9-1-1

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9-1-1; What Is Your Emergency?

Sunday, May 31, 2009

Police Telecommunications

Taken from book of same name, written by Alan Burton who was a Captain at Contra Costa County California Sheriff's Department

Following are excerpts from the Foreword written by George K. Burton, retired Captain from the same Sheriff's Department


In many law enforcement departments, the communications center is considered a "step-child," unwanted by records, patrol or services divisions. However, this all-important function of modern police activity is vital to successful operation of the above listed divisions along with the entire law enforcement management.

Law enforcement communications now include many things -- base station transmitters, patrol car mobile radios, mountaintop repeaters, mobile radio systems, car-to-car radio traffic, handie-talkies, pocket receivers, tape recorders, communication traffic handling, communications records and personnel examination and selection.

Excerpts from Chapter 1: Essentials and Organization, Importance of Dispatching

The purpose of a modern police communications system is to allow centralized control of police personnel who are dispersed over an area of operation. To accomplish this purpose there must be a two-way flow of information, as no intelligent control can be exercised without information from the area of operation. In addition to this primary purpose, there is the invaluable asset to the officer of having available to him those support services which are essential to an efficient execution of his tasks.

As the area of operation expands, the need for communication increases. It makes possible the rapid dissemination of the critical information needed for apprehending criminals. The wealth of knowledge stored in the department's records, as well as in other agencies, is only a request away. It provides communications to remote areas where telephones are not available. A network of radio and teletype communication keeps the patrol force mobile while controlling a fluid traffic movement. The dispatcher and field officer must know all the fundamentals of radio operating procedures in order to cope with any type of incident and to be able to operate as a team when human life is endangered or other emergency arises.

Telecommunications facilitate nearly every police operation, both in the field and at the headquarters. Rapid communication enables the immediate redeployment of the force to meet diverse situations, promoting the safety of the individual officer.

One needs only to recall the history of the police service prior to 1930 to realize the importance of telecommunications. The field officer ventured out into the world, fortunate indeed if he had an adequate call box or signal-light system. Runners frequently had to be sent searching for a patrolman to tell him of any crime or incident. Today, with an average of half the field force away from the headquarters, these men would be considered as lost to the command, except through whatever means of communication exists.

Dispatchers are important, too. Today, many dispatchers are sent to school to learn the most efficient and proven operating procedures and techniques. This was virtually unheard of in the recent past.

What has made police telecommunications so important so recently? In part, this is the result of taking the service for granted. The general thought was to leave the "radio people" alone; throw them a few dollars every year, the fewer the better; send them the typewriters after the repairmen condemns the machine; give them the sick, lame and lazy to work the desk; and have faith that everything will work out alright. This, however, is no longer the custom, thanks to many dedicated people. An awareness of telecommunications has been expounded in magazines, in newspapers, and even through the medium of television adventures. Behind the scenes, quietly but objectively and successfully, has worked the police dispatcher's best friend: APCO.

Telecommunications facilities are no less expensive now than they were a decade or so ago. Keepers of the budget seldom approve appropriations without severe scrutiny. The point is, money is being spent. People are interested. The realization is at hand: police communications is indeed here to stay.

The police communications system is charged with the responsibility of certain basic tasks, among which are the receipt and transmission of police information and orders, using the telephone, radio, teletypewriter and/or other communication devices. In most cases these facilities are locally controlled and operated; in others the headquarters equipment is owned and operated by adjacent or nearby jurisdictions. Whether locally operated or not, the essentials must nevertheless be provided.

Responsibilities of the Dispatcher

The communications operation of a police agency is said to be the nerve center, for through this facility flows virtually a myriad of calls, requests, and bits of knowledge. If this then is true, it can be stated with the utmost certainty that the dispatcher is the kingpin, the conductor, a guide, a pilot, and a director. Conversely, the dispatcher may be none of these, for without proper selection and proper training the dispatcher can be the scourge of the field officer.

The term "dispatcher" is not universally used among American police agencies, although it seemingly is used more than any other term. Depending upon local custom, such designations include the following: radio dispatcher, radio officer, communications officer, radio clerk, communications clerk, dispatcher-clerk, communicator and many more. The title, it is felt, should be descriptive of the duties performed. For this reason, references to "operator" or "dispatcher" would be preferable to "clerk" since telecommunication devices are "operated" and "dispatched" over, not "clerked."

Any person operating radio equipment, regardless of rank or position, is the voice and reputation of his department. The dispatcher is part of a weapon which can be a deadly hindrance, or an efficient furtherance; the operation of which is within his power to render effective or useless.

The dispatcher in one area may not perform the same duties as the dispatcher in an adjacent jurisdiction. While the position unquestionably demands skills not possessed by every member of the department, there is not always a demonstrable need for supervisory or command rank. The dispatcher, regardless of rank or status, must act as the "voice" of the commander in that his orders are so recognized by department regulation.

The dispatcher must have a wealth of the most desirable traits. The quality of rapid and accurate thinking, reasoning, and judgment is a necessity. The highest degree of intelligence available is none too good for such a trying position. Visual and auditory memory proficiency are indispensable. The dispatcher must be capable of working at traffic peaks with a cool mind, possessing the ability to make decisive judgments that are correct. Operators must have good radio voices, be alert and conscientious in their duties, and know the operation and use of each piece of equipment in the radio control room. The dispatcher must be able to determine the amount of manpower needed, select field units for assignments, direct them to take action, and follow up the assignments to assure proper completion. Decision-making is necessary, relative to out of service units, one-man units, overdue units, and scores of major and minor crises that arise daily.

Dispatchers must be trained in correct radio procedure and be required to follow the guide at all times. The dispatcher's position is one of control and responsibility.

What is the job of the dispatcher? Primarily, it is to serve as the link in the line between the caller and the field officer. If the only motive for employing a dispatcher is to mechanically parrot the words of others without understanding or realizing what is being said, then radiotelephones should be placed in the patrol cars connecting them through the telephone exchange with telephones in the homes and businesses in the community. This service is available. It will soon be discovered, however, that the dispatcher is much more than a mere link in the telephone line.

Of all the descriptions of the dispatcher, what constitutes one, or how important they are or should be, the following sums up the whole idea.

Policemen tend to take a good dispatcher for granted, and to curse the poor dispatcher. The good, accomplished dispatcher looks after the officers like an old mother hen after her chicks.

The patrol officer has an advantageous approach to the position that a fledgling civilian dispatcher does not have. A good dispatcher gains this knowledge, but he lacks at the start what a policeman has from personal experience. This is the first-hand knowledge of the street and the people. The civilian dispatcher gains this knowledge through experience only.

The dispatcher, if he is efficient at his duty, is the most valuable man on the watch. He most certainly has a prime position of responsibility.

The dispatcher dwells among docket books and telephones, report forms and cases, disembodied telephonic citizen voices, and disembodied officers' radio voices. He controls each radio car and is responsible for knowing the disposition of the men on patrol.

The Lieutenant and Sergeant are responsible for their men, but the dispatcher must know their area disposition and their availability at each moment. He must analyze each complaint and assign the patrolmen accordingly. He assigns the calls according to the beat boundaries, with the more serious calls having priority, and he must determine when to ignore beat boundaries. As he assigns the men to the most serious complaints he must take up the seemingly routine complaints in chronological order, to be handled as he can get to them (or as the men become free to be dispatched to handle them.)

Telephones and trunk lines abound in the station. The switchboard is a many-eyed monster with the individual eyes alternately, continually lighting. Often the dispatcher is harried as he works his phones, attempting to find a common denominator for speed, efficiency and politeness.

The result is reduced to a few lines typed upon the Police Bulletin and an appropriate radio dispatch. A few words from this man then sends a police unit to a troubled destination, perhaps across town, to investigate a shooting, barking dogs, noisy party.

In the repository of his memory, the dispatcher has flagged certain thoughts. When it seems that an officer has been out overlong on a call, the dispatcher will send another unit to the location to see if the first man is all right and has control of the situation. If the call had seemed to be of serious proportions at the beginning, the dispatcher would have sent two units, if he had them available, to the scene. There does exist those "sleepers" however, whose true dimensions are not known until the officer arrives. It is such a situation that the dispatcher is envisioning when he has another unit check the originally assigned radio officer.

The dispatcher is a chess-player, and the city is his board. He receives notifications of the opponent's moves by telephone. When his king (life, property and the peace) is in check, he must counter-move. He can move his pawns (foot patrolmen, when he has them) and his knights (traffic units, when he has them). These are somewhat restricted because of the specialty of their assignments. His radio cars are his rooks and bishops, which he will move across beat and across town to achieve his objective. The queen might be represented by his roving car, or crime prevention car, where he has them, or more likely, by the patrol sergeant. This unit will move anywhere, when needed to support the other pieces, or units.

This chess player moves his men among the welter of noise and seeming confusion, often in a complaining, urgent atmosphere. If, occasionally, he is unable to get his king out of check, then the checkmate results in death, or grief, or great financial loss. And this chess player may not deliberate over his next move; these moves must be made immediately, and they had better be correct.

Tuesday, May 12, 2009

Brain Attack: The EMD's Role in Recognizing Stroke & Ensuring a Timely Response

Taken from Public Safety Communications Magazine, May 2009
Written by Steven McDade, REMT-P, RPL, CHS, is the director of the Abbeville Co. Office of Emergency Management.


The telecommunicator answers a 911 call. A female voice starts frantically describing her husband's symptoms. Through proper use of the All Callers Interrogation EMD Guidecard, she determines the male is possibly suffering from a stroke. The last time he presented with normal signs and symptoms was 45 minutes prior to the 911 call. An advanced life support ambulance (ALS) is dispatched within one minute and enroute within two minutes. The EMS providers arrive on scene within eight minutes of the initial 911 call. The responders know it takes 30 minutes to get to the nearest Stroke Center from this location by ground or eight minutes by air.

Are these times important to the 911 telecommunicator? Is there a difference between the local emerency department (ED) and an ED that's also designated as a Stroke Center? What importance does time have in the event of a stroke?

Years ago we were introduced to the term heart attack for the description of someone experiencing a myocardial infarction. Through public education and extensive training, emergency medical dispatchers (EMDs) and field personnel learned to recognize and treat the signs and symptoms of a heart attack. More important, we came to understand that time wasted is in fact tissue damage and means death for the heart muscle. The same principle holds true for stroke victims. Time = Brain Function. We must treat stroke-like symptoms as a brain attack.

Several recent studies have demonstrated that the majority of strokes, or brain attacks, should be treated with the same urgency as if the patient is having a heart attack. Getting to the right hospital in the right time frame - within three hours of onset - can greatly minimize the long-term disability a stroke can cause.

The Stats

Each year, nearly 800,000 people suffer a stroke. And brain attack is the third leading cause of deaths and the most common cause of disability in the United States. Stroke can cause significant disability, including paralysis, speech and emotional problems. Among stroke patients, one-third will die, one-third will be disabled and one-third will experience little or no disability. Approximately 25% of those who recover from a stroke will have another stroke within five years. New treatments are available that can reduce the damage caused by a stroke for some victims, but these treatments need to be given soon after symptoms start.

The direct and indirect medical costs associated with a stroke will reach almost $69 billion in 2009, according to the American Heart Association. The average cost per patient for the first 90 days after a stroke is $15,000, although 10% of those cases exceed $35,000.

Signs, Symptoms & Treatment

A stroke occurs when the blood supply is suddenly cut off to part of the brain or when a blood vessel in the brain bursts and blood spills out around the brain cells. Thus, patients may present with either an ischemic or a hemorrhagic stroke, respectively. Ischemic strokes account for approximately 80% of all brain attacks, with hemorrhagic strokes accounting for the remaining 20%. Hemorrhagic strokes can further be classified as intracerebral (12%) and subarachnoid (8%).

The most common cause of an ischemic stroke is a blood clot that forms in the vascular system. A clot can form anywhere in the body; if it travels up and plugs a cerebral artery, it's called a thromboembolism. Possible origins of the clot are the heart, the large artery that supplies blood to the brain, a small artery or the blood itself crossing the blood-brain barrier.

The most common cause of an intracerebral hemorrhage is chronic hypertension, while the most common cause for a subarachnoid hemorrhage is an aneurysm rupture.

Callers may describe several signs and symptoms that indicate stroke. These include sudden numbness or weakness of their face, arm or leg, especially on one side of the body; sudden confusion or trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness or loss of balance or coordination; and sudden severe headache with no known cause. Other warning signs are double vision, drowsiness, and nausea or vomiting.

For treatment purposes, the remainder of this discussion will focus on the ischemic stroke. It is the most common, associated with 80% of all brain attacks, and is the one we can treat more successfully.

There are many risk factors associated with brain attacks, some are modifiable and some are not. Risk factors that are not modifiable include advanced age, male gender and family history of myocardial infarction or early stroke. Those risk factors that are modifiable include hypertension (systolic and diastolic), diabetes mellitus, hypercholesterolemia, cigarette smoking, prior stroke/transient ischemic attacks (TIAs or mini strokes), carotid disease, heart disease (especially atrial fibrillation), hypercoagulable states and drug/alcohol abuse.

Where should treatment be centered? On the penumbra, a zone of reversible ischemia around the core of irreversible infarction. The penumbra is salvageable in the first few hours after the onset of an ischemic stroke. Because you can't determine by exam how much of the brain can still be saved, treatment should be centered on a common chain of survival. That chain of survival comprises the seven Ds.

  1. Detection: Stroke onset.
  2. Dispatch: EMS activation and response.
  3. Delivery: Prehospital care to hospital (exam should include the Cincinnati Prehospital Stroke Scale, the National Institutes of Health Stroke Scale and/or the Miami Emergency Neurologic Deficit (MEND) Prehospital Checklist).
  4. Door: ED triage.
  5. Data: ED evaluation; CT scan.
  6. Decision: If the patient is a candidate and it's less than three hours from symptom onset, consider thromboytic therapy.
  7. Drug: Thrombolytic therapy can reduce the risk of disability by 30% but must be given within three hours of symptom onset.

The EMDs Responsibilities

What's the 911 telecommunicator's role in a brain attack? Our role should be centered on the first three Ds. To assist with detection, we need to ensure telecommunicators are trained and certified in EMD. Nothing can take the place of training. A key to minimizing long-term disabilities and even death is getting the patient to an appropriate care facility within three hours of the onset of signs and symptoms. The EMD must ask the proper vital point questions to determine the true medical emergency and its onset.

We need to know when the patient last presented without signs and symptoms. Utilizing this method helps minimize confusion about the timing of the stroke's onset, and it's the best way to determine if the patient is within the targeted three-hour window for drug therapy. It's vital to remember that the caller may have difficutly focusing because of the telescoping of time and the emotions involved, but we (911, EMS and hospital) need that critical information to be most effective in detection.

Obviously, if our 911 telecommunicators are trained properly as EMDs and can detect that the patient or caller may be experiencing a brain attack, the telecommunicator will take the next critical step: dispatching the proper EMS unit(s).

Through proper pre-arrival instructions and assessment of the patient by field personnel the delivery section of the seven Ds is initiated. From this point, delivery includes making sure that we know where the patient should go.

What is the most appropriate facility for our patient? Similar to the classification of Trauma Centers and Heart Centers, hospitals can also be classified as Stroke Centers. This step is a critical piece of the puzzle because it ensures the patient receives the most appropriate care. The locations of and travel time to these specialty centers must be included in EMD training. This is also important because if we identify the best receiving destination for the patient, we will be able to determine where they should be transported and if it should be by ground or air.

The need for a speedy response is dictated by the drug used to treat ischemic strokes: t-PA. According to the NINDS Web site, "The window of opportunity to use t-PA to treat stroke patients is three hours, but to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes. A five-year clinical trial conducted by NINDS found that selected stroke patients who received t-PA within three hours of the onset of stroke symptoms were at least 30% more likely than placebo patients to recover from their stroke with little or no disability after three months."

Conclusion

In the past, we may not have given much thought to our role as it relates to the patient suffering a brain attack, but as research and science continue to develop, it's evident that as 911 health-care professionals and "the first of first responders" we are the first link in the chain of survival. We must stay abreast of current information to ensure we stay a strong link to the survival of the patient, all the while doing our best to minimize long-term disabilities and possibly prevent death.

So, what about the 911 call for the husband who was experiencing a brain attack? At the end of the day, time was a critical factor in the treatment and outcome of this patient. Thanks to proper questioning and appropriate dispatch procedures, our patient reached a Stroke Center within the three-hour window and was administered thrombolytic therapy following a CT scan and the ruling out of any contraindications. As a result, he was discharged four days later without any disability.

Think about how the outcome could have been different. If the 911 telecommunicator had not been trained in EMD or had not followed the correct procedures, what would have happened?

Monday, May 11, 2009

Dispatchers = Compassion: How to Recognize & Prevent Compassion Fatigue

Taken from Public Safety Communications Magazine, May 2009
Written by Debra Peterson, communications supervisor with Salt Lake City (UT) Fire Dept. serving as training coordinator. She has worked in public safety since 1977 and in communications since 1980.


Ask any dispatcher what traits they deem necessary to be an effective public safety telecommunicator and somewhere in that long list of attributes you'll inevitably find the word compassion. No one can disagree with that. If you ask yourself or a co-worker why they wanted to become a dispatcher in the first place, you'll most likely hear such comments as "I wanted to help people" or "I wanted to make a difference."

Hopefully, they (and you) still have that same optimism and enthusiasm today. But what if you don't? What if you hear yourself saying: "I can't do this anymore." "What's the use?" or even "Why do we keep going there?" If you've said or thought something along these lines recently, you may be suffering from compassion fatigue.

Burnout

First used by the U.S. Army Nurses Corps in the early 1950s, the term compassion fatigue is now a psychological condition recognized in numerous professions, such as animal shelter workers, clergy and psychologists. During the past 20 years, the public safety communications profession has focused on Critical Incident Stress (i.e., what it is and how to identify and manage it). Although not formally recognized until recently, compassion fatigue has probably always occurred in the dispatch profession, but it's just now being considered a professional hazard. Also known as burnout, it's at the far end of the stress spectrum.

Stress is experienced through all five senses - taste, sound, sight, touch and smell. Memories are also formed using all five senses and stored in different parts of the brain. Example: Imagine for a moment a loaf of freshly baked bread. See it all nice and browned on top. Smell the aroma as it fills the house. Hear your knife cutting through the crust. Feel the warmth as you pick up that first slice. Taste the different textures of crust, inner bread and warm melted butter. Your mind has just pulled stored memories from different areas of your brain to make one complete picture - a memory - of an incident.

Now, let's switch to the dispatch world. You answer a phone and hear a mother screaming that her baby is choking. You calmly go through the steps you've been trained to perform, get proper incident information; send help; and give pre-arrival instructions. When help arrives, you hang up the phone, but then what?

If the phone isn't obsessively ringing and demanding our immediate attention, most telecommunicators replay the event again and again and again in their minds. First, you hear the phone ringing. Then you hear the mother screaming. You see the address on the ANI/ALI screen. You feel your fingers on the keyboard making the log and hear your co-worker dispatch the call while you turn your attention back to the caller and give pre-arrival instructions. You have used three out of the five senses to make one memory.

Two days later, you answer another call that turns out to be very similar, a screaming mother with a choking baby. You go through the same steps to process that call but something else happens. In a split second, you remember the previous call, that you were eating (taste) a healthy green salad just as you are now during this call and that your co-worker is again wearing the same ghastly perfume (smell) she was wearing two days ago. Your subconscious recorded everything from the call two days ago and is now involuntarily bringing it back to you. The current call will be added to your memory storage banks as a new incident and can be recalled when you least expect it. Imagine this cycle happening over and over. It can cause compassion overload.

Although the event hasn't happened to you, all of its emotion has been shared and transferred to you. You experience it through someone else's eyes, making it the "secondary circle of trauma." Because telecommunicators don't get the satisfaction of delivering hands-on treatment and because conforming to new HIPAA laws means it's virtually impossible to call a hospital and find out patient disposition, telecommunicators are left imagining outcomes or scouring obituaries for several days after an incident.

Unlike Critical Incident Stress, which is incident driven, compassion fatigue is cumulative and forms over time. Many would expect the 20-year veteran telecommunicator to be more susceptible than a three-year veteran. Not so. Just as everyone handles and manages stress differently, everyone's capacity for compassion is also different. The key is prevention, and the first step is recognition.

Recognize the Condition

Symptoms of compassion fatigue closely resemble those of post-traumatic stress disorder (PTSD). Just like burnout, compassion fatigue is an exhaustion that not only refers to emotional fatigue, but also physical and spiritual fatigue. You may have a diminished ability to experience joy or care for others, or you may begin to doubt your lifelong belief system. You're irritable at home and work, you experience sleep disorders, feel helpless and inadequate, and try to avoid tasks that typically would cause you more discomfort. You feel that you don't do anything right, and you've alienated yourself from friends and family. No matter what you say to yourself to talk your way out of the dumps, you still compare yourself to the mouse in a cage, running circles on a very, very small exercise wheel with no escape from the human suffering you're exposed to daily.

Take Care of You

Firefighters are taught to first care for their own safety, then their partner's and then the public they serve. Although that order goes against their human and moral instincts of wanting to help, the reality is they cannot help anyone else if they're incapacitated. There are numerous safety rules in place they must follow. Example: No one goes into a burning building without their personal protective equipment (Hollywood got it wrong in Backdraft), nor would they climb the stairs to fight a high-rise fire without their high-rise pack. Police officers also have safety rules to follow. Rather than jump into the middle of a group of five people fighting with knives slashing, officers wait for backup. Again, you can't help someone else if you're incapacitated.

Telecommunicators' jobs differ from those of our first responder counterparts because we handle all calls while they handle one at a time to completion. We are in information overload. So where's our safety net?

To avoid or conquer compassion fatigue, your life has to be balanced. Forty hours each week you're giving compassion, expending energy and helping people solve their problems, which range from the everyday mundane to life-threatening situations. Then you go home and care for family members or take care of household problems. And just like a battery that needs to be recharged, you run dry to compassion and energy. You need to replenish and receive, or take in, as much as you give out.

During the initial training for Critical Incident Stress Management, potential team members are told, "Stress is our body's normal reaction to abnormal events." So compassion fatigue can be defined as a natural consequence of stress that results from helping traumatized or suffering people. But it's also a preventable consequence, and no one is immune to this condition. It comes back to personal management and your life balance.

Preventetive Steps

The first step in preventing compassion fatigue comes from within. Focus on the positive rather than the negative. You can't control what calls you're going to answer that may put you in touch with a screaming mother and choking baby or other trauma, but you can change your thoughts. Rather than be angry because this mother has unwisely chosen to give a whole hotdog to a nine-month-old child, be positive and focus on the fact that you're doing everything you can to help the baby.

Whenever I hear someone in our office say, "It's been a bad day. I killed three people," I remind them that they did not kill three people and that we, as a team, used every tool available to us to turn the situation around and make it better. Sometimes life just goes wrong. Try remembering the oft-cited homily, "Look at the glass as half full instead of half empty." This may be difficult at first, just like the safety rules for firefighters and police officers on the street, but it will get easier over time.

Second, keep a healthy skepticism. There's nothing wrong with being angry at the father for abusing his child or the drunk driver who just killed an entire family, but put it in perspective and let it go. Allow yourself to feel sorrow, anger and empathy, and then move on.

The third step, and the most difficult for some, is exercise. If you've ever been in a CISM debriefing, you know that exercise is very important and a main coping and stress relief technique. It's easy to sit on the couch and click through all the TV channels while eating a chocolate bar or bag of potato chips, but exercise gets rid of the harmful hormones released in your body during stressful times. The good thing is that exercise can come in all forms. If you don't like the regimen of a gym workout, look around your house for things to do. As I write this, I know there's a driveway with about six inches of snow that needs to be shoveled, which translates to roughly 30 minutes of exercise for me. When was the last time you cleaned out your kitchen cabinets and put down new shelf liner? Does your shower door have hard water deposits and scum accumulation? As you can tell, I like to exercise and accomplish a task at the same time. It makes my mind more peaceful and allows me to rest easier. The key is to find what works for you and stick to it.

The fourth and final step in a healthy stress-reduction plan is to rest and relax. Find time for yourself, and do things you enjoy. Whether you prefer reading, gardening, playing the piano or soaking in a hot bubble bath complete with candles (yes, guys, you can soak too), it's important to take a vacation from responsibility for at least a few minutes every day.

At Work

Your employer can also help create a healthier work environment. Found at www.compassionfatigue.org, the Compassion Fatigue Awareness Project suggests that employers provide a respite for staff following any traumatic event. I know of one dispatch center that has a special room with a big comfy lounge chair, low lighting, a candle and access to soft music where their dispatchers can seek refuge after a difficult situation or call. This center provides a safe haven that encompasses four of the five senses, and dispatchers often provide their own nourishment to complete the circle.

Education is also important. Just knowing what to be aware of is usually all it takes to break the compassion fatigue cycle and keep a healthy perspective on life and the trauma we deal with. Two hours of stress management education is required in the initial Utah State EMD Certification class, as well as two hours for every recertification after that. (One example of how to fill that requirement is reading this article.)

Our biggest asset in creating a healthy work environment is each other. We sometimes spend more time interacting with co-workers than we do with family. This enables us to know each other well enough to recognize possible warning signs of compassion fatigue, such as prolonged grouchiness or a defeatist attitude. If these co-workers are open to dialogue, you can talk to them. If not, refer the situation to your supervisor. You'll be doing them a favor.

Well deserved (not phony) praise goes a long way toward creating a positive, caring environment. Tell the person sitting next to you they did a good job on a call, or tell the radio person they handled "that shooting" well. Allow yourself to feel good about a job well done, even if the ultimate outcome wasn't desirable. James Matthew Barrie (the creator of Peter Pan) said, "Those who bring sunshine to the lives of others cannot keep it from themselves."

If you're curious to see how you rate on the compassion scale, log onto www.isu.edu/bhstamm/tests/satfat.htm. This free online test created by B. Hudnall Stamm and Charles R. Figley is not meant to diagnose or confirm one's compassion or lack thereof; it's just a guide to see how you're faring and if there may be cause for concern. I took the test and confirmed what I had already surmised: I'm in the safe and healthy zone for now. I was glad to know that my occasional outbursts against society are normal and healthy. Remember, compassion fatigue is just a term, not a disease. The goal is to turn compassion fatigue into "compassion satisfaction," in which you feel the same rush of adrenaline and eagerness to help people you did during the first week of your career, regardless of how many years ago that was.

911 Dispatcher Creed

Today I.......

made life and death decisions....helped keep a Deputy safe....treated every caller as if they were my family....prevented a suicide....sent help in a serious car accident....helped find a lost child....exposed and overcame a bully....assisted in catching a crook....was a friend to a total stranger....calmed a frantic victim....prevented a drug deal....directed Lifesaver to a serious emergency....sent Star One flying to assist....stayed on the phone to comfort a parent....remained calm when a Deputy and citizen asked for help at the same time....reunited a family with their lost dog....learned something new....recovered a stolen vehicle....worked with integrity....educated a citizen....told a Deputy where to go (and he went)...helped a co-worker....made sure the EMT's were dispatched along with proper ambulance....remained compassionate....gave someone a phone hug that really needed it....worked with a great team....saved lives....worked with heroes....raised the standard and made a difference.

Today I kept my level...and I'll do it again tomorrow.


911....Professionalism with Compassion

Thursday, May 7, 2009

Shift Work and Circadian Rhythms

Excerpts taken from "Managing the 911 Center, A Book for Public Safety Communications Managers" 3rd Edition
Written by Eric Perry, ENP


Circadian rhythms are the biological clocks that regulate all life. Proponents of circadian rhythms believe that these clocks do not follow our twenty-four-hour day but rather a day about twenty-five hours long. Since humans should really be on this circadian day, we are continually thrown off our natural cycle by living our lives in twenty-four-hour increments. There is a great deal of interest in this science of chronobiology. The medical community was initially skeptical, but today there is more acceptance to how biological clocks affect our functioning. Our internal clock tells us when to eat, sleep, look for food and process it. Our metabolisms peak and ebb throughout the day, and these changes accompany biological variations in heart rate, temperature, blood pressure and others. They follow a regular predictable pattern, with the most noticeable ebb occurring during sleep. Circadian rhythms are reset by light, so theoretically, when light hits your retina, your internal clock is reset. The implications of ciradian rhythms go beyond our basic biological functions and have been linked to sleep disorders, jet lag, depression, and a host of other maladies. If a twenty-four-hour day forces the human body off its natural twenty-five-hour clock, then having to work the night shift must throw it into complete disarray.

Some PSAPs use variations of traditional eight, ten and twelve-hour shifts. For those who are bent on twelve-hour shifts, who cannot bear to give up four days off in a row, there is some hope. Often, shifts are modified such that a person works a month of days, on the four-on, four-off cycle. This means four days in a row working 0700-1900, followed by four days off. Then another four days of 0700-1900. This is done for four weeks. Then the employee changes to a month of nights, on the four-on, four-off cycle. This means four days in a row working 1900-0700, then four days off.

There are pros and cons to twelve hour shifts. There seems to be a general preference, by those who have done both, for the latter arrangement. The consensus is that there is more of a routine, and that the first day off is not necessarily spent sleeping.

The simple fact is that human beings are not designed to perform shift work. We are supposed to get up when it gets light, go to work, come home and go to bed when it gets dark. We are supposed to have a good, restful sleep and when the sun starts to rise, get up again. Unfortunately, 911 was not around when we were evolving such natural rhythms.

Not so long ago, everyone worked eight-hour shifts. Today shift systems use eight, ten, twelve and twenty-four hour systems with many combinations and permutations. There are no right or wrong shift systems, only those that are not as bad as the others. Good shift systems allow your dispatchers enough time to rest and recharge between work periods. This means rest periods and lunch breaks at scheduled times. Good shift systems allow for flexibility in overlapping human resources during busy periods. Shift systems should enhance your operational effectiveness, not tip it over.

In some operations, where the 911 facility is an extension of another emergency service, communicators and field personnel operate as one team. The communicators are actually part of the same shift, platoon or watch. This sort of a "oneness" system can cause some problems, but if your agency has been doing things this way for some time, it will be very difficult to change. Still, there is no strong case for keeping the same dispatchers tied to a particular shift of field personnel. The argument presented by those who support the oneness system is that the team approach is the best approach and that dispatchers are part of the team. But the very reasons put forth for the oneness system create potential operational problems.

One of the first things that becomes apparent under the oneness system is that each shift tends to operate with its own rules. If you have four shifts, then you have almost four different agencies. People being people, they will create their own way of doing things, introducing unwritten SOPs that will be unique from one watch to the next. This creates an immediate bias in the area of communications operations. For example, by "knowing" the best people for certain types of calls, the stage is set for communicators to be biased and selective in their dispatching. Have you heard the story about the person that could do almost everything? She was very busy. Then there was the person who could not do anything. She was bored. Both collected their pay on the same day, and the pay for both was the same.

In a situation where an automated CAD system assigns calls according to available units, does the computer know quirks and personalities? Another example: the consolidation or amalgamation of communications facilities that serve many independent agencies over a large geographic area is nothing new. If the arguments put forward by the oneness supporters were sound, centralized dispatch facilities would have to ensure that every agency served had the same group of people working the same shifts at every location. It would also mean that airlines should schedule the same pilots so that tower controllers get to know all the pilots coming and going.

A communications facility does not have to be married to a particular watch. A healthy overlap of a shift of dispatchers with a group of field personnel is actually better for the operation. It promotes professionalism by reducing bias and prejudice. It encourages adherence to SOPs, and creates both variety and stability in the overall operational work force.

Some people view twelve-hour shifts as the most unkind system of scheduling dispatchers. One of the reasons that agencies use twelve-hour shifts stems from wanting the shifts to track the field personnel on their shifts. But twelve hours in a communications facility is completely different than twelve hours anywhere else. Inside the communications center, things do not stop. The center is a funnel that catches everything and then redistributes a portion to a team of field personnel. The work received by field personnel is a fraction of the overall work processed by the center. Twelve hours working in a funnel is not the same as twelve hours working with fractions. On the road, you can frequently escape the mayhem. In the center, you cannot.

A Brief History of Public Safety Communications

Excerpts from "Managing the 911 Center, A Book for Public Safety Communications Managers" 3rd Edition
Written by Eric Parry, ENP


Our history is a fascinating one. Some people can still remember a time when there were no two-way radio communications systems serving emergency services. Back then, metropolitan beat cops would periodically use call boxes to check in with the local precinct. If a call had come in that required police attendance, the beat patrolman (there were only guys back then) would be told the nature of the call and the address. He would then walk to the call location and deal with the people and events as he saw fit. Later, larger police departments switched to one-way radio transmitters that broadcast in, or just above, what we know today as the AM radio band. Patrol vehicles were equipped with AM radio receivers and would tune to the dispatch frequency to listen for calls. The dispatcher, usually a senior police officer, sat behind a monstrous radio transmitter. When a call for assistance came in, he would throw the switch and start reading out the information. He had no idea whether or not anyone had heard the transmission, but it worked. This is where the oft-used expression, "Calling all cars, calling all cars..." originated. Calls were broadcast in this fashion, and units would respond.

In some rural areas, the local telephone operator took calls for assistance. If a police officer was needed, the operator would activate a red light atop a tower (often the town water tower). The patrol officer would periodically check the tower, and if the light was on, go to the nearest telephone and call "central." The telephone operator would provide the details of the call, and the patrolman would investigate.

Other emergency services were not as sophisticated. Early ambulance services were often operated by funeral homes using converted hearses to transport the injured. In larger cities, hospitals or fire departments operated the ambulance service. Their communication methods were simple: the phone would ring, details were recorded, and a crew would go out. In those days, this is how it was, and it worked.

Fire departments operated in the same way, except in smaller towns, where volunteers did the job. In such towns, the volunteer fire department was summoned by ringing a bell, usually located on the roof of the town hall. Later on, these bells were replaced by pole-mounted sirens activated by whoever answered the "fire-phone". Upon hearing the bell or siren, volunteers would head to the fire-hall, where someone hopefully had scrawled the location of the fire on a chalkboard. The volunteers would then board their fire truck and head out into the country to try to save someone's farmhouse. In those days, instructions to callers (commonly known as "post-dispatch and pre-arrival" instructions) did not exist or were often deemed inappropriate for call takers to give. As such, life-saving instructions or evidence-preserving advice was virtually non-existent.

As time passed, society grew and technology evolved, our emergency services were pressured to become more accessible. The public started to demand better service.

"When I phone the police, I expect someone to answer."
"When I call for an ambulance, I want to receive life saving advice before the paramedics arrive."
"When my house is on fire, I want the fire department to know exactly where my house is located."

The public was growing tired to having to dial a different seven-digit number for each emergency service. Telephone operators were busier with other business, and were not always as easy to reach. As a result, changes started to occur. Certain police officers were assigned to answer the phone and dispatch calls over the radio. Private ambulance services with trained crews, and dedicated call-takers trained to offer pre-arrival instructions began to appear. Fire departments delegated certain firefighters to be responsible for call taking. Our radio and telephone systems also advanced, and new technology provided emergency services with tools to be faster and more efficient. Emergency call taking was centralized. Structured protocols for emergency medical call taking and dispatch were developed. Simplified calling (911) was introduced, and everything started to go faster still.

But what about the people who operated the centers? Who were they and where did they come from? In the period before and after the Second World War, most people who took calls and performed radio dispatching cam from inside emergency services. They were police officers, firefighters, or ambulance personnel. Unfortunately, some were injured or disabled employees who had been determined unfit for active duty, and were summarily dumped into "telecoms."

In communities located near military bases, something else occurred. After the Second World War, military communicators who were getting prepared to leave the armed services began to apply to emergency service organizations as dispatchers. These people, as it turned out, would start a subtle revolution. They were, perhaps, the first professionally trained communicators to work as public safety communications dispatchers. They were trained to listen to radio signals. When the radio conditions were noisy, they could pull the signals "out of the mud." Most were experts at copying Morse code signals. In the military, these "sparkies" had spent hours with headphones on, sitting at an old typewriter, methodically typing out coded messages. As they heard each number or letter, they could automatically strike the appropriate key. Due to their military training, they tended to be tactical in their approach to emergency operations. And they were respected by the male-dominated, paramilitary emergency services.

These ex-military dispatchers broke many barriers. They proved beyond any doubt that agencies did not have to keep their field employees working in their communications centers, allowing much-needed police, fire, or ambulance personnel to return to active duty. The hiring of ex-military personnel continues today, and they continue to do the job well.

But life in public safety communications has changed drastically in recent years. Evolving technology has made the computer the master of the operation, reaching vast and varied pools of information. The days of pencil and paper and typewriters are fast disappearing, although we revert to them when the electricity fails or when our newest system has crashed. Today, the keyboard, mouse, and multiple flat screen displays are the tools of the trade.

So who is the modern public safety communications dispatcher? They are men and women from every corner of our society. There are few boundaries in this profession. If you have the right personality, the aptitude, the skills, and the desire to do well, you can do this job.

Wednesday, May 6, 2009

Definition of a PSAP, Qualities of a Dispatcher

Excerpts taken from "Managing the 911 Center, A Book For Public Safety Communications Managers" 3rd Edition
Written by Eric Parry, ENP


Emergency service communications centers that perform 911 call processing are referred to as Public Safety Answering Points (PSAPs). PSAPs and public safety communications centers often differ significantly from one location to another. For example, one PSAP may do only call processing, which includes emergency call answering, caller interrogation, and call transferring to a specific public safety agency. Another PSAP may support call processing and call dispatching. Or, the communications facility may be part of an agency that receives calls transferred from a PSAP, then dispatches resources to emergency situations. Smaller PSAPs do "vertical" call taking and dispatching, where the call taker and the dispatcher are the same person. Larger PSAPs do "horizontal" call taking and dispatching where a designated call taker gathers initial caller information, then horizontally transfers the information to a designated dispatcher. Whatever your operation, all public safety communications facilities share common issues and problems.

Most people have little idea what goes on inside a PSAP. Many don't understand the impact that our dispatchers can have on the outcome of an emergency call. The PSAP is the first point of influence in an emergency situation. Our dispatchers are the very first "first responders" - the ones who begin to render emergency service the moment they answer a call. The public has a stereotypical image of what happens when an emergency call is processed. Very few people understand the complex chain of events behind a single phone call. It comes as a surprise that William Shatner is not standing in the background, ensuring every call a happy and successful outcome. Even fewer understand the kind of people drawn to this profession. Here are some personality traits common to the successful public safety communications dispatcher:

Public safety communications dispatchers are vocal

It comes with the territory. A shy person, or one who is hesitant to express what is on his or her mind, rarely becomes a dispatcher. Expect dispatchers to be avid and aggressive communicators.

PSAP dispatchers are blunt

They will tell you exactly what they are feeling and sometimes what they think you should do.

Compassion

People without compassion could not do this type of work. Compassion for others is what draws a person to this work. Dispatchers want to help people in need. Almost every call they take is for assistance of some kind - from someone in crisis to someone requiring directions to someone just wanting to talk.

Generosity

Generosity and compassion go well together. Every call requires a dispatcher to give someting - assistance, a listening ear, an answer. They are not afraid of self-sacrifice - they do it throughout their shifts all the time.
Fun
PSAP dispatchers are fun to be around. They tend to have good senses of humor and to appreciate a good story. Some people do not understand that PSAP business can be funny, but in a stressful environment, seeing the humor in a situation can be the key to survival.
Smart
They seem to know everything, and what they do not know, they will want to know. Stop and think about this. A dispatcher's job requires a huge array of knowledge. They are asked questions by everyone who calls. They must remember details and procedures and know what to do in all types of situations.
Good dispatchers are experts at multi-tasking
Watch a good dispatcher in action. Not only is she able to monitor radio channels, talk on the phone, type information into a keyboard, and keep an eye on a computer screen, but she can also carry on a conversation with her colleagues, asking and answering questions simultaneously! This is known as multi-tasking and is an important part of this job.
Good dispatchers like to be in control
Good dispatchers are no strangers to the concept of control. It comes with the territory. This job requires a natural ability to take charge of a situation, and get things handled.

Monday, May 4, 2009

Just Another Day on the Job?

Taken from "Notes From the Trenches" February 2001
Written by Linda Olmstead


We dispatcher-types get so used to working behind the scenes that it's sometimes difficult to accept the accolades for truly remarkable efforts. We stand up at our consoles and high-five our partners, chortle with glee when the field folks catch a bad guy (with considerable assistance from someone wearing a headset instead of a gun), we enthuse to everybody that walks in the door about the cool incident somebody on our shift just handled really well. But if there's a chance someone might actuallly notify the media or write it up in an industry publication, we get all shy about it. Awww, 'twarn't nuthin' - just doin' my job.

Then the media blast us - or another dispatcher or any public safety responder in the world - with 24 point font in big, bold headlines and we're all indignant about the injustice. After all, hundreds of thousands of calls got handled just fine, but one incident (every now and then) goes sideways and we're incompetent, untrained, negligent or otherwise bad for the public???? (muttering)

We'd like to see them do our jobs. You got yourself into that mess; try getting yourself out of it without us. What if you dialed 911 and nobody answered, huh? I mean, ever. (Because sometimes it does happen, but not all that often, compared to the millions of such calls that are answered promptly and efficiently.)

No Dent

We also lament the fact that Public Education efforts don't seem to have much of a dent in the number of truly stupid 911 calls. Public Service Announcements, "music on hold" messages, billboards and pamphlets left in public places are, well, boring to the masses. It's easy for that stuff to just slide on by without making an impression. (I find that the folks who are most interested in reviewing PSA material are US - not the target audience. We are constantly looking for good material and we'll roll our eyes when we find something that we just don't think "hits the mark." But who else reads 'em, hears 'em or gives a hoot? Certainly not the myriad of commuters carrying cell phones, or the kids traveling from pay phone to pay phone, or the people who may suddenly, someday, need to call 911 for their own emergency.)

"Everybody" knows what 911 is for, right? (snorting with laughter) Just like everybody knows exactly what should happen when they dial 911: exact location is immediately pin-pointed, specific medical instruction is readily available for any circumstance, and the Answers to All Your Questions will be provided. (more muttering) Yeah, right.

School kids are getting the word, though. Ask any grade-school or kindergarten student what 911 is for, and you'll hear appropriate replies: "The police come and catch bad guys." "The firemen come and put out the fire." "The ambulance comes and takes your mom to the hospital." Would that their adult family members have that same understanding!

"I've been stuck in traffic for 20 minutes now - what's the hold up?" "My neighbor is parking his car in from of MY driveway and the mailman can't reach my mailbox - make him move." "Did we just have an earthquake?" "There's a stray dog in my yard." And hundreds of thousands of similar complaints which don't even slightly resemble emergencies. Grown-ups make those calls to 911.

Use Training

Unfortunately, the public doesn't take classes in "How to Report an Emergency." Sometimes even tenured dispatchers need to be reminded of that (as silly as it may sound.) We know what differentiates a burglary from a robbery, but the public doesn't understand those distinctions. We know what sort of information we'll need to dispatch a call; the public is clueless in this regard. We just have to utilize our training, skills and knowledge to get them through their experiences, as safely as possible for them and the responders. We're the trained professionals here. Let's prove that fact rather than badger a "poor" reporting party. That's not the time to educate someone on "how to use 911."

But it is tempting, isn't it? Awwww, come on, I know y'all want to install the Magic Button that zaps the heck out of someone when they've made a 911 call for something ridiculous. Our dispatchers want to disable cell phones that make inadvertent calls to 911, particularly when we call back the number on the Caller ID display and the person who answers argues with us.

It's just a mystery how your phone dialed 911 all by itself, sir or ma'am, but we still have to check it out. Wouldn't you prefer we cared enough to do that? Trust us, we've got lots better things to do than randomly dial numbers and accuse folks of hanging up on us.

Several months ago, the dispatchers at my Comm Center called back a cell phone multiple times after a caller deliberately hung up on us. You see, the initial call was a suicide "announcement." Not the caller's plea to save her after a realization she wanted to live, but a confession of sorts before she died. Alone. Unidentified. Secreted in a cheap hotel and with her identification hidden so when somebody did discover her body, they wouldn't know who she was. The thing that foiled her plan: Caller ID. (Now we had a phone number to start the process of finding her, as inadequate a bit of information that served to be.)

The illegal drugs she chose to "burst her heart" didn't create that effect, but the effects confused her enough to let us continue the process of interrogating her in fits and starts with each subsequent phone call back to her. (She could have simply turned her phone off.) And, finally, she didn't anticipate the amount of effort we'd expend to find her before she died. She'd also tied a noose around her neck to ensure she died by strangulation when she got too tired to hold her head up. Well, one dispatcher kept her focused on talking to us, again and again, and again.

There were five of us on duty in the Comm Center: two radio dispatcher, two call-takers, and me. We were all involved in saving that woman's life. To be extremely honest, the fact that it was indeed "our save" - just us dispatch-types - without other people suggesting courses of action or doing field work until we located her - was very cool. (Oh, sure, after we found out where she was, the police, fire and EMS responders did the "hands on" work and got her safely to a medical facility. But we found her in time.)

The hour spent between her call to 911 and the moment the cops broke into that motel room was a flurry of unparalleled teamwork. Although one dispatcher had taken the original call, another took up the task of calling her back over and over again and establishing an emotional bond to get more information in dribs and drabs of disconnected conversation.

The rest of us utilized our pooled geographic knowledge, DMV access, reverse directories and Thomas Guides, made other calls here and there, got a Language Line interpreter involved at one point (with another person who knew her), called several motels to compare what we were learning with their registration information, oh just tons of effort. And it all paid off - for her, and for us.

Brick Wall

Of course, we're not the only dispatchers performing these remarkable tasks. Y'all are out there in your own Comm Centers handling other such incidents, equally as difficult and miraculous. Under incredibly adverse conditions like no ALI, or even no ANI at all. Others have encountered the brick walls built around cellular subscriber information, and surmounted them - or even attacked the problem at hand from another angle without assistance from the carriers. (As we did)

Meanwhile, the radios still get answered, the phones still ring, other calls are dispatched and the rest of the public and our field personnel receive optimum attention. The world rolls on.

So, it's the same old thing. Nothing much new. Right? (grin)

Fun Trainees

A "typical" trainee syndrome is that they know a little bit and they don't know what they don't know yet. Ya know? (grin) We hire entry-level people with no previous experience in public safety, but none of them have ever thought to call 911 for some of the stuff the public reports on those lines. (Well, not that they'd admit, I guess, after spending only a short time in the Comm Center.) But when they get one of these bizarre calls, their expressions are just so precious. (grin)

Those of us who've been around any amount of time at all are much harder to startle. We've heard an awful lot of strange things over the years. Now and then, something will raise an eyebrow or generate one of those looks at the phone handset (or console). You called 911 for THAT?

If you ever thought that yours is the only Comm Center to receive truly stupid 911 calls, you might consider buying a little book by Leland Gregory II called "What's the Number for 911?" or even adding the "Wacky 911 Calls" CD to your collection. Neither one is expensive and they're filled with the stuff that takes our time and attention away from the people who really have a reason to dial 911.

Even when nothing very spectacular occurs for a long period of time (those "mellow" shifts to which we refer instead of using the Q word), there's still the opportunity to appreciate callers who think we provide services that are only on their list of "what 911 does." Hopefully, those requests generate a bit of a shared chuckle after the call has been terminated. Or the situation was innocuous instead of something splashed in Headline News to erode public confidence in our abilities. One can only hope. Yeah, well, one can also do the best job with what you've got - and then hope it still turns out well. Most of the time it does. Wouldn't it be nice if the public understood that too?

You Gotta Love This Job

Taken from "Notes From the Trenches" January 2000
Written by Linda Olmstead



How many of us are in this job for the money? May I have a show of hands? Ahhh, we do it because it's a rewarding career, right? Day in, day out, this shift and that shift, we put on our headsets and plug into that console to be there for the public and our field personnel. After all, the work we do simply shouts for recognition.

(ahem) You betcha. That's why there are so many reproductions of that charming Norman Rockwell painting of the dispatcher giving pre-arrival instructions at the same time she presses transmit buttons on her console, right? Oh, and those bronzed figurines of the dispatcher, wearing his headset, leaning forward into his console - those are hot items at the trophy store, too! Come on, admit it: little kids tell their parents "I'm gonna be a 911 dispatcher when I grow up!"

Okay, so maybe it's not like that at all. But weren't you proud when you were first hired? You hardly sat back in your rolling chair because of that tangible alert mode, and you jumped to answer the line when it rang - it could be anything! And, it usually was. (wry smile)

Some time during your training period, didn't you wake up in a sweat at home, positive that you'd just "lost" an officer on your channel? I bet you even answered your phone at home with "911, what is your emergency?" more than a couple of times. This is vitally important work that we do! Oh, and the emotional high when a "baby not breathing" begins to cry, or the radio crackles, "No further assistance needed - one in custody!"

We all want to do well. We all want to shine. I suspect most of us have watched one or a dozen of the reality-based television programs and paid more attention to the dispatchers' voices, what they said and how they said it, than to some of the action scenes. Movies, too, right?

Small Screen

Matter of fact, we usually only heard a dispatcher's performance. Not many visual shots of Comm Centers, were there? (At least not until "Rescue 911.") But then those "recorded live" programs hit the small screens and I don't know if any of y'all have had those camera crews show up to ride along with your officers, but when they showed up for a week long shoot at mine, they didn't even roll practice tape inside the Comm Center.

This rewarding job of ours is a pretty thankless one. If you can't engender your own sense of value and worthiness, chances are you're gonna be feeling pretty low now and then. You're supposed to do an excellent job; anything less is usually worth criticism. This isn't a sit-back, put yer feet up, kinda career. We are here to serve the public - and they tell us that on a frequent and strident basis.

Overtime. Shift work. Feast or famine: if you're not slammed-to-the-wall busy, you're bored. Time for a crossword puzzle, one ear cocked for the sound of the phone ringing or a voice crackling across the radio. Somebody walks in about then and makes a snide comment about how easy you have it. (They don't visit when it's busy because - no surprise! - they're out there in the field responding to the calls you're giving them! But what they saw then is what they assume it's like for you: easy street, while they're out there bustin' their humps going from call to call in the rain.)

You can't get that day off you requested months ago and you have to get someone else to trade a shift with you so you can attend your daughter's school play on a Friday night. Somebody else got a day off they wanted. What's up with that?

You tell a hostile reporting party that "we can't exactly go out and shoot the dog so it doesn't bark any more, ma'am," and you get written up for it. Jeez, it's the truth, isn't it? We can't send 'em out there to shoot barking dogs, right?

You Love It

So. You are in this business because you love it. Most of the time. Or some of the time. Or once upon a time. You get really good at it, too. You want to make things better, (face it, things can always get better, right?) so you cram for a promotional exam. Maybe you don't want to promote, but you manage to talk the administration into allowing Comm Center personnel participation in some high-or-medium profile program.

Meanwhile, the phones ring, the radios blare and you go from This Call in That Level of Completion to That Call still in progress as you finish up the last little bit of the Other Call for which you've been waiting to get the field units' disposition so you could close out the log on it. It's a juggling act, fraught with tension and the sure knowledge that there is no net to catch the flaming swords you've got whizzing about in the air.

Yup, there are icky times and some rough periods (especially if you're a supervisor, because then you're in the middle between the dispatchers you care so much about and the administration which has a far different view - and I don't mean a diametrically opposed goal, just a larger "monster" to feed than the "why can't we fix this problem right here, right now?" standpoint of the line dispatcher.)

Act Now

You see, as dispatchers, we get problems dropped into our headsets and we act now to solve them as best we can. Stuff comes in, actions roll out. There ain't no "wait and see" or "let's look this over carefully" going on. (finger snap!) Get the necessary information as expediently as possible and follow through with an appropriate action, chop, chop! That clock is ticking, you know. Four minutes without oxygen and the brain starts to die. Fires double in size every twelve seconds.

Now, Comm Center supervisors, as a general rule, started out as dispatchers. But you know what? Their problems are not the same; seldom is the situation as immediate as those presented to y'all by telephone or radio. (I hazard a guess that most dispatchers are so well entrenched in that "Now! Quick! Don't hold that call!" mode that they think everything is an immediate need.)

I'm not denigrating anyone - I have to deal with my own desires to solve stuff now, this minute. Don't let it percolate, it might get bigger, badder and nastier! That's how I worked for so many years. I want to solve problems as quickly as possible. Can I? Probably not. And it's not necessary, either. Honest.

But try and tell that to the dispatcher-within-me. I take work home with me now, and when I come back to my desk, there's stuff left over from the day-or-week before, that I haven't had a chance to finish yet. Never did that as a dispatcher; ya stay 'til ya finish the call, or unitl you can brief someone well enough for them to take it over at the end of your shift and the beginning of theirs. Unless your geographic area was in a disaster situation, that same incident wasn't sitting there waiting for you the next time you came back on duty and plugged in your headset.

Support Role

Comm Sup job responsibilities are more geared towards supporting their subordinates than they are for the public. Yet, the needs of the agency and the wants of the public certainly affect the manner in which they can address problems facing their staff.

So, now and then I have a sick stomach for awhile, or I have trouble getting to sleep. It's not the sound of the crying baby or woman on the phone that preys on my mind any more, or the 15 minutes between the time a unit failed to respond for a status check and a beat partner located the patrol car upside down in a raging river.

Those aren't the things that bother me when I walk through the parking lot towards the Comm Center. It's the onus of telling a trainee he or she isn't going to make it, or discovering the budget has been slashed again and we're all gonna have to sit in those cruddy chairs for another two years. Or having to cancel Christmas for someone because somebody fell and broke a leg and can't come to work for quite some time - and I'm working Christmas, myself, so somebody else - with kids - can have the day off when we're already short staffed.

As frustrating as it can be, I love this career. There are times when I wish I was a dispatcher again, because I was "healthiest" then - work wasn't taken home (except emotionally, for processing). I didn't have to worry about things like this report or that project or the interpersonal wrangle between this and that dispatcher.

Thankless Job

A supervisor's job is really very thankless, even more so than that of the line dispatcher. Y'all know how seldom folks get acknowledged for doing a good job on the operations floor; well, few supervisors get praised for getting a massive project done that took weeks of work, or for getting up in the middle of the night to listen to a troubled employee and make a decision to bump it up higher so that person gets some professional help.

Nobody claps us on the shoulder for dealing with vendors who point fingers at other vendors and finally the technical problem is solved but only because you had enough knowledge about the system(s) to explain to each of them what the heck was really going on and voila! it gets solved. And so on and so forth.

My partner Comm Sup and I put our hearts into trying to make things run smoothly in the Center. We carry banners into battle with administrators, for our dispatchers. Sometimes we win, sometimes we lose. But, like dispatchers who work a pursuit or help save a choking baby or who coordinate response to train wrecks, we're simply expected to do our jobs.

What's this you say? Comm Sups want recognition, too!!??!! Huh.

Maaaan, I'm whining. (wry chuckle) For all the worry, for all the heartache, for all the long hours and not-so-great-pay - certainly not much of an incentive to promote! - this is still the career in which I hope to stay until they drag my skeletal remains from the Comm Center.

My signature line quote is exactly how I feel, happy to be here, proud to serve. Once in awhile, there's a dip and I'm not as happy as I have been on better days, but I'm always proud to serve.

It Suits Me

More than once, I've heard an angry, upset and stressed out dispatcher say, "This place makes me sick!" on the way out the door at the end of a rough shift. (Rough because of a snippy comment on the air - responded to in kind, or because some hostile caller screamed through the phone and then had the gall to complain when the dispatcher yelled right back. Or when an expected day off didn't materialize. Stuff like that, not the handling of a structure fire or a heart attack or an hysterical rape victim.)

This job doesn't make me sick. But sometimes I make myself sick. Over 23 years in public safety communications, and I've only started to use sick leave in the last couple of years because, frankly, I'm aging and fat and physically inactive and stuff tends to wear out on ya as the calendar pages flutter past. Nobody makes me smoke too much. Nobody forces me to eat meals of dubious nutritional value.

I'm drawn to this kind of work because it suits me. Other types of work are boring; I spent over a year trying to get back into Public Safety Communications when I relocated in 1991. For a year I worked in the private sector. Oh my. At first it was charming; I didn't have to deal with 911 stuff or cops or firefighters or anybody with a radio but that wore off within a month.

I'm an adrenaline-dependent kinda gal.

For new dispatchers who wonder "Is this job going to make me sick?", all I can say is: If it does, develop effective coping mechanisms or find another line of work. Y'all can come into my office any time for Ibuprofen, vitamin C or chewable antacid tablets; I might even have chocolate to dispense. (Sometimes I ask if anybody ELSE has any chocolate to share!)

Just don't ask a Comm Sup to solve a personnel problem in twenty minutes flat or get your headset repaired by the end of the shift. Yah, that's what we're expected to do for you, that's true. But I can't work that miracle. (shrugging helplessly) I do promise to understand it when you snap at a rude caller; I just won't condone it. Do we have a deal?

We Are the Sum Total of Our Experiences

Taken from "Notes From the Trenches" June 1999
Written by Linda Olmstead


The calls we take, the incidents we handle, the skills we develop, the tasks we conquer; all those bits and pieces plus everything in our personal lives makes us the person - and the dispatcher - who strives to do the best we can each day.

Right now, there's a dispatcher somewhere, re-living an incident she handled in 1984. I know this because we discussed it on-line in the Dispatch Chat session I host on America On-Line. It was prior to any Critical Incident Debriefing programs, so she's carried it around inside for years and years.

Not only does it dredge up "my own stuff," but I think of the staff at my comm center, where there's a young (in age and in time on the job) Communications Operator who handled a critical incident only a few months ago: the shooting of one of our sergeants on a routine traffic stop.

We're luckier, nowadays - some of us - because we had a Critical Incident Debriefing session a day or two later. But I know it's never going to go away and she tightens up inside every time a unit takes a while to respond when she makes a status check.

Yes, I know you needn't have experienced something that drastic to feel anxiety when a unit doesn't respond right away but that's now a unique part of her, and who she will be as she becomes a veteran dispatcher throughout her career.

Several months previous to her experience, one of her partners worked a critical incident in which two officers were badly injured in a collision enroute to one of their calls. We didn't handle that one as well (we, the management) and that bothers me. It bothers the dispatcher, too. Just a couple of weeks ago, she mentioned it had been a year since their accident and I wanted to hug her and apologize for my part in having that incident - and the emotional fallout - become a part of her experience.

New Kids

I've been in the public safety communications field since 1977. I could, if my emotional make-up was wired that way, feel resentment over how much has changed and how the new kids in the centers "get" better training than I did, how working conditions have changed (mostly for the better) and how well, like how I had to use an honest-to-God teletype machine instead of a computer to access criminal justice files, how we had to learn all the arcane access codes - no pre-formatted masks for us! - and how I had to practically shout really loud out the windows to call my units because it was long before radios were even invented. You get the drift (grin). I walked uphill both ways to work, too.

But that would belittle the accomplishments to these talented young dispatchers and serve no earthly purpose of any value to anyone - and least of all to me. I'm here to assist them, not discount their experiences.

And it's one reason why I love to work in the CommCenter with 'em. My "war stories" give me a chance to validate my own reality and pass the time when we're not all tied up in some incident or another. So much of what I did is certainly an opportunity to laugh more than marvel at my repertoire of events long past. Working a console alongside 'em also keeps my skills fresh - and adds new ones, I love that!

Events in our personal lives - on a day to day basis - are also pieces of the puzzle encompassing our personae. We used to think - and pronounce, at regular intervals - "You can't bring your personal life to work with you" or "Leave your personal problems outside the door of the comm center when you get to work." Geez. We could stumble over all that stuff on the threshold, ya know? (sigh)

Humanistic management now realizes that you can't shut that stuff off and still be a whole person. I don't know about other supervisors, but I sure don't want parital human beings working for me! No, it's true you don't have the luxury of dwelling on any incident to the exclusion of current events you're handling right now, let me explain further.

Moms & Dads

Parents bring their cares and concerns about kids to work with them. I don't happen to have children, and so I know some calls could be handled so much more skillfully and with a certain touch that I cannot demonstrate, if one of the dispatchers with kids were behind the helm. Moms and dads have extrasensory hackles that rise at the hints of evidence I might never recognize. I grew up in an abusive family situation with an alcoholic parent who raged out of control now and then. This gives me an advantage over some other folks who haven't experienced that in their youth.

I happen to know that pet-lovers take home strays encountered through the performance of their jobs - and with the cooperation of field units who sneakily bring 'em into the comm centers "until Animal Control can pick them up." That's how my house has filled up with four-legged residents over the years. (grin) I also know I'm not alone in this behavior.

Personal Life

Not too long ago, one of the dispatchers had a serious situation arise at home while she was on duty; we managed to get someone to come in to work for her (me) so she could go home and attend to the matter. She wouldn't have had her full attention centered on the public and our officers and it wasn't fair to make her shove her personal life to the side just to get the job done here in the Comm Center.

What I found interesting was the fact that this was a decision made in my absence by an administrator; usually it's either me or my partner Comm Sup who, while on duty, discovers a situation like this and handles it. I was very glad he called me at home - he was as concerned for her welfare as he was cognizant that the job needed to be handled by someone better able to pay more attention to it. (I guess I have underestimated some of the brass. Due to "past practices.")

Nobody should simply expect their dispatchers to "buck up, buckaroo." Nobody should expect their officers to do so, either! Our commander shared the story with my shift one night of the sergeant who told him, many years ago, when he was just a "young pup road dog" to "suck it up" after he'd shot and killed someone. He still has dreams of that incident, reliving it now and then.

Now, that doesn't mean any of us should keep that emotional baggage open and ready for boogie-men to leap out and wrest control while we do our dangest dealing with peoples' tragedies over the phone and the coordination of units on the radio. That's simply counter-productive.

Blinking Light

A trainee of my acquaintance once answered a 911 call to hear a man shouting, "We've just been robbed!!" She quickly told the caller, "We're on our way!" and hung up, turning to the radio and alerting units on one of the user agency channels in a very officious manner, "Units, we have a robbery just occurred."

My jaw dropped. Before I could formulate a coherent "training suggestion," one quick-thinking unit transmitted, "Uhhhh. Center. Where??!?" She looked at the blinking console light representing that channel, looked right at the phone handset sitting back on the hook where she'd placed it and then turned to me, dumbstruck. Thank goodness the victim called right back so we could complete the interrogation process.

The trainee and I had a fairly lengthy discussion after we determined the incident was a "cold" burglary and we got the appropriate beat unit dispatched. That was an example of someone without any relevant articles in her tidy little Samsonite carryall of experience.

Our individual baggage sometimes causes us to make faulty assumptions instead of the often-valuable intuitive leaps of understanding necessary to take an appropriate action.

Overturned What?

Then there are the simple errors of "huh?" that happen. Ya think you heard what the caller said, but you got it wrong - through a combination of background noise, poor connection, or simply another one of those life experiences (or assumptions of the worst kind). One night we had reports of "an overturned train." Turned out to be one of those "sounds like; one syllable" charade situations: a big ole crane fell over. (Not the kind with wings and a beak that usually stand on one leg in the slough, though.)

Anyway! A big ole construction crane fell over on the railroad tracks (well off the highway) along our gorgeous Big Sur coastline. Cellular coverage in that area is spotty, at best. Our caller was excited and he made reference to the railroad tracks, where this "sounds like 'train'" fell over... I'm not sure whether we were relieved or disappointed to discover we hadn't had any trains overturn on their tracks but I bet Union/Southern/Western/whoever-they-are-now Pacific breathed huge sighs of relief. Then, about two hours later, an officer on the other radio mis-heard the dispatcher when she said, "Taggers" and thought he was being dispatched to tigers on the overpass.

The Baggage

You see, one of the abilities to deal with all the baggage we've collected is to make light of it; sometimes we use pretty sick humor to get around something dreadful. And we often use a mixture of commonly used "industry terms" to push the envelope of humor. Officers use a phrase fairly regularly, and often (ahem) wryly: "Dissipate with traffic." It's generally (and appropriately) used when there's something on the roadway that doesn't need to have anyone respond to remove it; styrofoam beads, small pieces of wood from pallets, feathers, small amounts of produce fallen off trucks, etc.

Small wildlife carcasses often fit the bill, i.e., snakes, birds, opossums, and sadly, smushed cats. now and then, a beleaguered officer responding to a traffic hazard from the office where he/she's got reports stacked up to here to complete will mutter "Oh, let it dissipate with traffic" regardless of the type of hazard. Sometimes, when we get reports of intoxicated subjects walking on the roadway in a very remote area, we quip that we need to get a unit there before the party begins to dissipate with traffic. (cringe)

It's not unlike that tendency of those of us in this Biz to label dead animals as: Flat Cat, Pizza Kitty, Frisbee Possum, Sail Cat and other such gross terms for "road kill." Again, just a macabre method of getting one's feelings around a common occurrence without aching with the reality every time.

Friday, May 1, 2009

Mental Health: Safeguarding the Future of Public Safety Communications

Taken from Emergency Number Professional Magazine, April 2009
Written by Robert T. Smith, Telecommunicator II-Trainer for Wilson County ECC (Wilson, NC)
He has experience dispatching for Police, City and County Fire Departments, Sheriff's Department and EMS.


At any point in time people across the nation will need emergency assistance, either from law enforcement, the fire department or EMS. Public safety communications personnel are trained to provide life saving instructions to sometimes hysterical callers while sending the proper field units to provide emergency assistance. When the public calls they expect a trained professional on the line that can fix all the problems and tell them exactly what to do. This demand placed on any person can be a daunting task and create intense pressure on an already tense job. Living in a world where technology is rapidly changing it's important to remember the one thing that is constant in the world of public safety dispatch -- our employees and their well being.

Keeping Control
Public safety communications by its very nature is challenging; sometimes taken for granted is the amount of stress put on communications center employees. With the addition of phase two cell phone capabilities, CAD and GIS, just keeping up with the technology can be a hard task for any communications center. The telecommunicator is always in a situation where he/she will be listening to someone who desperately needs help; however, other than sending help, they can't physically do anything about the situation. Some people have a hard time adjusting to the idea of only being able to send help. This in turn puts an extreme amount of stress on the person and the communications center. It is human nature to bring something personal to the calls that we as telecommunicators take. When we take the call of a baby who is not breathing and are providing CPR instructions we can't help but think of our children or a loved one. When we hear the desperation and fear in a caller's voice because she is hiding in her house and someone is breaking in, it's hard for any human being not to become emotionally involved to a certain point. These emotions are a normal part of doing the job, however, it's important that we not lose sight of our goals and maintain control of the call. The citizens we serve are calling in a time when everything is going wrong and it is difficult to get the information responders need if we are unable to keep control of the call.

Support Systems
Some telecommunicators have a need to save the world with every call they take. While they mean well, the goal of saving everyone is unrealistic and sets them up for failure. With public safety work that just isn't possible. Not everyone can be saved by the 911 telecommunicator, law enforcement, the fire department or EMS. This failure can be devestating for any telecommunicator who feels it is their responsibility, and some may not be able to cope with the thought of losing someone during a call. It is necessary to have a support system in place for employees who have had a hard time accepting this, and are working through it. This possibly can be resolved by a senior telecommunicator who could mentor and guide the employee through dealing with tough calls. For a new team member it means everything to know that your team has your back and they are willing to help if problems arise. This can have an increase on the moral of the shift. We in public safety communications should strive at all times to do the best job we can with the information we have.

It is important to notice our employees at work. Are they distant or quiet? Do they seem upset? Has their workload become nonexistent compared to the rest of the team, forcing other people to pick up the slack dropped by a particular employee? While it is all too easy to blame the employee for being lazy, or not being a team player, no one knows what is going on in their life outside of work that may be giving them problems. So many times we all have problems that we bring to work accidently or we have no choice and have to bring them with us. No one can truly understand what's going on in their team members' life so it's important to try not to judge. Maybe it can be as simple as to ask them what's going on in their life or if something is bothering them. It may be something that can be helped by letting the person talk to someone on shift, in turn saving a lot of headache for the administration. Some may require or want to talk with professionals such as therapists and stress debriefs. While it may not be feasible to provide the kind of help that an employee may need, the fact of asking and showing a caring attitude can help.

Communication
Communication can have a profound effect on any employee and show results in many ways. Team meetings are an excellent way to solve problems and build moral in a communications center. Having a meeting in small groups may prompt more communication and allow all the team to vent frustrations. The most important thing is attempt to address the issue, don't just ignore the problem; this will only prolong the inevitable and create a bigger problem. Our employees are the future of public safety dispatch. By handling stress appropriately, employees' moral and productivity can be richly increased. This will, in turn, create an atmosphere built on trust appreciation and dedication to our field units and our citizens. Every supervisor and administrator wants their employees to be happy.

Professional Help
Recognizing stress in the workplace is vital when attempting to increase the productivity of any organization. While it may not be possible or feasible for communications centers to provide professional help in dealing with the stress of the job. It may be necessary for telecommunicators to seek the help of a therapist or mental health professional. Sometimes speaking with a co-worker isn't enough and the stress can build in ways that only a mental health professional can understand and assist with. Just having a non-biased third party can reap great benefits, and it can give any telecommunicator someone to vent to without being judged.

Peer Facilitator
Having a trained peer facilitator on shift is an excellent way to identify stress in the communications center. The training involved with being a peer facilitator can prove vital when telecommunicators have taken some dramatic and highly stressful situations. Providing this training on shift will possibly give anyone going through a difficult time with a call the chance to take care of a potential problem before it gets out of control. However, the confidentiality should be the foremost concern for the employee and the trained peer facilitator. Doing so will ensure that the therapeutic process doesn't have any negative outside influences. While having a trained peer facilitator may not be an option for many communications centers there are a number of resources available for telecommunicators that are in a potential crisis. There are many municipalities and communications centers across the nation that have access to critical incident stress management teams. These teams are trained and can recognize potential problems with fellow co-workers and possibly provide assistance. Usually, most administrators have contacts for the stress management teams and can call on them whenever needed. This training, while vital for high priority incidents, it is important for all communications center personnel to use these resources if they feel there may be a problem in the center. There are many options for communications centers to provide help for their employees in a time of need. While all of these options have their benefits it's important to remember that they all aren't for everyone. Each administrator should research what options are available for them and then seek the help their employee or employees may need. Taking care of our telecommunicators today will ensure that we provide a dedicated, highly trained and capable to carry on our great profession to the future.

Healthy Lifestyle
Most municipalities are also involved in promoting a healthy lifestyle for their employees. This usually is in the form of wellness programs with medical checks, and promoting all around healthy activities. Working out can not only make our employees healthier, it also will give an outlet for their relief of stress. Intramural sports are also a great way for employees to have this outlet to relieve stress. While it may not be possible for communications center personnel to participate in an intramural sports program, the administration should strive to encourage participation in whatever team building activities are available. Giving employees this activity on their day off can not only relieve stress, but promotes teamwork, a healthy, active lifestyle and will increase the moral of any organization.

Generally speaking, I believe all employees want to succeed in their chosen profession. They want to do the job right, and pick up the tasks quickly. When this doesn't happen, stress put on the employee can develop into serious issues with the job and create problems amongst co-workers. Public safety telecommunicators are no exception; dealing with life or death situations and the stress of making quick decisions that will affect other people's lives, can be overwhelming. I believe we have a duty to our community, our field units and ourselves to provide the most qualified and mentally healthy people for the job. In public safety telecommunications, we as telecommunicators are highly trained to provide professional service while being caring, compassionate and empathetic. In order to safeguard the future of public safety communications, we should strive to approach the well-being of our fellow teammates as we do our training in order to provide a healthier and happier dispatch environment.