In Part 1of this series we discussed a model Total Wellness Program and some of the benefits it has experienced since its inception. In this part we will discuss the concepts that have been coming up all over the Country and some recommendations you can take for your agency and start working on them right away.
I am sitting at the National EMS Physicians Association conference in New Orleans and have sat in on two separate lectures and a full working group with over 50 members all discussing first responder health and safety and what can they as medical directors do to help our responders. Last week, I attended the Safety and Apparatus Symposium presented by the Fire Department Safety Officers Association, a group who's motto is to improve the health and safety of all first responders. There they discussed several trends including annual physical fitness testing, health and wellness program concepts, department safety cultural challenges, and cancer prevention. At all of these events, along with the NFF meeting that was discussed in Part 1, several themes seemed to resonate across the board regarding safety and health. They are outlined below:
- Make a commitment to invest in the concept of a total wellness program.
- Create a peer support program, where the line staff determines who the peer support team is comprised of.
- Provide your peer support personnel with training on stress management and information on getting further help for members.
- Partner with your surrounding medical community to provide services to employees.
- Work with metal health clinicians who have a solid understanding of what ALL first responders go through. Assure that you provide them with opportunities to learn more about what this life is like.
- Create a culture of safety from the top down and a zero tolerance policy regarding safety violations.
- Establish what must be reported to senior staff and what should remain privileged and make all staff aware of the difference and the line.
- Create support network and communication networks for members families.
- Provide administrative support for the program.
Investing in a total wellness program is beneficial to a department on so many levels, but let’s stick to financial. Every year departments of all shapes and sizes, including volunteer services struggle with staffing due to injuries and leaves. This becomes very expensive and time consuming by back filling spaces, paying overtime, and struggling to find appropriately trained personnel for the open spots. While most departments rely on worker’s compensation to cover the salary and medical expenses of the injured party, there is still a cost to departments for their lost time. Also, when on leave for a personal illness or injury, departments still have to cover for the lost time. On a volunteer department, especially one with already low staffing, this can be devastating. They may be required to request mutual aid from neighboring departments or, in some cases, have to pay for their areas to be covered. Another financial benefit is patient generation. Hospitals, medical providers, and mental health providers want volumes of patients. They are more likely to partner with your department knowing that in the future it will lead to patients coming in their door. Plus, some want to help their community or just think it’s really cool to work with first responders. On a hospital level, imaging, surgeries, and rehabilitative care are all huge money generators and by working closely with a department to streamline their facilities processes to meet the needs of first responders they can create a profitable win-win situation.
When you are creating one of these programs you need to have buy-in from your line personnel. The all to frequent error many departments make is to have a command level officer be in charge of these programs and then select who they want to be the peer support staff. By having the line staff elect/select the people that they want to go to a department instantly builds trust. One of the things many first responders express is that they are concerned that in the small world of their departments, their personal information can spread quickly. By having people they trust ion these roles and training those people on the value of confidentiality and what must be reported and what is best referred, they can have that trust. One novel recommendation is to create a survey with the names of all department members, then have staff select their top three people that they talk to when they don’t know something or have a problem. Then take, let’s say the top ten vote getters and there is your peer support team! This will show the line staff that the program is about them and not management controlling them and will, hopefully, foster participation.
Working with families is a huge missing component in most first responder organizations throughout the Country. Be it as a result of scheduling, the hours, and/or the stressors, frequently our loved ones don’t truly understand why we are acting the way we are. Further, they often don’t know or can’t comprehend the things personnel are going through. There are studies out there that show the divorce rate of first responders to be at over 80%. There could be many causes for this but at the end of the day, this additional stress does not make for a healthy department or work environment. By making the significant others of responders feel involved and supported, every day not just when something bad has happened, you are making part of the family. Frequently different department members call their co-workers their “brothers and sisters.” Well how would one think their home family would feel about them having a completely separate work family? While for some bringing their home and work together may be uncomfortable or something that they are not used to. Having your spouse and family understand better the things you are going through and what others in their shoes are experiencing will only improve their total understanding and hopefully create a more healthy and supportive environment.
Creating one of these programs isn't easy, and certainly isn't free. But this is the price that must be paid to support those that help us all every day. Next week we will talk about what the @NFPA is doing today and what the future holds for wellness in Part 3.