People applying to work in emergency services are often asked why they want to do this work. Most emergency services applicants have one or more experiences in their past that motivate them to want to work in this field. Perhaps they have a sibling who died or a parent who was saved. It may have been that they saw an emergency scene and admired the work of the responders. It could have been that they were called on to help in an emergency and felt their assistance was inadequate. Or sometimes in their family there is a heritage of this type of service that inspires them. Emergency services personnel almost universally cite their desire to help their fellow-man as a strong motivation.
A few people express that their motivation is wanting to be a hero. These applicants are often regarded with skepticism. It is almost universally believed in emergency services ranks that there are NO HEROES. There are just people doing what they have been trained to do and do it safely. If a person expresses a desire to “give their life for another”, they are shown the door quickly.
Mitchell and Bray (1990) describe emergency response workers as “inner-directed, action oriented, obsessed with high standards of performance, … easily bored, and highly dedicated.” In addition, these authors describe emergency workers as people who like control, both of the situation and themselves, and enjoy being needed.”
When asked about their main concern regarding their work, the most common answer among emergency services personnel is “safety.” The physical hazards of their work are usually quite evident to society as a whole, but there are other hazards that are not as obvious.
According to the United States Fire Administration’s Stress Management Model Program for Firefighter Well-Being Report, “Stress is one of the most serious occupational hazards in the fire service, affecting health, job performance, career decision-making, morale and family life. Emotional problems, as well as problems with alcohol and drugs, are becoming increasingly evident. High rates of attrition, divorce, occupational disease and injury continue.”
Certainly a major stress factor in the lives of emergency services workers is their erratic schedule. Emergencies happen at all hours of the day and night. Responding at varying hours disrupts the body’s systems. The effects of this disruption can be minimized when agencies keep workers on a particular shift as long as possible, but shift change happens.
Firefighters and EMS personnel often do not have the luxury of regular hours, because they often work 24-hour shifts. They may be up and functional all day and have no calls. They might go to bed at 10:00 PM. Then at 1:30 AM, they are dispatched to a life-threatening emergency. So with three and a half hours of sleep, they must be wide awake and ready to save a life. Then, before they can return for some much-needed sleep, they are off to another trauma. They may not get back to sleep before their shift ends at 7:00 AM. Then they are off for 24 hours, and the routine starts all over again. Career firefighters have a very similar schedule.
Volunteer responders, both firefighters and medical first responders, probably have the greatest disruption to their natural sleep cycles. They almost always work at full-time jobs during the day. Evenings and weekends are spent training and maintaining equipment. In addition to all this, they respond to emergency calls. These calls may come at 2:00 o’clock in the afternoon or at 3:00 AM. As you can see, being a volunteer responder requires an enormous time commitment and a willingness to risk sleep deprivation.
In addition to the toll these schedules take on the responders themselves, this lifestyle also has an impact on their family relationships. An extreme example of this is a young firefighter who was at a local restaurant with his wife celebrating their wedding anniversary. The tones went off for a structure fire. He heard over the radio all of his fellow firefighters going en route. The urge overwhelmed him. He picked up the radio and told the engine to pick him up in front of the restaurant. He left his young wife at the restaurant to finish dinner and make it home on her own. He arrived home after she had gone to bed. This may be an extreme example, but learning to balance legitimate work and family responsibilities can be especially challenging in the emergency services environment, where lives may be at stake.
Most emergency services organizations face life and death situations regularly. One of the ways personnel attempt to deal with such dramatically appalling situations is “dark humor.” Having just completed their duties on a medical call where someone dies, they might stand at the back of the ambulance or rescue truck and smoke a cigarette. (Nicotine helps to calm their nerves.) They remark on unusual things that happened during the call or on another recent call. Regular citizens, non-emergency responders, might say, “How can you joke after something so tragic?” Actually, it is a way to distance themselves from the events – a way to protect themselves from feeling the emotions that might otherwise come.
Emergency services departments and their personnel see people in a variety of compromising situations. Therefore, they may speak about the body and body parts in ways some would see as crude. A woman might have fallen while getting out of the shower. She calls 9-1-1, but cannot move to cover herself. The first units on scene see her totally unclothed. On the scene of a severe vehicle crash, a grossly overweight man may have multiple trauma injuries. In order to determine the extent of his injuries, responders must cut his clothes off of him. It is not inappropriate or uncommon for trauma patients to be delivered to the hospital completely naked with only a sheet covering them. After all responders have seen, naked human bodies and body parts normally regarded as private become commonplace.
Emergency services workers deal with a cross-section of society. Many patients are not at the top of the social ladder. Whatever their status, some patients can be difficult people with which to deal. A balance of sternness and kindness can be difficult to maintain. This can be especially true when a crew is awakened in the middle of the night to care for a patient whom they conclude is a “whiner” with no genuine need for an ambulance.
The use of tobacco by emergency services personnel is common. Even with all the known health risks, smoking and chewing tobacco is sometimes commonplace. The need for nicotine seems to be strong in many who regularly experience stress.
Finally, it is common for emergency services personnel to have close interpersonal relationships with others in emergency services. If married to a non-emergency services person, an EMS worker might experience tension in their marriage concerning these “special relationships.” The many stresses upon marriage and family life brought about by the lifestyle of emergency services personnel has led to these occupations having extremely high rates of divorce compared to the rest of society.
Speaking of cultural uniquenesses, there are two traits or characteristics that seem to be highly valued by many firefighters. First, a person is often respected based on their perceived physical strength and/or fighting ability. This is one of the ways “pecking order” is established. Secondly, males (and sometimes females) tend to regularly present themselves (and value themselves) as having great sexual prowess. We realize that the aforementioned are generalizations. They may or may not exist within all departments.
Emergency services personnel are normal people doing a job that requires great courage. Most are highly dedicated. They manage their fear and come quickly when we need them. Most of their unique behavioral characteristics are their attempts to manage the challenges and stresses that come with the job.
It goes without question that the world of emergency services is a culture within a culture. Emergency services personnel face unique challenges and ways of adapting to those challenges that set them apart. They are a much-needed and largely underpaid and under-appreciated element of our society. And yet, in many ways, we could not function without them. Their needs differ in many ways from the rest of the working world. As a people group, they require specialized ministry if they are to be reached, discipled, and sustained in their Christian walk.