A Comprehensive Guide for Health and Wellness Professionals Who Want to Work in Fire
The Fire Service Needs Your Expertise!
Let's first start by defining Health and Wellness (HW) Professionals. Included are Athletic Trainers (ATs), Physical Therapists (PTs) Strength and Conditioning (S & C) Coaches, Dietitians, Mental Health Professionals, and potentially Occupational Therapists (OTs). These professionals can provide valuable services and resources to the men and women sworn to protect lives and property, often at the risk of their health and longevity.
Very few departments have these HW professionals contracted or on staff, and the potential for a substantial return on investment (ROI) in monetary and quality-of-life terms exists. For the most part, departments aren't aware of how impactful these HW services can be. Understanding the fire service and expertly walking departments through what it could look like to have their own S & C coach, Dietitian, or other HW professional can help them appreciate the advantages and see the value.
Several departments in the United States have robust programs utilizing contracted or employed HW professionals, including Denver,Indianapolis, Fairfax County, and Austin Fire Departments and some larger police departments. These agencies provide Strength and Conditioning, Athletic Training, Physical Therapy, Nutrition, and Mental Health Services or a combination thereof. However, employment positions for professionals within departments are few and far between. It's primarily a create-your-opportunity scenario; the process can seem daunting and lengthy.
What would providing services for fire look like? There are a few things to keep in mind-
Every agency is different, but…
All agencies generally need the same basic types of services and…
A comprehensive needs analysis is the only way to determine what to provide
I've made a free PDF with the basic steps, and you can grab it here.
Keep in mind, and we'll revisit it later, firefighters are at higher mortality risk than the general population, primarily due to complications of cardiovascular disease (CVD), accidents, suicide, and cancer. They're highly prone to injury on the job, which can devastate the department and the employee.
Their jobs are both physically and psychologically demanding and as caretakers, firefighters often fail to take care of an essential asset: themselves.
So, what services would be helpful for fire departments and their personnel?
Injury reduction measures
Injury education
Injury evaluation
Comprehensive and effective return-to-work programs (sometimes referred to as work hardening) after injury
Concierge services for treatment either within the department or via referral network
Wait times for the worker's comp system are crushing individuals and departments
Physical fitness evaluations
Programming to capitalize on fitness evaluation data and optimize health and performance
Group/team training
Fitness education, including ergonomics and optimizing for job performance
Nutrition education, meal planning and preparation, and counseling services
Mental health support, including counseling
If you're lost and looking for direction regarding providing fire services, you can check out my course: Building your Career in Fire: A Health and Wellness Professional's Roadmap.
Click here to get on the waitlist for my course!
For some additional perspective, check out the following FRW Podcast Episodes!
Megan Lautz, Mo Shea, Troy Torrence, Kelly Kennedy
If you're an AT interested in public safety, check out PSATS!
Fire Department Organization and Culture
In the United States, different types of agencies provide fire protection services, possibly combined with emergency medical services (EMS) and various other services, including Underwater Rescue and Recovery, Hazardous Materials, Technical Rescue (above and below grade), and fire investigation. Many fire departments are volunteer, paid-on-call, or part-time, although full-time career fire departments typically cover larger jurisdictions.
Fire agencies may be associated with a city or village, a county, or even cover multiple jurisdictions as a fire protection district. Their employees may provide EMS or contract with another company or hospital-based EMS provider to cover medical emergencies in their communities.
It's important to note that most career and part-time departments operate on a rotating 24-hour shift schedule where employees work an entire day or more at a time before receiving time off. Examples of the schedule include 24/48, 48/96, and other variations. Although firefighters can sleep at night, they typically sleep poorly even if not interrupted by emergency calls. As outlined above, many departments are categorized as all-hazards and respond to other calls besides actual fires. Requests for medical services, car accidents, natural disasters, and cats in trees are all responses that FDs field.
Call volume in the US has increased exponentially in the last few decades, and many agencies have also downsized due to budgetary constraints. Therefore, the wear and tear on individual personnel is higher. They're responding to more calls and getting less sleep than previous generations of firefighters.
Mental health challenges are increasing in numbers. The great news is that the stigma of raising our hands and saying, "I need help," is decreasing. The bad news is that suicide takes more firefighters' lives than other line-of-duty deaths combined.
The job is stressful, and the hours are long. Firefighters see unspeakable pain, suffering, and trauma, and then we respond to the next alarm and do it all over again. So although firefighter FITNESS is critical, firefighter WELLNESS is what saves our lives. Upstream interventions and education on sleep, nutrition, mental health and movement all address mental health challenges on the front end, where we can have a considerable impact. As Desmund Tutu said, "There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they're falling in."
Neglecting Firefighter Health and Wellness: Why In-House Programs Aren't Enough
Typical fire departments engage in do-it-yourself (DIY) on-duty in-house program management, if there is a program at all. So the very first responders you trust and count on to be there when you need them are splitting their time and attention by attempting to manage programs they have neither the time nor the background/training to handle. As you can imagine, emphasis on the HW program quickly goes to the wayside when other duties appear.
Throughout the world, many fire departments don't emphasize HW at all. They provide neither time, space, equipment, instruction, or support for their members when they should benefit from all the resources a professional athlete would enjoy. Think of it this way: when your house is on fire, or your loved one isn't breathing, wouldn't you want the fittest, healthiest, and most mentally well first responders arriving at your home?
Check out this podcast I did with Troy Torrence on this topic!
Physical and Mental Demands of Firefighting
Consider this: firefighters aren't superheroes. They're the general population with all the challenges therein, and then we deprive them of sleep and expose them to decades of ongoing trauma. Any mental or physical health challenges observed in the civilian population are amplified in the firefighting population.
Firefighters face greater mortality risk than age-matched civilians and primarily die on duty due to cardiovascular disease (CVD) complications and motor vehicle accidents. It may surprise you that cancer and suicide, in addition to complications of CVD, kill our firefighters off-duty.
Sport science has elucidated some benchmarks required to perform structural firefighting effectively, and they include:
Minimum VO2max of 42 ml/kg/min
Sustained anaerobic ability
Lactate tolerance of 6-13 mmol during strenuous FF operations
Additional requirements for:
Muscular strength, endurance, power
Joint mobility/stability
Proximal stability ->> Distal mobility
Proper body mechanics (Frost, David M.; Beach, Tyson A.C.; Callaghan, Jack P.; McGill, Stuart M.. Using the Functional Movement Screen™ to Evaluate the Effectiveness of Training. Journal of Strength and Conditioning Research 26(6):p 1620-1630, June 2012. | DOI: 10.1519/JSC.0b013e318234ec59)
Healthy body composition
The physical demands of firefighting and its toll on the body are tremendous, and it's critical we don't leave firefighter physical health and wellness to chance anymore.
Check out research articles by AZ here.
Although physical fitness interventions are crucial, we can't overlook the importance of mental health resources. With suicide claiming the lives of many of our first responders off duty, access to quality employee assistance programs (EAP), peer support, and early and ongoing education and intervention is imperative.
