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Book excerpt: ‘The Firefighter Family Academy: A Guide to Educate and Prepare Spouses for the Career Ahead’

Exploring the distinct stressors first responders face during medical calls

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The following excerpt is from “The Firefighter Family Academy: A Guide to Educate and Prepare Spouses for the Career Ahead,” found in Chapter 1, titled “Firefighting 101.” Dr. Rachelle Zemlok delves into the unique challenges firefighters encounter during medical calls, which might not be shared with their spouses. Following each section of her book, Dr. Zemlok offers practical advice for spouses on how to utilize this information effectively. She emphasizes the importance of their role in supporting their firefighter’s well-being, contributing to the family’s overall success. Dr. Zemlok enriches her guidance by sharing personal anecdotes, showcasing both her successes and setbacks as a firefighter’s spouse herself.

Listen to an audio version of the excerpt below.

Stress of Medical Calls

Medical calls have dangers and stresses that are different from fire calls. Firefighters responding to them need to worry about not getting sick from patients. They may be responding to patients with preexisting diseases or infections that the firefighters know or do not know about. They may be directly coughed or sneezed on by a sick patient before they are able to get their protective mask on. They are constantly dealing with the products of humans that many of us get nauseated from, including blood, old or new urine, feces, and, of course, vomit. These fluids often times fall on them, their equipment, and may be spread all over the scene. In order to do their job effectively, firefighters need to subdue the natural human response to such sights and smells. They may also respond to very unhygienic scenes, such as the home of someone who hoards trash. Regardless, firefighters are expected to remain professional and continue providing medical services, no matter what is thrown their way. They are required to make every scene work for them and provide the same emergency medical services they would at any other call, even if it is on top of old rat-infested garbage. Not to mention that they may be running these medical calls in the middle of a perfectly good lunch or dinner, and then return to their meal afterward.

In addition to the medical scenes described above, firefighters are often the first ones to respond to horrific scenes that many of us would have a difficult time even seeing in a movie, such as fatal car accidents, individuals who have died after being shot, suicide scenes, child deaths, and other freak accidents. They may see bodies mangled, deformed, and even in pieces at times. They also witness family members and friends of victims in hysterics while they assess and attempt to provide medical services. Each of these scenes has the potential to leave a lasting image in their minds- images that they would rather not have. As I stated previously, firefighters responding to such conditions have very little room to react emotionally. They often become good at compartmentalizing such experiences as “work” and continue to go about daily life. However, as a human being, the reactions or visual images always have the potential to come up later due to needing more time to process the information. There will be certain calls or scenes that may have a much larger impact on some firefighters and may require more efforts to process, such as discussing with colleagues, in a debriefing group, or with a mental health professional.

Spouse’s Guide

As the spouse, it is important to understand that any of these scenes or difficult calls, in general, can happen at any time of day. For example, during a fun meal with the crew, in the middle of the night when your firefighter is woken from a deep sleep, or even right when he or she is about to get off shift and come right home to you. Unfortunately, firefighters are not always going to come home and tell their loved ones they had a rough call and need some time to readjust and process it. Maybe this is because your spouse wants to protect the family from the details, maybe your spouse is worried he or she will be judged by their reaction, maybe he or she would rather move on, or maybe your spouse simply does not have the communication skills to do so.

Something you can do as a spouse is discuss a plan early in the career before this ever even comes up. You can have a conversation about what your spouse thinks might be needed following a difficult call if it were to ever come up (which it will). What will help him or her process it and re-adjust to coming back to home life? Everyone is different. Will your spouse want to make time to talk about it with you, hit the gym, zone out for an hour in front of the TV, take a nap, get coffee with friends, go for a bike ride, etc? Sometimes our spouse’s behavioral signals are clear enough that we can recognize when he or she needs something. However, without discussing this scenario in advance and directly asking our spouse, we run the risk of misinterpreting “signs” as hurtful behaviors. Instead, you can both come up with a sign or signal that can be given to let you know that your spouse needs a little extra time after the shift to re-adjust to home. That can be direct, like a call or text to you before getting home so you can prepare yourself. It can also be as simple as letting you know he or she is going to go on a bike ride or visit the gym upon getting home. If you know that being supportive means allowing space in the morning schedule for your spouse, then you already know how to arrange the family schedule when you get word that this was one of those shifts. This is not always going to be possible if you have pre-existing plans; however, just acknowledging the experience and prioritizing it when it is possible can make a huge difference and bring the two of you closer in the long run. As I mentioned previously, I believe the best case scenario is for firefighters to have some sort of routine built into their schedule following the end of every shift. This will allow them to decompress. Being “on” in the ways I just described is very different from being “on” at home with kids and a spouse. An activity or routine that can help make the transition back home will help an individual be more present with family and whatever home life brings. I recommend a similar routine to anyone in a similar line of work to “re-set” before transitioning home. You may also want to pay attention to your partner’s signs of burnout or being mentally exhausted, such as being zoned out, extremely tired, moody, quiet, etc. Therefore, when you recognize a change, you can try to encourage some self-care activities.

I have found in general that taking a real interest in what my husband does on a shift-by-shift basis is supportive to him. Just trying to follow what his experience is like and how calls went helps him understand that I am here for him and interested. When difficult calls do happen, he is more likely to mention it to me because I already have a basic understanding of what good calls look like and why this may have been a bad call. There are times when he can talk about what was frustrating on a call without sharing the gory details about it, and there are other times when he first asks how much I want to hear about the details. Often times after my husband gets off shift, I make it a point to first ask him what he needs before I discuss any tasks I have for him. I want his wellness to come first and our to-do list second.

“The Firefighter Family Academy: A Guide to Educate and Prepare Spouses for the Career Ahead”
Publisher: BookBaby

Dr. Rachelle Zemlok is a licensed clinical psychologist in California, specializing in work with first responder families. She serves as the strategic wellness director at Lexipol, supporting the content and strategy related to first responder mental health and wellness, with a special focus on supporting spouses and family members through the Cordico Wellness App. Prior to joining Lexipol, Zemlok founded First Responder Family Psychology, which provides culturally competent therapy to first responders and their family members. She is the author of “The Firefighter Family Academy: A Guide to Educate & Prepare Spouses for the Career Ahead.” For more information on Dr. Zemlok or to connect with her please visit her website.