A Duty To Act

In this conversation, Jennifer and Bobbie Merica discuss the innovative approaches to training first responders through realistic simulations and moulage techniques. Bobbie shares her journey from personal trauma to creating Moulage Concepts, a company dedicated to enhancing training for emergency responders. They explore the importance of resilience in both training and personal experiences, emphasizing the need for community support and engagement in mental health initiatives. The discussion highlights the significance of storytelling in training and the impact of immersive experiences on learning outcomes.

takeaways

• Dr. Corsa has a diverse background in public service and EMS, including working as a firefighter, paramedic, and trauma surgeon.
• Providing medical care in rural and isolated areas presents unique challenges, such as limited access to hospitals and unreliable transportation.
• Having progressive protocols, advanced equipment, and highly skilled paramedics is crucial in delivering quality care in remote locations.
• Pre-hospital innovations, such as ultrasound and ventilators, have significantly improved patient care and outcomes.
• Longevity and experience among paramedics in remote areas can be both beneficial and challenging, as retirements may lead to the need for training new personnel. The greatest innovation in EMS is the increased knowledge and capabilities of paramedics and EMTs.
• Advancements in equipment, such as the stair chair and power stretcher, have greatly improved patient care.
• Safety is a crucial aspect of helicopter operations, and the dedication of rescue technicians is commendable.
• Medical program directors play a vital role in coordinating and implementing programs to address the opioid crisis.
• Buprenorphine can be used in the field to help patients in withdrawal and connect them with follow-up care.
• Prolonged field care requires a different mindset and planning to provide care in remote and austere environments. The future of EMS lies in recognizing the importance of tailoring care to the specific needs of each community.
• Critical thinking skills are essential in EMS and should be integrated into training programs.
• Coordination and communication are crucial in mass casualty incidents, involving multiple agencies and organizations.
• Comprehensive triage systems, such as the RAMP method, can help prioritize patients in mass casualty incidents.
• There is a need for improved pre-hospital pain management, including the use of over-the-counter medications, which could be administered by EMTs.

takeaways

• Dr. Corsa has a diverse background in public service and EMS, including working as a firefighter, paramedic, and trauma surgeon.
• Providing medical care in rural and isolated areas presents unique challenges, such as limited access to hospitals and unreliable transportation.
• Having progressive protocols, advanced equipment, and highly skilled paramedics is crucial in delivering quality care in remote locations.
• Pre-hospital innovations, such as ultrasound and ventilators, have significantly improved patient care and outcomes.
• Longevity and experience among paramedics in remote areas can be both beneficial and challenging, as retirements may lead to the need for training new personnel. The greatest innovation in EMS is the increased knowledge and capabilities of paramedics and EMTs.
• Advancements in equipment, such as the stair chair and power stretcher, have greatly improved patient care.
• Safety is a crucial aspect of helicopter operations, and the dedication of rescue technicians is commendable.
• Medical program directors play a vital role in coordinating and implementing programs to address the opioid crisis.
• Buprenorphine can be used in the field to help patients in withdrawal and connect them with follow-up care.
• Prolonged field care requires a different mindset and planning to provide care in remote and austere environments. The future of EMS lies in recognizing the importance of tailoring care to the specific needs of each community.
• Critical thinking skills are essential in EMS and should be integrated into training programs.
• Coordination and communication are crucial in mass casualty incidents, involving multiple agencies and organizations.
• Comprehensive triage systems, such as the RAMP method, can help prioritize patients in mass casualty incidents.
• There is a need for improved pre-hospital pain management, including the use of over-the-counter medications, which could be administered by EMTs.

Takeaways

• Arriving in the middle of a call can be dangerous as you may not be aware of the dynamics and tensions already present.
• Compassion fatigue can lead to a lack of empathy and compassion, which can impact patient care and increase the risk of violence.
• It is important for first responders to reconnect with their purpose and maintain a compassionate mindset to avoid burnout and negative interactions with patients.
• Having a clear and universal code for calling for help in emergency situations can improve communication and response times. Seeking professional help for mental health is crucial, especially in traumatic situations.
• Departments should prioritize mental health and create robust mental health programs.
• Sleep is essential for overall health and wellness, and shift workers face unique challenges in getting adequate sleep.
• Informal peer support has its limitations, and professional help may be necessary in certain situations. The aftermath of the stabbing incident had a significant impact on Benjamin and his crew, leading to silence and a lack of communication within the crew.
• Benjamin expressed concern for his captain and crew members who did not seek mental health help, highlighting the importance of mental health support in the fire department.
• The concept of administrative betrayal was discussed, emphasizing the need for departments to carefully consider the discipline they impose and the potential impact on individuals' mental health.
• Benjamin emphasized the need for more education and training on mental health at every rank in the department to create a better understanding and support system.

Sound Bites

• "I was blown away by that, that paradigm shift of calling it that."
• "The entire fight lasted less than five seconds."
• "I was not a very nice person... I was bitter and burned out."
• "If I could go back and anything, would just help my guys be compassionate again, know, make sure they're rested and remind them of why we do this job so that when we're on scene, we are better patient caregivers."
• "What is it that launches your instinct?"
• "You can only [pass judgment] when you are an expert in that field."
• "We're not going to talk about the stabbing, okay?"
• "That's a very strange dynamic."
• "The skyscraper in the room"

Takeaways

• Arriving in the middle of a call can be dangerous as you may not be aware of the dynamics and tensions already present.
• Compassion fatigue can lead to a lack of empathy and compassion, which can impact patient care and increase the risk of violence.
• It is important for first responders to reconnect with their purpose and maintain a compassionate mindset to avoid burnout and negative interactions with patients.
• Having a clear and universal code for calling for help in emergency situations can improve communication and response times. Seeking professional help for mental health is crucial, especially in traumatic situations.
• Departments should prioritize mental health and create robust mental health programs.
• Sleep is essential for overall health and wellness, and shift workers face unique challenges in getting adequate sleep.
• Informal peer support has its limitations, and professional help may be necessary in certain situations. The aftermath of the stabbing incident had a significant impact on Benjamin and his crew, leading to silence and a lack of communication within the crew.
• Benjamin expressed concern for his captain and crew members who did not seek mental health help, highlighting the importance of mental health support in the fire department.
• The concept of administrative betrayal was discussed, emphasizing the need for departments to carefully consider the discipline they impose and the potential impact on individuals' mental health.
• Benjamin emphasized the need for more education and training on mental health at every rank in the department to create a better understanding and support system.

Sound Bites

• "I was blown away by that, that paradigm shift of calling it that."
• "The entire fight lasted less than five seconds."
• "I was not a very nice person... I was bitter and burned out."
• "If I could go back and anything, would just help my guys be compassionate again, know, make sure they're rested and remind them of why we do this job so that when we're on scene, we are better patient caregivers."
• "What is it that launches your instinct?"
• "You can only [pass judgment] when you are an expert in that field."
• "We're not going to talk about the stabbing, okay?"
• "That's a very strange dynamic."
• "The skyscraper in the room"

Takeaways

• The transition from counseling to the fire service provided an opportunity for self-discovery and personal growth.
• Preserving mental and physical health in the fire service is crucial for resilience and longevity.
• Post-shift recovery protocols focus on physiological and psychological restoration, emphasizing the importance of relationships and holistic well-being. The importance of solitude and restorative activities for first responders
• The physiological and mental benefits of sauna, cold plunges, and cycling
• The impact of community involvement on overall well-being and resilience
• The concept of creating a wellness center within first responder departments

Sound Bites

• "The fire service has been a process of trying to hold onto both toughness and tenderness."
• "I had been researching and reading about more things that have to do with mental health and physical longevity."
• "At the core of that, you're gonna find that in relationships, that you're gonna find that in the space between you and another person."
• "Reconnecting with activities that fulfill and reorient oneself"

In this episode, Jennifer Darling and Josh discuss the progress and impact of their podcast, "A Duty to Act." They reflect on the most impactful episodes so far, including the Des Moines episode and the discussion on secondary traumatic stress with Pat Ellis. They also mention the importance of addressing cancer in the fire service and their plans to cover topics such as lifeguards, smoke jumpers, and tribal EMS. Josh shares his experience in building a data science course for EMS and fire leadership, emphasizing the importance of thinking like a data scientist and using data to make meaningful changes in departments. They discuss the value of a data-driven culture and the need for curious minds to analyze and interpret data accurately.

The Des Moines episode and the discussion on secondary traumatic stress have been the most impactful episodes so far.

Cancer in the fire service is an important issue that needs to be addressed.

Lifeguards, smoke jumpers, and tribal EMS are potential topics for future episodes.

Building a data-driven culture is crucial for making informed decisions and improving departments.

Curiosity and asking the right questions are essential for effective data analysis.

"The Des Moines episode is such an important issue." - Josh

"I hadn't thought about the life and death of it. I had thought about the working environment and longevity and recruitment and retention." - Jennifer

"Everybody wants to grow up to be an influencer. When I was a kid, everybody wanted to grow up to be an astronaut or a firefighter or a race car driver." - Josh

"Everybody's got an ear to ear smile when they get to tour an ambulance or a fire truck." - Jennifer

"Looking at the numbers without context may tell a completely different story than having that kind of context added into it." - Josh

A Duty to Act Podcast

Don't miss this engaging episode of "A Duty to Act" as Jennifer Darling and Josh discuss the impact of their podcast and the importance of data-driven decision-making in public safety. Tune in to gain valuable insights and stay informed about the latest trends in the industry.

Can a firefighter's battle extend beyond flames? In this episode I am joined by the courageous trio from IAFF Local Number 4—Jason, Aaron, and Joe—as they shed light on the daunting intersection between firefighting and cancer. We share harrowing personal accounts and the pressing need for legislative recognition of cancer as a job-related illness for these heroes. With heartfelt tributes to Mike Broderick and Brian Stokes, two fallen firefighters whose lives and legacies anchor our conversation, this dialogue is a testament to the power of advocacy and the urgent call for comprehensive cancer coverage for those on the frontline.

Imagine fighting fires only to face an even more insidious foe; that's the reality for many firefighters confronting cancer. This gathering uncovers the complexities of advocating for cancer to be covered under presumptive legislation, a term that currently applies to only a fraction of cancers in Iowa. We take a closer look at the health risks associated with firefighting, the emotional and financial toll of the disease, and the strategies employed to tackle legislative change. The episode is a patchwork of personal stories, the evolution of healthcare initiatives to better safeguard our firefighters, and the grassroots efforts that fuel the fight for fair coverage.

This narrative culminates in an urgent call to action, capturing the essence of unity and persistence in the face of political hurdles. We share a behind-the-scenes look at the legislative journey, from unanimous approvals to unexpected roadblocks, and the shared resolve of firefighters and their allies to continue the push for change. As we honor those who've sacrificed so much, we invite listeners to lend their voices, engage with the fire service community, and support the mission for better protection and support. This episode is not just a conversation; it's a rallying cry for solidarity and the undying spirit of those who risk it all.

(08:22 - 09:18) Creation of Cancer Definition in Iowa

(11:48 - 13:18) Innovative Fire Station Design Appreciated

(20:00 - 21:33) Firefighter Cancer Coverage Advocacy Plan

(23:45 - 25:21) Aaron and Voter Voice Software Success

(29:24 - 30:18) Firefighters Lobby for Legislative Support

(33:15 - 34:48) Impactful Visual Stories on Facebook

(44:49 - 46:27) Iowa Firefighters' Pension Concerns

(50:15 - 51:34) Unified Effort for Legislative Thank Yous

(53:40 - 55:18) Bipartisanship in Firefighter Advocacy

(01:01:03 - 01:02:25) Union Efforts for Positive Change

In this conversation, Pat Ellis discusses the importance of shifting to the next continuum of care and finding joy in life despite challenges. They also explore the experience of delivering difficult news and the need for training in this area. The concept of resilience is discussed, with a focus on preparing for the emotional impact of the job and wearing mental and emotional body armor. Decision fatigue and its manifestation are explored, as well as the relationship between stress and nutrition. The mindset of career personnel and the difference between volunteers and career personnel are also examined. The conversation concludes with contact information for further inquiries.

Takeaways

• Secondary traumatic stress is the chronic exposure to other people's traumatic experiences and can impact first responders' mental, emotional, spiritual, and physical health.
• Secondary traumatic stress is different from PTSD and compassion fatigue.
• Vicarious trauma is a shift in worldview that occurs after prolonged exposure to trauma.
• Moral injury is an emerging term that is relevant to first responders' mental health. Traumatic events can have varying degrees of impact on individuals, and reactions can differ greatly from person to person.
• It is important to be aware of the signs of secondary stress, such as isolation, withdrawal, and hypervigilance.
• Supporting others and promoting self-care are crucial in maintaining emotional well-being.
• Developing daily self-care practices and seeking help when needed can help individuals cope with the emotional impact of their work.
• Choosing positivity, practicing positive self-affirmations, and maintaining hope can have a significant impact on one's outlook and resilience. Shifting to the next continuum of care is important for individuals experiencing challenges in their lives.
• Finding joy in life is possible even in the face of difficult circumstances.
• Training in delivering difficult news is crucial for professionals in emergency services.
• Resilience requires preparation and the wearing of mental and emotional body armor.
• Decision fatigue can impact decision-making abilities and energy levels.
• Stress can affect nutrition and dietary habits.
• The mindset of career personnel may differ from that of volunteers.
• Proactive planning for resiliency is essential for maintaining well-being.

Sound Bites

Chapters

00:00Technical Difficulties

02:00Introduction and Microphone Setup

05:19Background and Purpose of the Interview

08:08Teaching Secondary Traumatic Stress

11:19Success of Recent Class

12:06Definition of Secondary Traumatic Stress

13:18Differentiating Secondary Traumatic Stress from PTSD

18:02Compassion Fatigue and Vicarious Trauma

19:41Introduction to Moral Injury

21:27Shift in Worldview

22:50Differentiating Vicarious Trauma and Secondary Traumatic Stress

25:33Variability of Impact

26:19Cumulative Effect of Grief

27:44Different Reactions to Traumatic Events

29:36Signs of Secondary Stress

30:01Isolation and Withdrawal

31:19Hypervigilance

36:03Supporting Others

37:30Self-Care and Seeking Help

38:05Preparing for Emotional Impact

49:41Daily Self-Care Practices

53:46Positive Self-Affirmations

57:01Choosing Positivity and Hope

58:59Shifting to the Next Continuum of Care

01:00:05Finding Joy in Life

01:00:22Dealing with Grief and Dying

01:00:42Delivering Difficult News

01:01:11Teaching Others to Deliver Difficult News

01:01:28Striving Towards Resilience

01:02:10Resilience as Psychological Body Armor

01:03:02Preparing for the Emotional Impact of the Job

01:03:49Decision Fatigue and Lack of Energy

01:04:20Wearing Mental and Emotional Body Armor

01:05:53The Green Apron as a Cape

01:06:32The Concept of Decision Fatigue

01:07:21The Manifestation of Decision Fatigue

01:09:06The Relationship Between Stress and Nutrition

01:09:33Different Manifestations of Stress Release

01:12:22The Importance of Education and Preparedness

01:13:46The Mindset of Career Personnel

01:17:48The Difference Between Volunteers and Career Personnel

01:19:47Contact Information

01:23:06Global Reach of the Podcast

01:24:04Proactive Resiliency Planning