We are all in this business to help people when they need help the most. To be the person that our community can count on, we need to be ready to meet the challenges of the work that is needed to help them. Most of us know that being ready means to have trained and prepared to get the job done. The truth is, however, that when we break things down and define the pieces that go into the idea of being “fit-for-duty”, there are many important components that need to be satisfied in order for us to be truly “ready”. If we are not paying attention to all those parts, we find ourselves not up to perform the job safely or not fit to help our team and community. Let’s look at what being ready really means by first breaking it down into its parts and then looking at what goes into each part.
So, what does it mean to be “Fit-for-Duty”? If we break it down to the main components, we can look at our readiness as involving the following parts:
- Training Readiness
- Medical Readiness
- Behavioral Readiness
- Ready Now
Some of these pieces are things that our department is responsible to help us with such as providing training, establishing policies and providing resources. Others are up to us to pay attention to and look after ourselves to be safe and a reliable resource. Let’s break down what each of the above pieces consists of.
Our training readiness is the foundation of our ability to be fit for duty. For most of us, it goes without saying that if we don’t prepare to perform the essential tasks we are assigned, we aren’t ready and able to do the job. Our respective agencies should have a clear policy addressing all aspects of required training to participate in operations and to attend department functions.
For all of us, this starts with the initial training and orientation we receive when we make the commitment to pursue a role in emergency services, such as our Firefighter I & II, SCBA certifications, basic EMT, OSHA and other foundational training. Additionally, we need to engage in proficiency training that needs to be performed periodically such as our annual OSHA and mask confidence updates or your periodic EMT refreshers and the “keep sharp” drills to maintain muscle memory and knowledge. Additional training, we all need to take part in is what I prefer to call “good citizen” training. Most states have mandates that require an annual review of training that relates to prevention and response to harassment, discrimination, workplace violence and sexual harassment. It includes learning about how diversity and inclusion can enhance our agencies and our lives. Many in our line of work don’t understand why we need to do it. The answer is simple: we have been acting badly for years. I would argue that while some say this is how firefighters and EMTs are, the truth is we have been wrong all along. The reason we are told we must have this training every year is also simple: we are still doing it wrong. These topics address how we keep our organization safe and inviting so everyone can contribute without fear or harm.
Our ability to perform our duties safely depends on whether we are physically capable of executing our assigned tasks without risk of injury or illness to ourselves or others. Like our training readiness, the department policies must guide what being medically ready means and how we measure it. This is why we do initial and periodic occupational physicals with qualified medical professionals. When I have a new medical condition that will take time to resolve, I must ask myself, “Am I healthy enough to be relied upon to do my job?”. If there is any doubt that we are honestly able to be safe when we work, we should report the changes to the department medical officer and work out the solution. All too often, we see a LODD report that a medical condition took down one of our brothers or sisters. I often ask, as horrible and tragic that is, “was that person hiding a condition, and how many others did we put in danger when they ‘fell out’”?
Medical readiness is a shared responsibility of your department and of the individual member. Do not hide a condition that could make things bad for you and for others. Follow policy regarding reporting of illness or condition that makes you unfit for duty. Another critical point is we must make sure the department physician or medical staff are qualified and understand the strenuous nature of our work that on occasion requires athletic levels of activity. We don’t need a doctor who thinks we sit around to be clearing people with serious conditions.
Lastly, while we talk about medical readiness, let’s look at your physical fitness. More than ever, the physical fitness of our team is being seen as a major function of our being fit-for-duty. Like I said before, most of the injury and loss of life in the fire service is related to medically related problems, and many of them are attributed to questions around the fitness of the victim. Our work often asks us to operate at the same activity level as a high functioning athlete. If we are not doing what we need to regarding physical readiness and nutrition, we are setting ourselves and our teammates up for failure. It’s up to all of us to get some exercise and eat right so we can be flexible, strong and have the stamina to get the work done without injury.
We do not often think about behavioral readiness, but I think it is important that we should. As many are aware, responders are exposed to a great deal of critical and traumatic stress in the routine performance of our duties. Advances in study of how we handle that stress have shown us that we need to protect ourselves from its short- and long-term effects. Our best defenses are to have ourselves in a “good space” when we respond to these calls. Ways to ensure this are partly through education and partly through keeping our own lives in order and knowing when we need help when things aren’t going well. We also need to be humble enough to know when we need more help.
The department is responsible to ensure you have had training that prepares us for those times when we are placed in “high stress” situations and to give us the tools to cope during those times and in our lives in general. There is increasingly more work being done today to provide resources to do just that. Encourage your agency to have an active “behavioral health” program. You are responsible to recognize that there will be days when you will be safer focusing on your personal, professional, and family lives and to choose not to respond because you are already operating at an elevated level of stress. The external stressors may include challenges we all face within our families, other professional responsibilities, and financial challenges such as reduced or lost income, experiencing an expensive loss like a car or home repair, or simply not being able to focus on things and needing a break from the responder stressors. We cannot afford to have you attempt high risk activities if you cannot provide 100% focus or are already in the “danger zone” because you’re having trouble coping with the cumulative effects of our work.
The last, particularly critical component of our ability to be fit-for-duty is all about our own character and ability to be self-aware and accountable to ourselves. After considering our training, medical and behavioral readiness, there is still the need of us to individually recognize we are up for the job and can perform safely when it is time for duty. For example, when was the last time you might have been fighting a pretty tough cold or flu, and when the bell rang for that big emergency, you still got up and went to the call? Were you ready and safe? Were you truly “Fit-for-duty”? Probably not. We need to be aware of our ability to be safe, whether it is a temporary medical condition such as a cold, flu, or injury. The same is true if you are having a tough day at home or in other parts of your life. Can you focus on the job, and can the rest of us depend on you to be paying attention in the days following the loss of a family member or during other significant life events? Accept that sometimes the answer to that question is no, and you need to sit “this one” out.
The last “Ready Now” concern is a big one. You are celebrating a holiday, a graduation, or a birthday. You may have had a few drinks or indulged in recreational use drugs. Maybe you are experiencing a temporary medical or dental condition that requires the use of medications that have a sticker on the label or packaging that says “May Cause Drowsiness”, suggesting they can impair you. Are you safe to be working for your fire department or EMS agency? Absolutely not. Too often we see people “answer the call” when they are using drugs and alcohol and the outcomes are tragic. Team members are senselessly injured, the community is harmed because a responder was impaired and ineffective, and the credibility of the agency is forever scarred. This one is on us. Simply accept that that fire or “big call” will not be the last one in your career, and you are just a single person who is not operating at 100%. They don’t need you. Take the night off and sit this one out.
Being fit to perform our duty as a responder requires both our departments and us to be making sure all these pieces of the puzzle are in place. We need to be trained up, medically ready and in a good place emotionally and behaviorally to operate at the expected level of a professional first responder. If any of these pieces are incomplete, we are not fit-for-duty. Lastly, it is everyone’s responsibility that when that call comes in or when we report for duty, there is nothing standing in the way of us being the people that our teammates and our community count on to meet the call for help and take care of the problem safely. Most of the things we have discussed here are in our control. Accept that sometimes there are things that are not and do what you need to so you can safely return to being fit for duty. Take the responsibility to be ready, when we need you ready and humble enough to know and accept when you are not.