Extreme stress situations have impacts on the people involved with the incident as well as those cleaning up the aftermath of these events. First responders have the unwavering responsibility to face stressful situations head on in a near unrelenting fashion in order to provide for the greater good of their community. Other than the primary victims of the traumatic event, no other group of people are so greatly impacted by the depth, breadth and frequency of the traumatic experiences than the first responders. In order to alleviate the negative aspects of stress for the first responder many organizations have taken shape to train for pre and post traumatic event management to better prepare and prevent long term effects of extremely stressful situations.
Stress can induce a plethora of mental, physical, emotional and behavioral ramifications that are varied depending on the person and the variables in their lives. With highly stressful situations come very risky and dangerous maneuvers where not only the first responder’s life is on the line but the victims as well. Life or death can hang in the balance and remain dependent on the series of fast paced and precisely executed tasks expertly performed by the first responders.
During stressful situations decision making becomes very difficult and almost impossible to perform. During a highly stressful situation the person could lose the ability to concentrate and perceive or process new information. This hampers the short-term cognitive skills and results in hasty ill-advised reactions (Shelton and Kelley 1994). In order to mitigate the results of the highly stressful situation, the issue can be broken down into two parts. The first part is the input of the stressor into the situation.
The stressor impacts the entire scenario in such a way that by removing it from the equation the results would be far different. Removing the stressor would allow the individual to address the situation and make a reasonable and well thought out action as opposed to reacting to a variable that does not provide insight into the situation but only provides a hindrance. It is easy to say “eliminate the stressor” but in reality it can be very difficult.
When first responders initially come into a situation there are stress factors looming from every direction. In this case a first responder comes into a fire riddled building and the number on stress factor that will be a determining factor is time. If the time to remove the victims from the fire was eliminated almost all the other factors would be rendered almost futile. Since time cannot be stopped the stressor in this situation will remain. What can be changed is the first responder’s attitude and response toward the stressor. Through psychological training and mental fortitude the first responder can change the inherent response and reaction to a burning building where lives hinge upon the very actions the responder takes so that he or she can make calm, cool and collected decisions and actions.
The first area of training that can help first responders navigate their mental reactions to situations the next would be their physical ability to perform the tasks. The mental aspect allowed the responder to gain a grasp of the situation and provided the vessel to carry out the necessary duties to perform their job functions but the next is the physical and technical ability to perform under stress. In order to prepare for extremely stressful situations in which a function must be performed the individual must be fully trained to a point that repetition of a core task becomes ingrained into their memory and muscle movement to a point where the actions become “fire and forget” functions.
By including intense hands on training the first responder will negate the possibility of a clouded mind that relies on interpreting new data and processing the positives and negatives of every reaction because the process they are performing has been accomplished hundreds of times with the expected outcomes being reached in every instance. Muscle memory and the elimination on the need for data interpretation allow the experience to flow through the first responder to the situation at hand providing the response necessary to save lives and mitigate damage.
Training for in-theater action allows for prompt responses to stressors and the ability to perform the job function in not so optimal conditions. First responders are heralded as heroes and have rightfully earned that badge of honor. After enduring the extremely stressful situations in which training and preparedness have allowed them flawlessly execute, the first responder must also be prepared for the aftermath and remnants of traumatic event. Post-traumatic stress disorder (PTSD) results from the overall experience of a traumatic situation that threatens a person’s life or instills a feeling of helplessness or non-control.
There is a difference between a reaction to a stress induced situation and PTSD is the fact that the individual becomes stuck in their reaction that include the sense of loss for safety and trust, disconnection to family and friends, increased fear and debilitating thoughts of the incident(Schiraldi 2009). Training a person on how to put out a fire or how to perform lifesaving operations during the heat of battle can be documented, standardized and put into a process. Training a person to reach out for help and recognize that their reaction to the extremely stressful environment may be greater than the typical post-traumatic ramp down is a more highly sensitive and difficult task to grasp.
First responders’ awareness can be heightened to not only look out for themselves for signs of post-traumatic stress but also for their brothers and sisters pushing themselves to save lives and willingly place their lives and bodies in harm’s way. Training and awareness are key in providing the first responders with the tools to do their job, make it out alive and unscathed then resume their lives to enjoy the fruits of their labor.
As the old adage goes “an ounce of prevention is worth a pound of cure”. First responders not only can prepare for extremely stressful situations it is imperative they learn their functional requirements in their job. Preparedness for stressful situations rely on pre-, current and post-stressful situation training to allow the first responders to prepare for the event, perform during the event and clean up the mess for the traumatic event in order to maintain the same quality of life as those not faced with perilous events. They can prepare through rigorous training and simulation events which will not entirely eliminate the stress factors but will provide the first responders the heightened ability to manage, adapt and overcome the events that are in their path for success.
Schiraldi, G., (2009). The post-traumatic stress disorder sourcebook: a guide to healing, recovery and growth. McGraw-Hill
Shelton R., and Kelley, J., (1994). EMS stress: an emergency responder’s handbook for living well. New York. Mosby.