We hear it all the time. “He’s just a rookie.” “She’s a rookie and doesn’t know a thing.” “Hey, rookie, go [insert mindless chore here.]” It’s fun and amusing to poke fun at the newbies sometimes – within reason, folks – but what hurts them the most is what we don’t do. We have a police academy and a fire academy. We have basic training for the military. Even EMS has a practical exam process. The one thing we’re missing: mental health training.
The Shock Factor [Trigger warning: sensitive situations]
The new trainees may have thick enough skin for some light hazing (that of course doesn’t take place), but they don’t know what they don’t know. The shock factor is not realized until it happens. They don’t know their first call will take them to a dying old man whose grown up kid is trying CPR on him. They don’t know the first fully involved house fire will result in the death of an entire family. There’s no training for a shrieking mother whose overdosed kid is lying on the floor. The rookies don’t expect to face childhood poverty, rape victims so young, or women so battered they gave up fighting. They don’t know the screams, sights, smells, would burn into their waking dreams.
No one signs up for this. We sign up to help people, to fight fires, bandage wounds, keep people safe. No one signs up for trauma because it’s fun. We sign up for trauma to help people out of it, not to wear the scars of it for the rest of our lives. A common motto is, “We’ll teach you how to pass the test but on the street you’ll learn how it’s actually done.” But even if a new trainee knows there’ll be blood, the shock of the irony smell is hard to prepare for. You can tell a new kid that CPR done right cracks ribs, but nothing prepares a person for the first time they hear and feel those pops.
Drop Outs & More
The after shock causes dropouts, PTSD, and other mental health issues. For some, the initial shock is too much and they may simply leave the job. Some have gone on break and never returned. Some completely throw all their training away and change professions. They simply don’t want to face the reality of the job. Others try to buck up and deal with it, or pretend it doesn’t bother them, but that eventually doesn’t work. Trauma affects everyone. Every. One. This blog page has discussed extensively what happens when we bury trauma.
An older (2015) but on-point article by Steve Whitehead weighs the difference between successful EMS careers and burnout by listing 5 Reasons You Should NOT Become an EMT. He nails the education piece quite well.
“EMT training also isn’t over when class is over. Being a good EMT requires a greater discipline for self-directed learning than most jobs in medicine. Your EMT class will give you the bare minimum of knowledge to help you understand the many injuries and illnesses you’ll encounter. The rest of the learning will be up to you and it never ends. If you’re going to be good, you’ll want to keep learning more than the minimum CE requirements.”
Preparing vs. Reacting
Sure first responders understand how to react to a situation, but they also help educate people to avoid those situations. We learn to prepare our homes to be safe; we label medications and have fire extinguishers. Drivers must be licensed and learn the rules of the road. We’re taught to look both ways, lock our doors, stay safe. We prepare ourselves to avoid injury, but are we preparing our first responders for the trauma they will certainly see?
Christopher Tedeschi for Vox writes that, “Between 11 and 37 percent of first responders experience PTSD, compared to 7 to 10 percent of the general population.” This is something we’re not quiet about at FRC, but since the mission goes on, we’ll say it again. We have got to get proactive!
“The first time I heard Laura McGladrey speak, at a Wilderness Medical Society conference in 2018, she compared psychological stress injury to carbon monoxide poisoning that mountaineers can experience while using stoves in their tents — a preventable condition that tends to show symptoms only when it’s become life-threatening.”
They save skiers and hikers in the wilderness. Here’s how they think about resilience. (2022)
Imagine that, knowing a situation is preventable and letting it happen anyway? We know the mental health dangers, so let’s start preventing their festering and brewing. Let’s catch them small before symptoms become life-threatening!
Equipping Everyone
How do we do that? That’s the big question, right? Well, we don’t just have incoming rookies that need this. We need to start equipping everyone with safe and successful mental health strategies. We need awareness, preventative care, and plans in place for the moments we couldn’t prevent.
Awareness is key and must happen in order to get the rest in place. No administration is going to spend time and money on anything they don’t feel is necessary. Part of FRC’s biggest agenda is smashing the stigma of mental health. If people lose the notion that being mentally injured is shameful or shows weakness, we have a better chance of healing through those moments. We need to make everyone aware of the effects and damages mentally caused by trauma.
Preventative care is next. Just like we learn safety around fire, traffic, the wilderness, or anywhere, we need to prepare our rookies (and our vets) with education and other mechanisms. This way, when trauma happens, and it will, they will be better prepared to recognize it, face it and its aftermath effects, and recover. This is FRC’s biggest challenge and we’re not backing down!
When all plans fail – or were never in place – we need reactive plans. When a first responder, rookie or not, suffers, we need to treat the injury as much as we would treat a broken arm. Healing and recovery is possible, but it takes time. Coaching, therapy, sometimes even medication should not be our only or first plan though. The best way to equip everyone is to be proactive, not reactive to trauma and mental health care. Let’s not set our rookies up for failure. Let’s aptly prepare them for what’s to come and help them to thrive as first responders.