In Part 1 of this series we discussed a novel example of a total wellness program. In Part 2 we discussed ways you and your department can implement a Total Wellness Program in your service starting tomorrow. This time we will talk about the future. One of the really cool things the @NFPA does is send our staff liaisons out as much as is possible and reasonable so we can learn what new practices and resources are out there and bring that information back to our technical committees. Our technical committees ultimately decide what is put into a code or standard but even if somethings don’t make it in, we as an organization want to make sure we are sharing that knowledge and information with the world. In my very short time with the association I have been so lucky to have been able to travel and learn from innovators all over the Country. There are some really amazing things on the horizon for our emergency responders. From innovative technology that uses the biometric sensors in smart phones to better track exposure times, to resiliency programs that focus on not just the responder but their families as well and create a healthy means for them to work through their stresses and issues.
One of the coolest concepts that is being discussed is the “Tactical Athlete.” This is the best term I have ever heard to describe our responders. Now you may hear this and think it “tactical, like totally tough and kick in doors and chase bad guys” but that’s not what they mean by this. The context in which this was first presented is in the world of injury management. Traditionally, if a responder gets hurt, they go to see an occupational health physician and that doctor refers them to specialists, but manages their injury and rehabilitation. In the world of the tactical athlete, injuries are managed by sports medicine physicians. This is because a first responder isn’t like someone who works in an office environment. Occupational doctors see patients and try to best manage their care to get them back to their specific occupation. For the most part, not always but mostly, these are people who work in an office or manufacturing who have a repetitive use injury and need to be rehabbed just enough to get back to work.
Our first responders don’t fit into these traditional occupational boxes. While there are many occupational doctors who have taken time and made effort to understand
the needs of responders and looked at innovating their care, there is still things that a sports medicine doctor has access to that they don’t. Our responders sometimes do repetitive motion (ie; EMTs lifting and moving patients), go from complete rest to running upstairs and ladders (ie; fire fighters), and even go from an excited state to a completely aerobic state (ie; police officers in a foot chase). All of this variation and stress takes a toll on the body similar to an athlete who exercise and makes repetitive motions for their skill but also has moments of complete change. Your body must be flexible and maintained in such a way that it can handle these stresses. This flexibility and maintenance is what the sports medicine doctors specialize in. A sports medicine physician also can reduce the time in which a responder is out of work. They do this by accelerating the time it normally takes to get imaging, make care decisions, and perform procedures. In the traditional model, you would still have to see an orthopedist but after being referred and possibly treated by an occupational physician first. There are less layers in the new model.
I spent some time with a sports medicine physician recently discussing this model. Dr. Jennifer Luz is a sports medicine physician with Steward Healthcare in Boston and is one of the team physicians for the Boston Ballet, Boston Cannons Lacrosse team, Boston Breakers Women’s Soccer Team, and several local colleges. Dr. Luz has always had an interest working with first responders as the granddaughter of a police chief and the daughter of a federal agent. She was a resident at Spaulding Rehabilitation Hospital in Boston and was involved in the care of victims and responders that where at the events of the 2013 Boston Marathon. Dr. Luz recently made as simple analogy; “If Tom Brady hurt his shoulder, he would have an MRI within a day and surgery within a week. This would be to not only expedite his recovery, but also to prevent any further damage while waiting for care or approval to receive care. Why is a first responder any different? Don’t we need to get them healthy and back at working helping/protecting us?” This point illustrates the importance of changing our mindset and looking at responders in a different way.
There’s more to the tactical athlete concept than just the way responders are cared for. There’s a component of maintenance that must accompany the care. Maintenance of not just the body but also of the mind and spirit. Many departments are looking at innovative ways to promote health and wellness as it relates to tactical athletes. Some are working with companies to improve fitness like Boston with their O2X program. Others are bringing in Yoga instructors to increase endurance and flexibility. In Indianapolis they are conducting a nutrition study measuring the heart walls of fire fighters and trying to create ways to reduce cardiac issues in the fire service. There is a behavioral component too. Finding mental health clinicians that understand the responder world and life, performance coaches, mindful coaches, and working with families to integrate them into department life.
When you step back and look at all of this, you have to ask… Why? For too long being a responder has been too dangerous of a job. Too many have died both on the job or too early after suffering a heart ailment or from the terrible effects of cancer. How many have left the profession due to mental illness? How many of your co-workers both past and present have taken their lives? How many families have been broken up because of the ravages and stress of these jobs? How much money have you or others lost by being unable to work, either at your job, or if you’re a volunteer, at your day job because of an injury suffered helping others? How much money has your department spent covering your shifts or expenses while you are out injured? Is this money that could have gone to other programs?
The world of working as a first responder is hard. The hours are long, the calls can be stressful, and frequently people feel like they are alone. The long shifts and especially busier call volume days can create terrible eating habits and reduce your exercise and effort when you aren’t at work. Many first responders get home for their shifts and just “crash out” this is the phenomenon of decompressing and isolating yourself while eating and watching tv or playing video games. This frequently occurs because of the time they spend in a heightened state of adrenaline or excitement on their shifts and the body dumping and wanting to achieve balance. Many feel as though their work is a family and their home is a family, but they have difficulty integrating the two. The total wellness program and tactical athlete concept, as conceptualized, will intervene, help develop healthy eating and exercise practices, improve mental performance and coping mechanisms, and include their loved ones and make them feel as though they are a part of this process. Long term benefits could include, reducing the number of cardiovascular issues, behavioral health issues, and cancer victims. For the department they will reduced overtime and worker’s comp expenses, have an easier time keeping staffing adequate, and improve moral. I know that for me (pictured)... This is something I certainly would have loved to be a part of in my time on the streets! It’s a win-win!