would be virtually impossible to find).
The fact of the matter is this, if you were to ask me today about the successful rescues over the course of my career, I would be hard pressed to say that more than a small handful are remembered with any clarity. If you ask me how many were screwed up or didn’t go well, I can almost recite chapter and verse of what, why and how I could have improved. I could expound on how the potential existed to change the outcome for the better if only we had… if only I had…
So where does this all lead? One of the best, and in my opinion underutilized tools, is Critical Incident Stress Debriefing (CISD). It wasn’t until much later in my career that the thought of talking about a call or “confronting our feelings” after an incident may prove beneficial. Sure, after the signs of Post-Traumatic Stress Disorder (PTSD) start to show themselves we generally (hopefully) recognize there is a problem with either ourselves or a co-worker and that individual (or individuals as the case may be) is/are referred for counselling or professional assistance. CISD actually happens as quickly after the call as possible when all the players can be brought together, and is generally facilitated by a peer or peers from a neighboring agency. An outsider if you will – similar background and experience – but outside the responding organization. It is an opportunity for those involved to speak in a non-judicial format and speak freely about the incident, things that went right or wrong. (I referred to it as Festivus – the airing of the grievances – but we typically skipped the feats of strength). Overall, it gave the responders an opportunity to diffuse some, if not most of the negative feelings, gave them an opportunity to know that others felt the same way and were dealing with the same feelings and issues as they were. To be brutally honest, I hated them. I was generally dragged kicking and screaming like a school kid on the way to the principal’s office. I also learned to appreciate them a great deal and they made a difference in the way I looked at various calls over the years. Did it solve all of the problems over the years? No. But it did help clarify the thoughts and processes to deal with the issues.
In emergency services we have a very dark sense of humor which is necessary to deal with the horrendous things we see and experience over the course of a career. Man’s inhumanity to man, the force of physics in action, etc. The most important thing we can do is to look after one another. Our co-workers, team members and associated emergency responders are the people that have our back and provide the support we need in order to function “normally”. It is our obligation to support them as well. We need to make sure they are “packaged, prepared and ready” for the next response, just like the lifesaving equipment we use on a regular basis.
“You have not lived today until you have done something for someone who can never repay you” – John Bunyan
About LeRoy Harbach
Senior Instructor in professional service since 1981 (retired) with CMC Rescue since 1999.
Firefighter, City of Waukesha (WI) Fire Department
Member, City of Waukesha (WI) Special Services Team
Battalion Chief / Training Officer, Caledonia (WI) Fire Department
Member, United States Air Force Reserve C-130 Aircrew