# Mental Health



## ffemt8978

A recent thread got me started thinking about this, so I figured I would post it as a poll and see what you say.


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## rescuecpt

The recent stressful situation I encountered has made me talk a lot about it - but mostly to co-workers and friends in the biz because other people cant understand why I do what I do, and they can't understand some of the clinical facts involved.


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## ffemt8978

Okay, now that I got you thinking about this topic, let me ask another question.

Do you think that Critical Incident Stress Debriefings (CISDs) are a good thing and should be mandatory attendance, should be voluntary attendance; or should be done away with?


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## rescuecpt

I think CISDs are good, but I don't think you can force people to attend.  They are much more beneficial when everyone who attends wants to be there and freely shares their experience - It is critical for the Chiefs and other officers to strongly encourage people to be there, but in a volunteer department, it is very difficult to use the word "mandatory".

I know FDNY and NYPD have mandatory counseling sessions, which at times I think can be helpful, but just like the CISDs, if you force people, it is less productive.


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## rescuecpt

I was on a business trip last week, but while I was away, my FD had the County CISD team come in and "debrief" willing department members about the hit & run.  One of my crew members from the rescue squad was mad because she said the CISD team spoke more about alcohol abuse than the actual circumstances... we don't even know whether the alcohol was involved.

I personally (if I was there) would have wanted to talk more about the sadness of finding my neighbor left for dead on his front lawn, the anger I felt for whoever did it, and then the mind-numbing confession by someone I know, who was sworn to help others, saying that he was behind the wheel.

But hey, what do I know.  I had my own CISD - the first great business trip I've been on (mostly made great due to the fact that we stayed at the Four Seasons Dallas and I was out of work by 5:30 every day...  oh yeah, the pool staff "spritzing" you with evian water when you got too hot and the mints on my pillow each night weren't bad either!)


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## ma2va92

> _Originally posted by rescuelt_@Jul 12 2004, 02:16 PM
> * mostly made great due to the fact that we stayed at the Four Seasons Dallas and I was out of work by 5:30 every day...  oh yeah, the pool staff "spritzing" you with evian water when you got too hot and the mints on my pillow each night weren't bad either!) *


 So what is the number to go this this place.. to ease stress.... Wait I may not need it.. the kids nailed me with the hose while washing the truck.. aka spritzing.. and my daugther's kitten left something on the bed... but i don't think it was a mint.


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## rescuecpt

Question:  Have any of you ever encountered a situation with a squad/department member who has a drinking problem?  What were the facts, what action did the department take, what did you do?  I have a captain who is a known alcoholic, who has been to treatment and regressed more than once, and who is "returning" to service in a few days.

My policy is if she appears drunk, she's off the rig, but I'm not always there, and a lot of alcoholics can hide it pretty well.

The Chiefs refuse to take a united, firm stance because they think they're covering their asses, and some of them are friends with her.  I think they would be better covering their asses and serving their friendship if they suspended her and got her help...


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## ffemt8978

First of all, no I haven't been in that situation yet (and hope never to be).

Does your department have a policy (or a state law) on responding to calls if you've been drinking?  My previous department had an unofficial policy of one drink was okay, but you had to notify the IC you'd been drinking.  If you had two or more drinks, don't even bother responding.

I'm sure that I don't have to remind you that alcoholism is considered to be a disease, and employers may not terminate somebody because they are sick.  This kind of puts you in an akward position, but I agree with your comment about if she appears drunk, she's off the rig.

Sorry I can't be of much help here, but please keep me informed of how this turns out.


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## rescuecpt

In the rescue squad's bylaws, if a member appears to be drunk, high, or has a known unresolved substance abuse problem, we are required to report it to the State DOH.  We are also required to file the report WITH THE CHIEFS.  Our bylaws are clear, we are not supposed to bypass the Chiefs to go to the State.

About a year ago we had a problem with a medic.  I was called into the County training directors office and asked some questions about a call with this medic.  I answered honestly, and the medic had some "counseling" and additional training from the County.  I was treated by the Chiefs office as if I had betrayed the brotherhood and they felt that I went outside the department seeking this attention and that I specifically WENT to the County to try to get the department in trouble.  Quite the contrary, I was sitting in an ALS class at the County office when the training director came to find me and pull me out of class.

That's why I'm hesitant to go through the Chiefs, since they are friends with the person in question and don't want "others" to know our problems.  But their track record with people with drinking problems isn't good - the firefighter involved in the hit & run a couple months ago (posted elsewhere here) had a known drinking problem, and one of the Chiefs had even talked a local police officer out of arresting him for DWI one night.

I don't want to jump the gun, who knows, the person may be better and may be working very hard to stay sober.  I think what I'll have to do is see what happens, and the first time I think something inappropriate is occurring, I need to report it to the DOH regardless of what the Chiefs say, think, want, etc., because in the end my loyalty is supposed to be to my brothers and my patients, and someone who is intoxicated isn't safe for anyone to be around.


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## Ray1129

> *Do you think that Critical Incident Stress Debriefings (CISDs) are a good thing and should be mandatory attendance, should be voluntary attendance;*



I don't think it should be mandatory attendance, but there should always be one available if needed....at any time.  It's not always going to hit within the first 48 to 72 hours.  It's when everyones done talking about that one call, things quiet down about it, and then you get to thinking about it on your own.  (You know how the guys (and yes, us as well) get.  They get a good working fire or a really bad MVC that is worth story time for weeks!)

I also think it should be mandatory for private companies to have a CISD team/crew.  Maybe work like the medical director and cover more than one company, seeing as how a lot of private ambos don't do too many stressful calls....but there should definately be a number *ON HAND* to call if that kind of situation arises.

I had an incident with one of my previous employers....They sent my partner and I on a call that still haunts me.  They knew this call was going to be a problem.  They sent us home after the call was done.  Told us to take a few days off to handle it.  But did they once ask us to come in to talk about it?  No.  Did they once offer any kind of services themselves?  No.  And when approached, did they help in the manner they should have?  No.  They got the money for their call, and to them the call was long over and done with.


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## Luno

Well, being new here, I'm going to have to take issue with Ray on his previous statement, "seeing as how a lot of private ambos don't do too many stressful calls" well I'm not sure where you work but here (I work private in King Co. WA) we get our fair share.  (in our station of 2 ambulances we average 6000+ call-outs per year) We get our fair share of DOAs (where you have to carry the deceased to the couch, and wait for the chaplain while the wife's screaming, because her husband died apx 4 hrs ago and she can't wake him up), the car grinders (including a 50 min extrication which the pt survived, btw, he seperated his brain from his spine), your run of the mill 15yo M SI/Trazadone OD, 13yo F w/vag bleed, 5yo hit by car, etc......  And to think of it all, I guess maybe you're right, after it's all said and done, very few keep me awake at night, I guess we just shut them out, except those few where you're looking into someone's eyes when they glass over, and no matter what you do, you can't bring them back.  That's the stuff nightmares are made of for me now.  But I will agree that private ambulances leave many things to be desired, and employee support leads the list.  i.e. we respond to GSWs w/o kevlar, because the owner of the co. doesn't believe that we need them.  (they are mandatory for the FDs)  There are also areas that we respond to that as recently as 18 mo. ago, there were bounties on our heads, yet, as long as the company makes their medicare pittance, we're expendable.  Oh, by the way, to answer that question in advance, I would do it all over again, just to help one more person.  But that's just me, and that how I deal.


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## rescuecpt

I guess Ray's private ambulance service is more transport than emergency - I know the private services around here do very limited amounts of 911 calls.


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## Ray1129

Sorry guys.  Yet again I keep forgetting the rest of the world is not like Maryland.  There are two private ambulance services in Harford County, and both primarily run routine transfer calls.  But that was not the point I was getting at....

I was just severely stressed about not having help.......at all.







And one more thing.  I'm a girl.


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## ffemt8978

> _Originally posted by Ray1129_@Sep 8 2004, 06:45 PM
> *
> And one more thing.  I'm a girl.    *


 So?


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## ma2va92

Stress... hmmmm play with the dogs and horses.... chat about it... and humor.. works well for me....

all else fails.. were is my nerve meds


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## Luno

FFEMT, I think she wrote that, as I had addressed ray's opinion as his.


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## Ray1129

> *
> So?*



Was clarifying for Luno....




> *Well, being new here, I'm going to have to take issue with Ray on his previous statement....*


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## ffemt8978

> _Originally posted by Ray1129_@Sep 9 2004, 05:33 AM
> *
> 
> 
> 
> 
> So?
> 
> Click to expand...
> 
> 
> Was clarifying for Luno....
> 
> 
> 
> 
> 
> Well, being new here, I'm going to have to take issue with Ray on his previous statement....
> 
> Click to expand...
> 
> *


 Just making sure


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## Ray1129

Oh no nononono....I'm not one of those 'I should get treated special because I'm female'.  Actually, I can't stand that.  If I'm going to do what you do, then I'm going to prove that I can do it.  If you're going to do what I do, then you had better damn well prove that *you* can do it.   :lol:


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## rescuecpt

Amen sister!


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## PArescueEMT

I think that I will pass on attempting the childbirth thing, but I think that I may rival you on some other things ladies.


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## rescuecpt

> _Originally posted by PArescueEMT_@Nov 27 2004, 08:55 PM
> * I think that I will pass on attempting the childbirth thing, but I think that I may rival you on some other things ladies.   *


 Just because you may "rival" doesn't mean you may win.


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## Jon

> _Originally posted by PArescueEMT_@Nov 27 2004, 08:55 PM
> * I think that I will pass on attempting the childbirth thing, but I think that I may rival you on some other things ladies.   *


 A: you always weasel out.

B: My former partner and I have a very intresting form of CISM - we critique the call, and whenever I point out that he did something wrong, he beats me. NOW do you know why I have body armor????


Jon


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## rescuecpt

> _Originally posted by MedicStudentJon_@Dec 27 2004, 09:31 PM
> * A: you always weasel out.
> 
> B: My former partner and I have a very intresting form of CISM - we critique the call, and whenever I point out that he did something wrong, he beats me. NOW do you know why I have body armor???? *


 HAHAHAHA...  you guys sound more like Ex's than former work partners.  (Oh no I didn't!!!)


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## Luno

Did I work with you?


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## rescuecpt

> _Originally posted by Luno_@Dec 28 2004, 10:35 PM
> * Did I work with you? *


 Who be dat?  Me?  PA?  MedicJon?


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## Luno

whoever gets beat, (actually, it couldn't be you, erika, I don't even pretend that)


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## Jon

> _Originally posted by Luno_@Dec 29 2004, 06:57 PM
> * whoever gets beat, (actually, it couldn't be you, erika, I don't even pretend that) *


 I don't think so, I'm only on the other side of the country.


Jon


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## PArescueEMT

No you didn't luno. I always beat the snot out of jon. but he deserves it. I could put in some fairly incriminating things if he doesn't object and you guys want it...


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## rescuecpt

> _Originally posted by Luno_@Dec 29 2004, 06:57 PM
> * whoever gets beat, (actually, it couldn't be you, erika, I don't even pretend that) *


 YEAH - cuz I'm the one giving out all the beat downs around here!  YEAH BOYZ...


LOLOLOL I crack me up!


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## MedicPrincess

> _Originally posted by PArescueEMT_@Dec 29 2004, 11:27 PM
> *I could put in some fairly incriminating things if he doesn't object and you guys want it...*


Let's here'em.  "EMT Man" shouldn't mind.....


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## Jon

> _Originally posted by PArescueEMT_@Dec 29 2004, 11:27 PM
> * No you didn't luno. I always beat the snot out of jon. but he deserves it. I could put in some fairly incriminating things if he doesn't object and you guys want it... *


 C'mon, Don't, man. You do teach me self defense - yeah, how to defend myself from bouncing off the ground (Monty Python Style - RUNAWAY, Run Away!!)



Anyhoo......
Jon


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## PArescueEMT

I wasn't talking about that... I was talking more about early morning Pt. care after little to no sleep.


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## PArescueEMT

That good ole' "XXX on scene... Jon, can you hand me gloves?"
Jon: "ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ"

I needed to douse him with a 10cc saline flush to wake him.


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## TTLWHKR

When I'm stressed out... I go to a chat room and talk alot, about nothing. I come in to a forum and type on everything I can think of. Or I just bottle it all up and let it out in the form of anger when someone really pisses me off.

or... I get drunk, have a good time, and then forget that I bottled it up.
I hide from stress...

h34r:


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## TTLWHKR

From Ray's post...
"Meeting your neighbors one siren at a time...."

Did you read that book too?

Population 485, Meeting your neighbors one siren at a time....


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## Wingnut

I'm on meds, and I haven't even started working yet....I suck


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## shorthairedpunk

I understand the concept of CISD and all that, but Im a fan of not really thinkin bout it, or if I have a particularly concerning call, I write a detailed report from start to finish, then I analyze it to find a mistake I made (which no matter who you are, there was a mistake) then I find relief because it puts me back in control, and gives me something to learn from. If ever I were to go through a call that wasnt the best and found out there was absolutely no mistake I made, then I would probably quit, it would meant I have no control over what happens, and my suspiscion that god is a prick would be verified.


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## PArescueEMT

> _Originally posted by shorthairedpunk_@Feb 13 2005, 11:43 PM
> * god is a prick *


 are you the mole????


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## Wings91

.


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## SunshineCamo

Exercise is a close second, but hobbies are my stress relief. I love to go shooting. During the week when i can't, I'll put on my gear and practice. I try to incorporate things I enjoy into everything I do. So I read between calls (about to finish the Wheel of Time, it's going to be emotional for me), I talk to my wife a lot, I have a few very close friends that I chat with, and I just try to stay calm. The best to de-stress is to not get stressed in the first place (which is admittedly hard in this line of work).


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## wilderness911

My dog is a master of CISD.


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## Seirende

wilderness911 said:


> My dog is a master of CISD.



Haha, yes! My poor dog has heard so much confidential information. She usually looks pretty confused, but, hey, she listens.


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## artman

I used to share my stress with my family members and always try to hear their words. It gives me a lot of relief.


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## TheScientist

Viewing the results of the poll, it's interesting how no one has ticked 'Talking with co-workers'


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