Raising Awareness

Raising Awareness

Charles Clampett

One of my passions for the past 15 years has been helping to raise the awareness of my peers with regard to critical incident stress (CIS): the causes, symptoms, and healthy mitigation techniques. I have dealt with the effects of CIS several times in my career and have luckily been able to eventually overcome it. As a peer support specialist, I have helped many of my brothers and sisters in emergency services deal with their stress over the years.

Many misconceptions exist with regard to CIS. Some of these include the misguided notions that can be summed up by unsympathetic statements such as, “Well, if you can’t take the heat, get out of the kitchen” or “If you can’t handle the stress, perhaps you should consider a career change!” This from professionals where empathy and compassion are supposed to go hand in hand with our stethoscopes and trauma shears. Fortunately, with returning veterans bravely being more outspoken with regard to their struggle with post-traumatic stress, some of the perceived stigma surrounding CIS has also dissipated.

I am a field paramedic of 25 years and now an emergency dispatcher, and believe it or not, the stresses are very, very similar. Being in dispatch doesn’t diminish the stress that we can feel dealing with a critical patient or agitated family member on the telephone.

One of my recent shifts in my emergency dispatch center highlighted this and began with a call from a frantic father who woke up and found his three-week-old son in cardiac arrest. The baby had been sleeping in the bed with his mom, and she had rolled over onto him at some point, suffocating him. Unfortunately, the child was pronounced dead at the scene. Frustration with the caller (who was having issues giving a clear address) coupled with it being a critical pediatric call and the impressively tragic circumstances, culminated in a significant level of critical incident stress.

My day went downhill from there. From that point forward, it was a seemingly unending parade of difficult-to-understand callers, people who couldn’t tell me where they were located, frantic people panicking on the phone, bad phone connections … all combined into a perfect storm of frustration. Soon, feelings of being that “first, first responder” began to evaporate and give way to feelings of irritation and anxiety.

I noticed throughout the day that my usual calm demeanor had cracked and given way to becoming easily frustrated with minor issues. I kept making simple mistakes. When it would get quiet for a few minutes, my mind kept going back to that call or another and the frustration that I had felt. This was culminating in actual stress and anxiety every time the 911 line would ring. Luckily, I recognized my stress and took steps to combat it.

In the short term, I simply took a break! I got up and walked around. I went into the crew room and enjoyed some time with some of the crew members. You could go outside and get some fresh air or go grab a cup of coffee and take a break. Take a few minutes to play a game on your phone or find a quiet place, put on some relaxing music, close your eyes, and think about being in the mountains or on the beach somewhere. If you are really bothered, talk to a close co-worker or supervisor. As peers, we need to be vigilant and be good listeners, especially if a co-worker comes to us stressed or in crisis.

Understand that if you or a colleague experience CIS, you are having a NORMAL reaction to an ABNORMAL situation. Take some time to do those things that make life worth living and relax. It is just as important, in taking care of others, that we take care of ourselves.

Charles Alan Clampett is a paramedic and emergency dispatcher with American Medical Response, Jackson, Mississippi (USA), and a volunteer firefighter with the McLain Volunteer Fire Department, McLain, Mississippi. He was supervisor for the 911 service in Jackson County, Mississippi, when Hurricane Katrina hit and part of the FEMA response team responding to the aftermath of Hurricane Michael.

Gear Up

Gear Up

Kevin Pagenkop, ENP

For those with a medical background, one of the first acronyms learned is “PPE.” Whether gloves, a gown, or eye protection, Personal Protective Equipment is vital for responders and clinicians to reduce their exposure to pathogens and potential hazards. The use of PPE is one of the primary steps taught, and evaluated, during initial certification training assessments as well as all continuing education. It is built so strongly into the culture of EMS that the use of PPE becomes routine and second nature. As emergency dispatchers, what should be built into our culture with the hope that it becomes second nature?

Think back to when you were first hired. The training was probably a blur of industry jargon; geography; CAD, radio, and phone training; as well a phonebook-sized stack of procedures and policies that had to be committed to memory. At some point, you were told that you would receive feedback on your performance through quality assurance (QA) case review and that you were required to accrue continuing dispatch education (CDE) hours. After enduring your marathon of training, where did the topics of QA and CDE get prioritized in your daily responsibilities? Sadly, QA is often dreaded, and CDE is only thought of as our certifications get ready to expire.

The value of continuing education is that it is continuing. Athletes aren’t going to stay in shape or build muscle if they only go to the gym once every two years. Would you want paramedics providing treatment to you or a family member if their only efforts to develop their skills were the bare minimum requirements to remain employed? As certified emergency dispatchers, don’t we too need to value the importance of improving our skills and increasing our ability to provide higher quality service—to both our responders as well as the public? Expecting someone else to provide this for us is not the most effective means of mastering the responsibilities of our job.

We need to change our culture, from day one during initial training, to highlight the value and importance of self-improvement. Personal development. Proactive training. Proactive Personal Education. The emergency dispatcher’s “PPE.”

If only the bare minimum of CDE is completed, are we prepared to take the call from the mother with an unresponsive baby, the caller trapped in her house that is on fire, or the person reporting that he is in imminent danger of being assaulted? If our understanding of QI tells us it’s the supervisor’s job to prompt us to review QA, or that it is our trainer’s job to direct us to review emergency protocols, then we’re learning by trial and error—and often on live calls. This creates needless stress and frustration as we stumble our way through high-acuity and high-emotion calls. At our worst, this increases the probability for poor incident outcomes and potential litigation. The emergency dispatcher’s version of PPE protects telecommunicators from potential hazards and dispatch danger zones by preparing us, ahead of time, to competently and confidently handle difficult or infrequent calls (like the PAI, ECHO, and CID cases referenced above).

Take the initiative to improve your skills. Take an active role in your own development. Be proactive. Here are some ways to develop your own PPE.

Proactive Personal Education can reduce stress, compassion fatigue, and fear as we focus on building our abilities and confidence—continually—like athletes building their bodies one gym visit at a time. Just like an EMT shouldn’t need to be told to put on gloves at the scene, emergency telecommunicators should apply their PPE, routinely, as a daily component of learning, growing, and mastering their role in providing emergency service.

Op-ed: Why first responders need a dedicated communications network

Op-ed: Why first responders need a dedicated communications network

By Claude Cummings – Guest contributor

As one of the most devastating storms to ever hit Texas, Hurricane Harvey taught us many lessons. One of the clearest is that we need to equip Houston’s first responders and public servants with the strongest communications platform available — and now we can.

First responders are the brave men and women who worked around the clock before, during and after Harvey made landfall, making quick decisions to keep our families safe and our city running. Since the storm was so severe, public employees were also tasked with performing critical support functions so first responders could effectively coordinate recovery efforts and relay emergency updates.

This op-ed article appears in bizjournals.com dated June 21,2019.

To read the full article please click on the button below.

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Why Train?

Why Train?

Heidi DiGennaro

When you started, everything was overwhelming. There was fear or excitement in touching the equipment, the constant dread you might break something, and the encouragement to go ahead from your trainer. Training seemed to take so long, and there was something both terrifying and liberating about operating on your own. Now you have a few months, years, maybe a decade or two (gulp!) of experience and everything has changed and some parts remain the same.

Technology moved forward, and in some cases, outpaced our ability to keep up with it. Forward momentum with technology has created challenges and caused us to adapt to keep up. The work—talking to the public and the field providers and ranting at the console when your foot comes off the pedal—has stayed the same. So why train and why train constantly?

Policies and procedures

If you do not have a strong foundation of what to do, policies are meaningless. They are words on a paper or screen if you do not find a way to apply them. It’s not the time to look up an active assailant procedure during an active assailant incident. The same goes for an MCI when heat exposure or a multi-vehicle accident occurs. It’s not good management to quarterback people about how they handled an incident and remind them about the policy they haven’t looked at since it went into effect.

Build confidence

Spend five minutes reading a policy or highlighting a procedure on the off chance you might need it. Mortar the gaps and cracks in your knowledge to create a stable base to lean on when the worst happens. Supervisors need to lead and to lead by example, knowing your procedures and policies. Use any roll call time to go over something, anything, every day.

Public safety

You never know what will happen, and refreshing yourself makes you smart and promotable, if that’s your intent. Training classes teach you what the agency/department does, and it saves you the embarrassment of fumbling for words when someone asks about a certain policy and whether you even have one. Knowing policies and following them during crisis is your best defense when someone outside your organization starts tearing apart your actions.

Liability

When you follow policy, your agency should defend your actions.

I’ve seen a few things in my 24-year public safety career, from police dispatcher, to calltaker, to backup fire dispatcher, to supervisor, to shift manager, with several other specialties in between. I have met people who know the policies, know exactly what to do, and how to do it when the equation Chaos + Oscillation Device + the Smelly Spread presents itself. Training saw me through the worst incidents. I use our roll call time to review, to train, and to amuse.

It’s simple—start now

Pick something to go over and search the internet for an image that matches your training topic. Word of caution: Tell your supervisors so they know your internet history will be a little “interesting.” Make learning humorous—there is always a “fail” out there on any topic. One minute, five minutes, 20 minutes—the time is never wasted. Even if one person remembers what you went over during a critical moment, everyone succeeds. An incident does not turn into a cluster. Someone survives because you and your people knew what to do.

That’s why we train.

Vision to Reality

Vision to Reality

Andre V. Jones

“KSU SR42, 18J, Lot D, looking for a white Honda Civic, 1805 hours KNHD245” was the start of my career in public safety telecommunications (at Kennesaw State University [KSU], Department of Public Safety & University Police, Kennesaw, Georgia, USA). It was not, however, the career I initially chose. I started off wanting to be a doctor. More specifically, an OB/GYN. My logic was that people would always have babies (job security).

While at Kennesaw State University, I would listen to the city and county radio and dream about being as awesome and professional as those I observed. I would go home, and I would pretend I was 911 dispatcher, handling and dispatching the WORST events. Make no mistake, this was not child’s play. I had maps, manuals, everything! This was very detail-oriented and well-organized role-playing.

As it were, I would go down another path of “job security” related to emergency services and emergency management, on-boarding with Marietta E-9-1-1 (Marietta, Georgia) and later consolidating with Cobb Department of Public Safety 9-1-1/Communications Bureau (Marietta, Georgia). When I got behind the console, tragedy did not faze me because I had already dispatched every emergency there was. I had accepted that the caller’s crisis was not my crisis, and I was there to help them, not become part of their experience.

These abilities I attribute to my dream, one that manifested itself with the act of “pretending,” which I was quite good at. In doing so, I learned dedication, reliability, integrity, and objectivity as well as empathy, kindness, and discipline. For me, I learned how to see the world as it should be and to treat people within the world as they would want to be treated. I saw, I felt, I dreamt, and I appreciated and valued my version of the “land of make believe” where I could create the experiences. It was then that I committed to the profession with a vision to become the best communication center manager I could be. Part of my professional development plan included goals in higher education where I earned several degrees as well as aspirations of presenting at conferences.

The one thing I did not consider in this venture when I stepped up to be a supervisor is that I had to be people-oriented. Though I may have become a charismatic person, I realized that I couldn’t make anyone do anything no matter how much I tried to persuade them for the sake of progress. I may have been the “best dispatcher,” but that was not the job description of “supervisor.” Many times I had to step back and learn how to follow regardless of who was leading. THAT was tough.

I learned that you can only control what you can control. In leadership, you must engage, cultivate, and inspire people to get results. You develop a culture that does what needs to be done because there’s a shared sense of purpose and duty to do the right thing right, and not just waiting for someone to give orders. It’s called empowerment: making something organized seem improvised.

So I dreamed. Not whimsical and magical dreams, but optimistic dreams. Then I designed and developed the framework to make these dreams—the visions—become reality. After all, I will still be a doctor, just a Ph.D. instead of an M.D. It is about to be a new year. What do you dream of? Can it be reality?

Route 91 Harvest Music Festival

Route 91 Harvest Music Festival

Charlotte Gentry

I am going to tell my story about that day, the Oct. 1 Shooting, even though in my eyes, that’s not the official name. I can’t bring myself to call it that. I am going to be raw, honest, and open because I think that is what people should hear. It may not be what you want to hear, but it’s what I need for you to know.

I went back to work on Oct. 3 because there were people at my job that would need my help. I was on the peer support team. I was OK. I never cried in those first few months. I didn’t have survivor’s guilt. I joined survivors’ pages and watched people talk about how they couldn’t leave their house. They couldn’t function and were sad all the time.

That wasn’t me (or so I thought). I shared my story more times than I can recall and every time it got easier. I didn’t have post-traumatic stress disorder (PTSD). It felt like it didn’t hit me as hard as I saw it affecting other people. I immediately started going back to concerts and back to my life. I kept busy for months trying to do things for my agency, so they got the recognition that they deserved. I was OK … but I wasn’t. I was just ignoring it. I was ignoring the anxiety, the emptiness I felt inside, and the depression. I would sleep as much as I could. I lost focus at work. I made HUGE mistakes, and hurt people trying to fill that void inside me.

When the shooting started, I was alone. And that is how I felt for almost the whole last year. People at work would tell me they were worried about me because I was different. I didn’t feel any different, but I heard this from multiple people. I lost my smile. I lost my happiness and never noticed. I was always anxious at work. There were so many days that I cried at work and times I just sat and looked at my computer screen. It is hard for people that weren’t there to know how I was feeling and it’s not something you can explain, so I tried to deal with it myself. I went to a trauma counselor and that didn’t really help. I found another counselor that was OK, but I didn’t feel like she was helping so I quit going.

My therapy became getting tattoos. I got six since the shooting and I’m going today to get another one. The pain of the tattoos helped me feel… something, even though it was pain. It took the pain that I didn’t know I had and made it go away for those few hours. Every time I felt anxious, I called my tattoo artist. I now have almost a full sleeve.

I took a lot of Valium during this time. Enough that it would knock most people out. But it didn’t stop the anxiousness and I didn’t tell anyone.

In this business you don’t let things get to you, right? Wrong; they get to us slowly over time and we never admit it. This is what I am doing. I am admitting that I was not OK, and it took me a long time to get there (11 and a half months to be exact). I never thought about hurting myself, but there were so many days that I wished I just didn’t exist. There are some amazing people that I work with, but just like any other center there are those ones that make work hell. They made my last year harder than it had to be.

Being shot at and involved in the worst mass shooting in America’s history wasn’t enough. I had issues at work and outside of work, but I always blamed it on something else. I was diagnosed with PTSD, surprise! I wasn’t OK. Like I mentioned earlier I made some huge mistakes; I hurt people and all I can do is say I am sorry. I can’t go back and change anything. My career isn’t the same. I made mistakes and I felt like the first job I ever loved, some of the coworkers that liked me (not all), abandoned me when I needed them the most. But you live and you learn, and these lessons that all this horrible stuff has taught me will always stay with me.

In the last few months I have started to come out of my depression for the most part. I rarely take Valium. I have started the journey to happiness. There were a couple of times during the last few months when what I had gone through and how much it changed me slapped me in the face. I was standing in the kitchen talking to my 81-year-old mom and she got teary eyed. I asked her what was wrong and she said to me, “I finally have my daughter back. I lost her for the last year.”

I didn’t see it, but now I know and I’ve started changing. I started working out, eating better, and I met my husband. We got married after knowing each other for six weeks. It wasn’t because I needed to have someone around; it’s because we just clicked. We knew from the first few dates that it was right.

They say the one-year anniversary of a traumatic event can be the hardest, and the week leading up to it was hard, but it was healing. I tried to do too many events to help heal. The night of Oct. 1, 2018, survivors made a human chain around the Route 91 venue. It felt like we had to be there at that exact time that the shooting started for the 58 people that lost their lives. We all lost a piece of us that we will never get back. Trauma changes people and you can never go back to who you were before that day. We have a new normal and the new normal isn’t so bad. That night at the human chain, I didn’t feel the closure I thought I would feel, although the hugs from other survivors were amazing. We knew how each other felt.

I visited the Healing Garden on Sept. 30, and looking at the wall with the 58 names on it brought tears to my eyes. My son and mom could have been there looking at my name. I am so glad they didn’t have to go through that. I felt the closure on Sept. 20, 2018, when I got to finish what we started at Route 91 and I got to see Jason Aldean perform. There were about 200 survivors at that concert and it felt right being around people that had been through the same thing I had. When he sang the two songs that he was singing when the shooting happened, I finally let myself cry. That is when I felt the closure. I was a member of a club I never signed up for, but I love my CountryStrong and LoveWins club. I am not OK. And it’s OK to not be OK … but I will be.

Charlotte Gentry Munro is the Quality Improvement Coordinator for Las Vegas Fire and Rescue communications. She is also a Priority Dispatch Software Instructor and a National Q. She was attending the Route 91 Harvest Music festival on Oct. 1, 2017, when a gunman opened fire on the crowd, killing 58 people and injuring hundreds more.