Today I read two posts on FFN that made me think about CISM - Critical Incident Stress MANAGEMENT.

One was the death of a Chief which is often devestating for the members. My 1st Chief was my uncle when he passed in 1988 it killed me in more ways than one. After that MY CHIEF was a man I had known since I was a child playing @ the fire station with his kids. He taught me a lot about being a PERSON as well as an abundance of things they don't teach you in class about fire fighting. He was my mentor & my friend as well as my Chief. He passed in 1996 & I still remember to this day exactly what I was doing when they "accidentally" told me. We were @ a training fire on a very HOT July day, my nephew had just been born that afternoon but I was told I was needed @ the live burn & I went. The Fire Chief @ that time was my cousin who knew how close I had been to the past chief and he had decided to wait until after the training to tell me but someone from another dept told me in a very non-challent way. That is a totally different story that I might share @ some point. But back to the original point of my blog tonight. . .

The other post that got me thinking was a young man who responded to an MVA & found his cousin thrown from the vehicle. It was almost a year ago that it happened so it is a bit late for CISM to be done properly but I would advise him to talk to his chief. There has to be someone he can contact for assistance and his chief should know who that is but the grief process often takes 18-24 months. Somethings you never FORGET. Flashbacks happen when you aren't expecting them even years later. I know this both from having had CISM training & from my own experience.

There are those who argue that Critical Incident Stress Management does NO good. Others say that it actually does more harm than good, or at least the Mitchell model which is used by the International Foundation for Critical Incident Stress Management uses. I argue this because the studies were not done specifically on fire fighters who had received the proper, step by step process within the recommended time period. The first step of CISM is called a defusing (not debriefing) and should be done between 24 & 72 hours after the incident.

A lot of folks believe that we have to be TOUGH & that things shouldn't bother us because we are used to seeing the guts & gore & such. That is crap!! We are all human. We have limits of what we can handle. CISM is recommended for several different types of incident including the death of a fellow fire fighter/EMS, mass casualty incidents, death of a child or a particularly odd/gruesome incident involving death. We did 1 when we had rescued 2 older ladies but the third one wasn't found until the 3rd crew went in. She was actually still alive when they brought her out but expired when we were getting her to the ambulance. I was running along side the gurney bagging her during CPR when it happened. Two of my fire fighters took it very hard because they felt that they should have been able to get her out in time.

The debriefing is simply where all fire fighters, EMS, dispatcher, law enforcement who were INVOLVED in the incident come together & talk about what happened, what THEY did. A responder often hears someone else say exactly what he/she is feeling as the conversation goes around the room. What we feel is most often a normal reaction to an abnormal situation. Now I'm preaching but that was not my intent.

You might think I'm nuts but I know that when we have been through an experience like this one of the best things we can do for ourselves is to have fun. We need to sleep. We need to eat a proper diet to refuel some of the minerals we lost during the incident & the following "mood". We need some commraderie & to be good to ourselves. We need to spend time with our friends & our families. It is a natural thing for us to take our bad mood out on our families but they don't deserve it & they often don't understand what we are going through so they can't give us the compassion & understanding & patients we might need to work through it.

I was on an incident where a mother & here two children died in their beds. I was first on scene & found the father sitting naked & burned on the porch steps next door screaming & crying to me to help them. I prayed that they had woke up & being scared had run to one of the other houses in that hallow but they weren't found. Until my buddy & I found them, still in their bed with the roof of the mobile home on top of them. It was the day after Thanksgiving 1996, the day my mother in law passed away. I thought I was fine until I went to my mother's house. She fixed me a turkey sandwhich & handed me a cup of coffee. I sat down on the couch & saw a picture of the family on TV. I lost it. I cried. My mother held me. Moments later my 3 siblings, all younger, all fire fighters since they were jrs came in. Poor momma had her hands full that day. Then again, she usually did with 4 fire fighting children, a son in law, a nephew & later a second son in law on the FD. (I bought her a tshirt that said, you think fire fighting is a hard job try being a fire fighters Mom - she added X4)

There were several times over the last 23 yrs that we used CISM including the entire county in July 1996 (that was a bad year) when a fire works store in the middle of our county caught fire & there were 9 victims on that 1 incident. The last time was this past Feb when we lost 2 children age 3 & 4 in a mobile home fire.

All Chief Officers & Safety Officers should familarize themselves with the process of calling in Critical Incident Stress Management. IFCISM is literally everywhere. Some insurance companies pay for the service & have their own teams. Some organizations are through churches or psychologist etc. . (I'm sorry these are the ones I would think 2x about using) not that I don't trust them but they aren't fire fighters or public service workers who have been there & done that. Chief Officers & Safety Officers should recognize that even if an incident or event doesn't cause them anxiety doesn't mean their fire fighters don't need attention or @ least information on what they should do when they can't sleep or have flashbacks or are angry & don't understand why.

As a CO or SO when you do call for CISM, although you may mean well, you can't order or force someone to attend a defusing. My poor Chief hasn't been Unit 1 for eons as some have & he is a good guy, in his mid 30s and a darn good fire fighter but he really did not understand why I gave him "the LOOK" when he said "And everybody better be there".

We lose too many good fire fighters & EMS people from burn out. We do our best & sometimes it just isn't good enough. There is a high divorce rate among fire fighters, EMS personnel & law enforcement officers. Between LIFE in general, families, multi-responsibilities & seeing things we shouldn't have to see once for the 15th time. . . Maybe showing a little respect & compassion @ times could prevent a few of them from leaving.

Stress is a killer. People find different ways of relieveing stress from exerciseing, riding bikes, motorcycles, racing cars, going hunting or to the movies etc.. a few of our guys go out & shoot pistols or shot guns. Sometimes if you write your feelings down on paper, IF &WHEN you cando that, you have gotten it out of your system & when you read it back to yourself the problem often doesn't seem to be as bad.

Personally, 1 of my favorite things is to get together with my brothers & their families & some of the guys from the FD or our EMS buddies @ my brother's house, throwing some hot dogs & burgers on the grill & later sitting around the fire pit if its cool enough, listening to some tunes, relaxing, catching up & drinkin a beer or 2 or a diet pepsi or 2 until the food's gone, the beer is gone, the fire is out & nobody has anything else left to gripe about.