A universal principle: Don’t make the situation worse

Three ways to maintain balance during difficult times and not exacerbate the problem

If there is one principle that every firefighter, EMS provider and law enforcement officer can agree with, it is this: Whatever you do, don’t make it worse than it already is. “First, do no harm.”

This principle always applies to emergency services but is especially relevant in these challenging times.

First responders are not responsible for the bad things that occur under their watch. The emergency was already occuring when you got there. That’s why they called you – because something really bad was happening. But first responders are responsible for trying to make things better, and at the very least, never adding to the damage and loss unless it is absolutely unavoidable.

In a time when stress management is paramount, first responders must do all they can to be sure that they never make a problem worse than it already is.
In a time when stress management is paramount, first responders must do all they can to be sure that they never make a problem worse than it already is. (Photo/courtesy American Ambulance Association)

Emergency responders understand this principle in an operational sense. You want to bring sufficient resources to resolve the problem but not to cause a lot of collateral damage. You want to do everything possible to help the victim and protect them from further harm.

But sometimes, first responders don’t apply these same principles to themselves.

Three ways to maintain balance

First responders are dealing with many stressors right now. They must respond to an unprecedented pandemic with few existing guidelines, while also handling emergency calls in their districts. They must balance their own needs with those of their positions and responsibilities in the organization.

There are three areas where first responders might be losing sight of that balance, to the detriment of themselves, their coworkers, and those they serve.

1. Focus on self-care amid chaos

When following the principle of never making a situation worse than it already is, first responders must initially look at how they are caring for themselves. First responders often like to push through difficulty, but what is happening now is a marathon, not a sprint.

If you are tired, find a way to get some rest. If you are sick, get informed guidance and medical care until you are physically better. Allow yourself to take a break. It benefits no one to come to work sick; in fact, it will only lead to more illness and more people unable to help. An exhausted, sick first responder is a liability – someone who is likely to make bad decisions and endanger other crewmembers.

As the medical director for the emergency department of a New York City Hospital, Dr. Lorna Breen was on the front lines of response to COVID-19. She worked tirelessly for her patients and ultimately contracted the virus herself. Following a brief recuperation, she went back to work, until the hospital sent her home again.

Like many emergency responders, she refused to accept limitations or defeat, and kept trying to power through. But this lack of attention to her own needs ultimately led to her death by suicide. This was a tragedy for her, for her family and for those she served so selflessly.

2. Accept support 

It is critical that first responders not only give support to others now, but also accept support for themselves. It is tempting during times like these to be constantly focused on the larger problem: the virus and its impact on the community. But all emergency responders have lives and issues beyond the job. Paying attention, checking in and allowing others to do the same for you will do much to mitigate harm.

Notice if your coworkers seem different – angry, depressed, manic, exhausted. Ask them how they are doing. Remember personal details, like someone’s mother recently entered a nursing home or that a colleague's son is recovering from surgery. Reaching out in a personal way will establish the possibility of connection when it might be needed most.

And let others do the same for you. Emergency responders love to give help, but they often hate to accept it. Set a good example in being open with your coworkers about how current events are affecting your life. Allow them to care for you too.

3. Manage conflict constructively

Finally, be conscious of managing conflict in a constructive way. Conflict is inevitable within groups, and stressful circumstances combined with physical and psychological exhaustion will just make it worse. Be prepared to handle conflict, both for yourself and as a leader among your colleagues.

Big problems require big solutions, and all first responders need to know that they have avenues of support and remediation when significant issues arise. But this is also a time when small things might seem bigger than they are. In that case, it can be helpful to remember that everyone – everyone – in the department is dealing with personal issues beyond the pressures at work, and sometimes the strain will show.

This is a time for tolerance and forgiveness. No one gets a free pass for unacceptable behavior, but it is also good to recognize that sometimes people just snap. If you have behaved badly in a moment of stress, apologize sincerely. If others have behaved badly, address the issue without vilifying the person. Try to get to root causes. Try to let trivial things go. There are bigger challenges for everyone right now.

Do no harm

First responders are tasked with taking a bad situation and making it better, and in this capacity, they often perform near miracles. In a time when miracles are needed more than ever, first responders must do all they can to be sure that they never make a problem worse than it already is.

Read next: A playbook for psychological health during the COVID-19 pandemic

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