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After Action Reporting and Curbside Manner

 

Saying the unsayable with regard to After Action Reporting (A.A.R.) and Curbside Manner as positioned by the National Fallen Firefighter Foundation Section 13 Mental Health and Wellness of the Everyone Goes Home®16 Firefighter Life Safety Initiatives – a personal view from Firefighterveteran Shannon Pennington.

Shannon PenningtonDr. Richard Gist from the Kansas City, Missouri Fire Department working with Section 13 and Vicki Taylor working as a clinical practitioner with the National Fallen Firefighters Foundation Life Safety Initiatives Section 13 have both produced, in consult with a few other fire service administrators, a “DRY HYDRANT” for the front line working firefighter regarding stress, Post Traumatic Stress (PTS) and Acute Traumatic Stress (A.T.S.) reactions. Traumatic wounds are those calls that require psychological modeling with interventions that work including the Critical Incident Stress Management / Critical Incident Stress Debriefing (CISM / CISD) models we have used over the past years. CISM  / CISD have been dropped and replaced by A.A.R. and Curbside Manner without scientific evidence they work.

 

After Action Reporting as positioned by the Section 13 team of Gist/Taylor and others is not what A.A.R. was designed for. Its origins are in command structures based on Armed Forces training and operational reviews. This is an in depth, time consuming process.  In firefighter terms it is supposed to involve the should have, could have, would have, and caters to management not front lines in determining who “f….d” up and who will hang for it. From a “Logisitcs Point of View”, A.A.R. is time consuming, detailed, and extensive.  Departments with large call volumes simply cannot afford to complete the numerous tasks required of A.A.R. nor can volunteer departments, since their time is limited to getting the job done and getting off duty.

 

Dropping CISM / CISD from the Section 13 one size fits all A.A.R. model and Curbside Manner will not and does not produce the required mental health intervention needed.  CISM, with the added component of the “D”, will continue to serve the front line Rubber Boot Warriors with the immediate debriefing that has worked for so many years. The exclusion of CISM / CISD in the Gist/Taylor Model will result in a “Dry Hydrant” crisis.

 

In our line of work, civilians should not be in charge of anything more complex than tying their shoelaces.  Along with the A.A.R. / Curbside Manner models comes a “Field Test” to check the firefighter for signs and symptoms of stress after a traumatic call. Firefighterveteran Pennington asks these questions:

  1. On whose order or authority will you, the front line Rubber Boot Warrior, be compelled to take such a psychological test?
  2. Will it measure up to the standards set for testing psychological injuries as defined by the current literature in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Addition (DSM-5) of the American Psychological Association?
  3. Who will administer this test to you?
  4. Will they be qualified to read the results of your test?

There is no compelling requirement to disclose anything about how you are feeling about a call.  That is between you and your family doctor and nobody else in your department.  All too often disclosure of a psychological injury causes harm to career and leads to dead end postings and f…ups running the show, and you into the ground.  If you want a career ending test, the A.A.R. / Curbside Manner model is it.  N.A.F.F.V.N. and Shannon Pennington give a thumbs down to the operators pushing the narrative through hoses that lead from the pump panel of bureaucratic bovine scat (thanks norman).

 

Instead, read up on the following:  Comprehensive Acute Trauma Stress Management (CATSM / ATSM) from Mark Lerner, PhD and Ray Shelton, PhD with the American Academy of Experts in Traumatic Stress. There is a workbook available which is easy to follow and gives you the tools for your mental health toolbox for under $30.  No bovine scat there.

 

In comparison, the Gist/Taylor model of A.A.R. / Curbside Manner looks like they took the C.A.T.S.M. / A.T.S.M. model and replaced the words  A.A.R. / Curbside Manner to do the same thing.  Re-inventing the wheel on work done already. Academic Plagiarism.

 

It can also be said that Gist has had a running wildland fire with Jeffrey Mitchell, PhD who brought us CISM / CISD.  The biggest glaring thought on my part is that Mitchell became a paramedic and rode the trucks and has front line experience.  Gist, on the other hand, is still wearing his loafers and tie while he waves his rattle and spits the nipple on his understanding of what the front line needs. Again bovine scat and dry hydrant.  Gist has a history of writing papers that take the opposite point of view to the effectiveness of CISM / CISD modeled by Mitchell and the International Critical Incident Stress Foundation (ICISF).  Look that up.

 

The academic versus the actual real world construct gets down to “putting the wet stuff on the red stuff” to use Chief Alan Brunacini’s fire ground tactics. The wet of CISM / CISM-D is ours through the blood, sweat, and tears that has been forged in us. We have used it and it works.  CATSM / ATSM works. If added to the CISM/ CISD protocol, it becomes another reinforced, effective use of the programs already used and in place.

 

We do not always use an Elkhart tool, but they are on the rigs.  We will need to put a hose clamp on the line of bovine scat coming our way from the boys and girls in the rear with the gear. Those on the nozzle end will need to put a firm thumbs down on the back pressure being delivered and causing ineffective delivery of the wet stuff on the red stuff of traumatic stress and post traumatic stress.

 

There are very large EGO’s involved here and the front lines of the American fire service are caught up in the backdraft.  Large diameter thinking means we get connected to the information and change tactics, but keep CISM / CISD.  Law Enforcement is keeping it.  EMS stand alone departments are keeping it.

 

We are flesh and blood, muscle and bone. Treating us like uneducated front line responders who fight the stress fires on every call simply draws attention to the “Perps” who are arsonists trying to burn down the CISM / CISD building that has been standing and sheltering us over the many years it has been used effectively.  It is a tool in the tool box. Those who are promoting  the  A.A.R. / Curbside Manner are “fools in the fool box”.  They are riding the horse backwards and expect us all to follow them.  That is just not going to happen.  My Thoughts, My Way.

 

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Everyone should view this.

 

Removing The Stigma of Mental Illness

Dr de Blois uses Mindfullness Training along with Equine Assisted Therapy.click the link below to view her web site and view her extensive credentials. She is a highly certified Trauma Informed Clinician.


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Station House’s residential program is designed to help first responders overcome substance addiction. The program is exclusive to first responders.



“If you have no capacity for violence then you are a healthy productive citizen: a sheep. If you have a capacity for violence and no empathy for your fellow citizens, then you have defined an aggressive sociopath—a wolf.


 

 

They can help you get back to the job or to a new beginning and quality of life with the tools necessary to master critical incident stress.

 


 

Stephanie Conn, Registered Clinical Counsellor, R.C.C., specializing in issues affecting emergency services personnel. Former law enforcement officer and CISM peer support.  Vancouver B.C.

 



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