What first responders wish the public understood about the job

The job is not the same as what you see on TV.

Recent television shows featuring first responders (think Chicago Fire, Med, PD, and 911) often depict firefighters, paramedics, and police officers performing heroic acts to save lives. Every week, some monumental event happens, and the responders have to find a ‘creative’ way to solve the problem. Unfortunately, for responders, we do not have these calls multiple times in a shift. Many of the incidents you see on TV are once-in-a-career calls. Also, many of the ‘creative’ solutions violate all the safety guidelines we follow.

​The structure fires you see on TV have clear visibility and the fire is obvious. In reality, visibility in a house fire is almost zero. Searching for potential patients is all about feel and sound; you cannot see your partner in front of you. Also, fires are hot. Really hot. Firefighters crawl on the ground because the fire can exceed 1500 °F at standing head height.

​Neither paramedics nor firefighters run to a call. Once on scene, we walk, often to the frustration of the bystanders. I understand your frustration. You called for help, and you are having an emergency. We don’t run for our safety. And your safety. Remember, you called us to come fix your problem. If we are running and activating our fight-or-flight response, we will miss some potentially important scene details. There is a lot to take in quickly to assess whether the scene is safe for us to enter and to identify potential secondary or tertiary ways we could be injured.

Calls don’t stop when the shift ends.

You might have heard of posttraumatic stress disorder (PTSD), a condition where the memories of past events cause problems in the present. Throughout a career in emergency services, there will be calls that stay with us. Not every first responder has PTSD, but everyone has memories of past events. Our memories are with us forever.

First responders are human beings too.

Society calls first responders heroes. Children play firefighter, police officer, doctor, nurse, and paramedic, and dream of being helpers when they grow up. We teach elementary school children to trust first responders. I agree wholly that we want children to trust first responders. However, calling us heroes dehumanizes us at the same time.

​Holding first responders to an unattainable standard is not your fault. Culturally, we’ve all been doing this, and it does drive people to join the fire department. What happens is when you call 911, you expect responders to arrive and solve or fix the problem, or save a life. If we cannot save the person, the anger turns towards us. If the fire is out of control and we can only stop it from spreading to other houses, people will blame the fire department. Expecting perfection every time is unrealistic. We already feel disappointment in ourselves when we do everything we can and still don’t achieve the goal. We want to save lives. We want to protect people. Unfortunately, there are some circumstances beyond our control.

Humor is often a coping mechanism.

First responders are known for their dark humor. And we have good reasons too. Busy departments, busy shifts, and busy trucks run from call to call. Without having the time to process any trauma we’ve seen, we use dark humor to compartmentalize the trauma so we can be present when we arrive at your emergency. Dark humor is a good short-term coping mechanism; however, without a way to process trauma, it becomes the only way we cope. This can create problems as we find other means to process and cope with trauma.

​So if you hear first responders engaging in dark humor, remember it is a way we can cope in the moment and be ready to respond to the next incident.

​Most calls aren’t what you expect.

A large portion of first responders' call volume involves helping people in the community who have no resources. A disproportionate number of unhoused people use 911 as their primary care provider. First responders act as front-line social services for the community. We respond to people in acute mental health crises, substance use problems, and other social issues. We have become the social safety net, a role we did not understand for decades, and are becoming more aware of our place in the community today.

​In one way, the 911 marketing campaigns worked well. If you don’t know who else to call, 911 has become the default. As agencies learn to incorporate the new role, we start to see services geared towards providing the social needs of the population. Community paramedics are used in areas to help reduce 911 overuse by following up with patients who have chronic illnesses. Police have crisis intervention teams (CIT) to address people having non-medical crises. The CIT officers are trained in de-escalation and provide other pathways for helping people in mental health crises.

​If you’re a firefighter, paramedic, or law enforcement officer in Orlando looking for support, I offer therapy specifically for first responders.